My unscientific sleep experiment...

ehusen · Post by **ehusen** » Mon Jun 25, 2007 12:40 pm

Hey all,

So I'm one of those guys who just "don't know if CPAP works for me...". I keep using it though because it keeps me from snoring, which keeps my wife from eviscerating me in my sleep. (And maybe that whole heart attack thing doesn't happen to me...).

Started with an APAP machine that didn't report data. After a year I paid out of pocket for a PB420E. I've adjusted the settings and basically I can go down to about 5 and it never really goes upwards in pressure during sleep (High end of setting is 14). It stays pretty much >95% of the time at just the lowest pressure setting. It didn't feel quite right at 5/6-14 so I've gradually moved it back to seven-14. At 5-6 I felt like I just couldn't breathe.

But when your AHI shows like < 1 almost all the time and your pressure stays at the low end all the time, you start to wonder if the thing even works. Especially when coupled with my "no daytime symptoms to begin with so how do I know it is any better?" issues.

So now I cough up the money for that SP7500, so I can check desats. With APAP I do not appear to have any significant desats and HR varies but well within normal ranges.

So I try a night without APAP and measure. Granted I can only see desats and not any AHI's but I'm most concerned about the desats. I had a total of 2 short ones about 90 minutes after I fell asleep and only down to 91%. And nothing the rest of the night. Tired wise, I felt about the same as always. I did still snore like a jet fighter without the hose.

So what can I derive from this? Ehhh, not much. Maybe it is time for another sleep study (which I hate with a passion and are expensive, although insurance will probably cover it) The APAP does appear to prevent some potential desats, even though they were relatively minor, IMHO.

I'll keep using the infernal machine, if only to prevent the snoring. And maybe it does help my heart/lungs/body survive...

Wulfman... · Post by **Wulfman...** » Mon Jun 25, 2007 1:21 pm

Eric,

I'm confused......
Why do you say you "don't know if CPAP works for me...".
If you say your AHI is < 1.0 most of the time and it's keeping you from "great bodily harm" (from your wife) .....it sounds like all is well (and working) to ME.

I'm not sure what all you're expecting. This is just going to be "life as we know it", from now on.

Best wishes,

Den

ehusen · Post by **ehusen** » Mon Jun 25, 2007 3:00 pm

What I'm saying is that most future CPAP users started with symptoms like daytime sleepiness. I didn't really have that.

What I did have was moderately high BP and a "strange" EKG. This led to all sorts of tests etc. At that point it was mentioned that I snore a lot. So I got the sleep study, which I only slept for 1/2 hour the whole night. This was supposedly enough to diagnose me with severe OSA.

Then I went through the seemingly standard process of a few days of misery trying to adapt. Then mouth breathing, then tape, different mask, then hose adjustment, humidifier, heated hose, etc. etc. I've now made my peace with it. I still get the red mark on the bridge of my nose but I haven't found anything to fix that and I've learned to just accept the red bar look in the mornings.

So now I can tolerate it pretty easily but I would, of course, prefer not to have to go through this nightime ritual. It does prevent my snoring and that is no small thing. My wife's sleep is important to me too.

So I can tolerate CPAP, and it prevents my snoring so my wife can sleep, but I don't see any other "visible" results. My BP went down, but only after meds and a lot of weight loss and exercise. (Sorry guys, the weight loss didn't come from CPAP. I had many many months of dieting and exercise to get there. Maybe the CPAP gave me more energy, I don't know)

That's what the SP7500 was for, to see if the CPAP made a difference in my oxygen and heart rate. And it appears that it may help somewhat. (I'm not sure it 2 desats over an entire night is serious or not).

Yeah, I admit I'm being a bit whiney here. But if I have to use this thing for the next 50 years, I want to know for sure it's actually making a health difference. It's really an academic question though, I'm a lifer, or at least as long as I'm married anyway.

I do eagerly await a better treatment for this condition though. But I wonder if there is any incentive for the medical industry to find one. CPAP is the "gift" that keeps on giving with a continual revenue stream of new machines, masks, hoses, etc. If there is a treatment that cures OSA, then there's no more CPAP money coming in...

Sorry if I sound a bit cynical. I am grateful that I can tolerate the dang thing. I know lots of people just can't sleep with a CPAP.

Snoredog · Post by **Snoredog** » Mon Jun 25, 2007 3:29 pm

Trying to understand what you have concluded from your test...

If you used the xpap machine and measured your O2 levels that doesn't really mean anything other than your levels didn't drop below 91%.

What you should have done was slept without the machine and monitored your O2 levels and looked to see if they dropped lower than <89%. Then you would know that you have some kind of airway blockage that puts stress on your heart.

