Urgent care for sleep apnea ...

After a basically useless ER visit last night, I've been wondering something, and thought it would be a good discussion topic. If something goes wrong with our apnea, or is OSA related, how can we get urgent care? The ER doc said that what he is responsible for is stabilizing acute symptoms that present in the ER. He says the problem with OSA, is that patients are awake and usually stablized by the time they get to the ER, like I was last night (by the time I saw him--3 hours later). If it is something happening that increases/unstabilizes our apneas, how can we get urgent care to correct the situation? The doctors aren't going to treat what they don't see in front of them. And it's not like we can instantly sleep and show them the problem. It's not like they are going to send us up to the sleep lab for a sleep study that night.

I can see apap being part of the solution, but of my understanding of apap, there is a range that needs to be adjusted. It sounds like if there was an acute event affecting the apneas, it possibly could fall outside of the range usually set. And, if the person thought there was a problem when they have a data-capable machine, they usually would have to wait until they download the info, etc. which would take some time, so they could correct it. Unfortunately, I don't have an apap or data capable machine, and am way too poor to afford anything.

Is there really urgent care for sleep apnea? Is this an area that needs to be developed, urgent care for sleep apnea? It seems the docs really haven't got past the diagnosis stage, and need to work on managing OSA when on pap therapy also. Lovey

I don't think anyone really wants to hear your opinion. Watch out for the eggs and tomatoes. Just warning you. I heard them talking about it in the front row.

Sleep Apnea usually doesn't kill overnight, it kills you by inches, damaging other organs and systems. The best defense would be to be proactive. Get a XPAP that records useful data, and the software to make use of it. Get yourself informed about Sleep Apnea, and any conditions that are special concerning your treatment.

Get back-ups for your equiptment, they don't have to be data useful, have spares of desposiables, if you want a battery solution for back-up. Worse case you can sleep upright in a recliner if need be. We as a group have spent many years without treatment, the odd's of our number coming up because we spent a night without our new friend XPAP isn't very likely. This doesn't mean "Fool With Mother Nature", that's when Murphy is most likely to step in and lay down his "LAW".

I can't imagine a situation where I would need to go to the ER for a CPAP problem outright. But then I have done most of the above, to insure my own care. Jim

I have been on CPAP for 14 years and never found a reason for urgent care for sleep apnea. Sleep apnea is a chronic condition that generally changes over time, and any changes in the condition are very unlikely to be something that requires urgent attention. Although the condition may be uncomfortable, it is highly unlikely to be immediately health threatening.

The biggest problems that would occur are equipment or power related, and the impact of these sorts of problems can be minimized or eliminated by having spare equipment and a battery backup power supply.

Basically, I had a bacteria go into my lungs last night, causing an asthma like attack that woke up me up. It might have been triggered by already low oxygen levels I have been having lately with OSA. Or the bacteria might have reacted differently with me because of the sleep apnea. If it was the bacteria (an acute problem) was causing my OSA to go out of control, wouldn't treating the bacteria be an urgent care problem, because it affects my sleep apnea?? In my "awake" state, the bacteria might not matter as much, but only when asleep, where my breathing is compomised by the OSA, makes it an acute problem in my opinion.

It just doesn't seem there is much ongoing treatment by doctors while patients are on pap therapy. It's an unusual "closed circuit" environment of wearing a mask for pap therapy. It has unique challenges that are caused by this situation, which in my eyes can be seen as urgent. But there doesn't seem to be a way to address any problems urgently, especially when problems are "hidden" because when we present to the doctor, we are not asleep, in the state that caused an urgent problem.

Of course, I'll do everything to prevent something becoming urgent and acute. I'll arm myself with knowledge to prevent acute situations. But what happens when prevention doesn't work and you find yourself in an acute situation with your sleep apnea?

We live in a sea of bacteria, it goes in everyones lungs, day & night, If your treatment for Apnea is working, you shouldn't be having low levels of O2 overnight. If you have trouble with asthma, or other pulmonary, you need to be treated by a pulmonary doctor, not the ER.

XPAP treatment is not a "closed circuit" environment, the XPAP takes air in filters it, (better than room air) and delivers it to your airway under light pressure, it vents into the room and washes the expelled gases from your mask.

If your breathing becomes so bad and you don't get enough O2, then you need the OR, but if you get in that way you also need to be under the care of a good pulmonary care doctor. Jim

Goofproof wrote:XPAP treatment is not a "closed circuit" environment, the XPAP takes air in filters it, (better than room air) and delivers it to your airway under light pressure, it vents into the room and washes the expelled gases from your mask.

I hadn't considered that, in that it takes in room air. But I don't get "washes the expelled gases from your mask"...could you clarify what you mean by that...I don't get it... Thanks.

lovey wrote:I don't get "washes the expelled gases from your mask"...could you clarify what you mean by that...I don't get it... Thanks.

Goofproof is talking about the exhaust vent on all masks. Where air is gushing out all the time. That intentional flow of air out the exhaust vent of the mask is carrying with it your exhaled CO2. Taking away (washing out) the breath you expel when you breathe out.

lovey wrote:

Goofproof wrote:XPAP treatment is not a "closed circuit" environment, the XPAP takes air in filters it, (better than room air) and delivers it to your airway under light pressure, it vents into the room and washes the expelled gases from your mask.

I hadn't considered that, in that it takes in room air. But I don't get "washes the expelled gases from your mask"...could you clarify what you mean by that...I don't get it... Thanks.

I think your mask is the same as I used over a year ago, it has rows of little holes drilled into the mask these are vents, that remove the expelled air and flush the mask out with clean air, at a rate of 30 to 40 LPM flow. Other masks have vent valves or orfices built in them for the same reason, supplying fresh air and venting our expelled air. Jim

You can hold your hand over the vent and feel the air blowing out, it's supposed to do that.

Thanks, that makes sense...I hadn't analyzed it--I thought it was just "air" going out, not C02. Thank you both for the "enlightenment"... Lovey