Hey Sleep Apnea folks!
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HoppyDaze
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Not pissed at all. Just no tolerance for the condescending anti folks. Always the same banter ...
HoppyDaze
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When was this? The machine I got doesn't make a sound except when I exhale and that's only because it's at such a high pressure. They're probably not all created equally.
troy2000
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Being a Vietnam veteran who spent six months in the Navy Hospital at Camp Pendleton, I've had an intimate, up-close look at military medical care. I mean no offense to those who provide it, because they're good folks and dedicated, but I'll take my current medical insurance and my current 'capitalistic' doctor any day.
Your assumption that doctors in the US habitually put profit first, and the health and lives of their patients a distant second, is deeply flawed and more than a little insulting. Especially since the best way to make a profit is generally to meet and exceed your customers' expectations on a regular basis, not to screw them over for an extra buck every time you have a chance.
add: and your belief that military healthcare providers, with both a military chain of command and a civilian bureaucracy on their back, are under no pressure to cut costs and do things the cheap way instead of the best way is almost touchingly naive.
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thatjonguy
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How long did it take everyone to get used to wearing the mask all night?
Sounds like you've got a good doctor. Mine is like that. I was at a concert enjoying a beer and an Italian Sausage. I felt a tap on my shoulder. It was my doctor. He said 'Mr. Black - with your cholesterol, do you think an Italian Sausage is something you should be eating.' He laughed and walked away. Completely freaked me out. I still finished the Italian Sausage though.
Sir_niveda
Well-Known Member
My girlfriend recently self diagnosed me with sleep apnea, and I was completely unaware that there was anything up. My BMI is about 20 so weight has nothing to do with it in my case. I've come to the conclusion that the only way to heal myself of this is to cut back on cigarettes (I know, gross, time to quit), as well as the beer. Of course we all know how hand in hand these go.
My girlfriend recently self diagnosed me with sleep apnea, and I was completely unaware that there was anything up. My BMI is about 20 so weight has nothing to do with it in my case. I've come to the conclusion that the only way to heal myself of this is to cut back on cigarettes (I know, gross, time to quit), as well as the beer. Of course we all know how hand in hand these go.
Some people are just assembled differently - maybe you've got a tongue like Gene Simmons, or a thin neck ... or a giant neck from playing javelin with I-Beams. If your physiology works, you could sleep on your side (I do, even though it effs with my shoulders). For me, I need the machine. A dental appliance (mentioned here a few times) or surgery (tongue surgery is very painful and very dangerous ... Since it will swell and can block an already problematic airway). There's also surgery for the deviates septum I'd you have one.
If you have it and are skinny, it may be worth looking at your kids physiology. A sleep apnea dentist recommended I look at having my kid's pallette split when their a baby, if they have a small upper jaw like me. If it would help I might consider it, but that seems like a horrible thing to do to a child to avoid a disease that they may or may not get. My wife has a larger upper jaw but is tall and thin also - maybe our kids will get lucky and won't have it.
If you have central, a standard CPAP can make it worse. It's like the CO2 sensor in your brain is broken, so you won't breath until the CO2 builds up really high ... and then you hyperventilate it off ... and then you stop breathing again. The CPAP continually forces the CO2 out of your lungs, so you never actually breath.
What ended up working for me was an Auto-PAP with a full range. I also used the "ramp" focus on my mask. What may work for you that didn't work for me is Deadspace therapy. Dr. Thomas at Mass General was experimenting with it in the early 2000's.
It took me about 8-10 sleep studies to get my masks and pressures right. If the mask isn't calibrated on your specific machine, with your hose and the specific vent placement (assuming you have an unvented mask, it won't work. Even with that it could be a slog. Depending on how bad you are it may not be worth it.
As an aside - to the "doctors are capitalists" guy - it's more a problem that Doctors have high insurance and all this other BS, and can't spend proper time with a patient to figure things out. Mine put me on antibiotics and a bunch of creams for a rash that never cleared up ... Until I figured out it was caused by a change in laundry detergent. Had the doc ran through a swab for fungal/staph and gone through a questionnaire, we would have figured it out a year earlier. However, the mess and creams were **WAY** cheaper than the test, and got me out the door, so they prescribed those instead.
HoppyDaze
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I'm realizing how lucky I got with my sleep study. They called it a split study. Half the night to see how many events I had and then the other half hooked up to the CPAP to see how effective it was. I went from 49 events/hr down to like 5 after they hooked me up. I have no idea about (obstructive vs. central) and CO2 levels...etc. My oxygen levels were as low as 83% which he said anything under 93% is not good for you. I'm going to have to get a full copy of all my results so I can better understand my condition.
normonster
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Lol...yes....misery loves company.
Misery loves a good bottle of DOC Ripasso.
From my observations, USA people are diagnosed with a hell of a lot of health issues. Given that the gene pool is extremely diverse, this seems more than a bit fishy to me. Probably has a lot to do with lack of sidewalks and bike paths, etc.
I will say that years ago when I was in Versailles, I did notice far more fat people than I expected...
...I'll be damned if they didn't all speak perfect English, tho!
I was diagnosed with sleep apnea almost a year ago, something around 55 events/hour. I was given an APAP machine and I still have many nights where I can't handle wearing the mask still. I'm 6'1" and just over 200lbs... so I don't think weight is a major issue... but I am no doctor.
Beernik
Well-Known Member
I accidentally fell asleep on the sofa with my mask off last night. Woke up in less than 8 minutes because I'm not used to the sound of my own snoring anymore.