Because even at the Minimum pressure of 4cm that can be enough to bring your oxygen levels back up to Normal levels, even though you may be experiencing Flow Limitations and Hypopnea at the same time. The reason is the machine is forcing oxygen into your system even at minimum pressure, that in itself can offer therapy.

It is sleeping without the machine that you want to know how you respond. If you monitor your O2 without the machine and levels never drop below 91% then don't use the machine.

Pulse Oximeters are really a screening device, they are not very accurate reason most insurance doesn't allow them to be used for making a diagnosis. They can be used along with other tests to come to a conclusion diagnosis but generally not by themselves.

DeltaSeeker · Post by **DeltaSeeker** » Mon Jun 25, 2007 3:54 pm

Snoredog, his experiment WAS without APAP.

I don't have to guess, I know what my AHI was prior to CPAP. And I had all the symptoms as well. Had to wait a long time between the study recommendation and the machine

I too have resigned myself to the perpetual red nose bridge. Hopefully one day they WILL come out with a better interface, or a better treatment. Until then I remain a grateful hosehead!

Linda3032 · Post by **Linda3032** » Mon Jun 25, 2007 4:55 pm

Ehusen, nothing we can say will help you to determine if you really have sleep apnea. That's why you should do another dreaded sleep study -- if your insurance will pay for one. I agree that 30 minutes isn't really enough time to fully determine if you have sleep apnea.

However, if you can get a copy of that 30 minute sleep study -- and it said you had severe sleep apnea which means more that 30 arousals per hour, then you might be convinced.

I also had no symptoms -- other than snoring. I also used the machine for the first year for my spouse. But after the first year, when I had a cold and couldn't use the machine, I did it for me.

Call me silly, but I prefer to breathe while I'm sleeping.

TerryB · Post by **TerryB** » Tue Jun 26, 2007 5:03 am

ehusen,
It seems to me that you have at least one fine reason to stay on CPAP, evisceration avoidance. If using the machine is a great bother to you then you may want to consider making other arrangements with your wife e.g. spare room, sharp objects removed from the house, etc. Most of us know we have a serious problem, you just seem to have minor problems. Another thought is that the one night of samples SATs without the machine may have been best case "lucky" results and not typical. Maybe a larger sample will make the case for using the machine more convincing.

Good Luck,

TerryB

ehusen · Post by **ehusen** » Tue Jun 26, 2007 8:56 am

Hey, thanks guys for the nice responses. You've all made good points. And I did admit I was being whiney in my post. (Thanks again for not jumping down my throat for complaining about it as well.) And let me reiterate to the newbies here what many have said, the information on this forum is truly priceless and the people here are a good bunch.

I would like to believe that benefits from using CPAP did occur, they were just too subtle and happened over a long time so I didn't notice.

Yeah, another sleep study is probably the answer but I just don't want to set it up. Like I said, I know CPAP's probably helping and I will use it, even if it were just a snoring cure. So I'm just looking for more positive reinforcement with the SP7500 and just curiousity as well. Since I've made the decision to use the CPAP already, getting another sleep study is kind of academic. (Especially since they didn't titrate me (4-18cms?, yeah thanks DME guy for that very accurate setting)) I pretty much did the auto-titration myself using the PB420E and narrowed it down to a low side that was comfortable at 7cms and a high of about 10 since I've never seen it go above 9 for me in anycase.

I do have a copy of my sleep study. It said I had desats down to 80% and something like an AHI of 93! That was determined within that 1/2 hour of sleep? Granted, I weighed 60 lbs more at that point so my apnea was probably much worse than it is now. (But I still snore like a freight train with its brakes on, skidding down a hill)

I really do sympathize will all those who have trouble adapting to it. The first few nights with the machine were horrific for me. I was one crabby middle aged man that weekend. But it did get better and now it's just habit with only the occasional irritation.

snork1 · Post by **snork1** » Tue Jun 26, 2007 4:55 pm

Might be time to EXPERIMENT with dental devices or other non-CPAP "for mild cases" reversible alternative treatments. Especially if you have capability for checking O2 sats and daytime sleepiness is not an issue.

I switched over to a TAP-T dental device in sort of similar situation. Stopped the snoring and took care of my mild/medium apnea.

You can experiment for a bit cheaper on your own by trying something like the Somnogard AP for $160 and no prescriptions required, before dumping cash into a TAP or similar.

More info on dental approach at
talkaboutsleep.com (see dental sleep medecine section)

Somnogard AP available at
http://nosnorezone.com/order.html

As always, its always better to use a Certified Sleep Dentist and make sure to do jaw exercises if you go dental. And go into it understanding it is an EXPERIMENT that does not work for everyone.

I sure am happy with my dental device so far.