I think I adapted to wearing a nose cup quickly because I worked a job for a couple years that sometimes required me to wear a 1/2 face respirator. Breathing with the two on is remarkably similar. So it was basically getting used to the idea of sleeping with it on.
Here's my question: what do you all do with your hoses? I've left a 1" gap between my mattress and headboard. I run the tube through there if I'm sleeping facing away from my machine.
I think I adapted to wearing a nose cup quickly because I worked a job for a couple years that sometimes required me to wear a 1/2 face respirator. Breathing with the two on is remarkably similar. So it was basically getting used to the idea of sleeping with it on.
Here's my question: what do you all do with your hoses? I've left a 1" gap between my mattress and headboard. I run the tube through there if I'm sleeping facing away from my machine.
troy2000
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You don't let up, do you? Apparently you love negative stereotyping of Americans.
I just have the Cpap on my night stand and the hose free floating on the bed up to my face. I don't move much when I sleep though.
It's remarkably similar to how my AV wires and brewing hoses are managed (or not managed). Then again, I tend to travel a lot, so there's no value to a preeminent routing.
Beernik
Well-Known Member
What do you do for distilled water for the humidifier when you are on the road? the few overnight trips I take, I've been using hotel tap water because I don't want to pack a gallon of distilled around with me for a day.
Im not sure what I'm going to do next year when I'm out and about for a week at a time.
What I ended up doing, and I'm not sure if this could cause rainout for some, is take a rubber band, place it around the bed post on the headboard and then tie another rubber band to that one. Then I ran the hose through the second rubber band. This way the hose has more than enough give should I wander into SWMBOs side of the bed unintentionally.
troy2000
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I've been meaning to get to the doctor about my apnea for years; there's no doubt I have it. Years ago when we first got married, my wife told me I would sometime wake her up snoring louder and louder, then suddenly stop breathing for so long it would scare her (I weighed about 140 lbs at the time, which would have been a BMI of 21).
I don't know about being tethered to a hose, though. I tend to flop around all over the bed at night. Of course I suppose there's a possibility that if I were breathing and sleeping better, I might not move as much...
I don't know about being tethered to a hose, though. I tend to flop around all over the bed at night. Of course I suppose there's a possibility that if I were breathing and sleeping better, I might not move as much...
GHBWNY
Well-Known Member
Same. Goodbye 30 lb., goodbye SA.
Right on... You're probably right about not moving around as much once you sleep better. In the first week I started treatment I had a sort of hallelujah moment where I woke up in the exact same position as I fell asleep in. This is coming from someone who often finds a lot of the bedding on the floor in the morning.
kleinstadt
Active Member
Ok. I'm an actual, real life sleep doctor, and this thread got unexpectedly heated. Wow.
Anyway, I'm seeing a lot of posters state they're not that overweight, they still have it, and they're baffled.
This is because it's not really the BMI. It's the neck circumference (size). The bigger the neck, the higher the chance you have sleep apnea.
It's more complicated than that, but that's a key metric in the Sleep Apnea Clinical Score, which I use everyday to risk stratify my patients. I've seen patients with a BMI of 50, but tiny necks, and no sleep apnea on the sleep study. Likewise, I just read a study of a guy today who had a BMI of 28, and an AHI of 35 (severe).
As for comments about the health system: sleep was a gold mine for a long time, but 1) docs didn't get any extra money from prescribing CPAP, just running the tests 2) Medicare slashed reimbursement for all sleep medicine a while ago, and it's hard to get new docs to specialize in Sleep Medicine.
I almost ALWAYS recommend CPAP. I work for a public system and everytime I prescribe CPAP, the system eats the cost. So, I'm actually at a disincentive to prescribe it. But I do, all the time. Why?
Because anything other than CPAP, including weight loss, is unlikely to do much to anyone with severe sleep apnea, which is the vast majority of my patients. If you have mild or moderate OSA, weight loss or the other doohickeys mentioned in the thread may work.
How is that? The research has borne it out. Study in JAMA in 2012 indirectly answered the question, "Will weight loss make my sleep apnea better?"
The answer: it's complicated. If you lose 25% of your total body weight, you can drop your AHI by 50% (further weight loss will not result in your AHI dropping more). So, if you have an AHI of 60, and you lose 25% of your body weight, you now can hope to have an AHI of 30.
Congratulations! You've gone from having severe sleep apnea to having severe sleep apnea. Weight loss can improve many things, but not always sleep apnea.
I have a feeling if I start answering individual questions I may never see my kids again, so I'll try to keep my comments limited to this post.
One last though: try to love your CPAP, but if you don't, I understand.
Anyway, I'm seeing a lot of posters state they're not that overweight, they still have it, and they're baffled.
This is because it's not really the BMI. It's the neck circumference (size). The bigger the neck, the higher the chance you have sleep apnea.
It's more complicated than that, but that's a key metric in the Sleep Apnea Clinical Score, which I use everyday to risk stratify my patients. I've seen patients with a BMI of 50, but tiny necks, and no sleep apnea on the sleep study. Likewise, I just read a study of a guy today who had a BMI of 28, and an AHI of 35 (severe).
As for comments about the health system: sleep was a gold mine for a long time, but 1) docs didn't get any extra money from prescribing CPAP, just running the tests 2) Medicare slashed reimbursement for all sleep medicine a while ago, and it's hard to get new docs to specialize in Sleep Medicine.
I almost ALWAYS recommend CPAP. I work for a public system and everytime I prescribe CPAP, the system eats the cost. So, I'm actually at a disincentive to prescribe it. But I do, all the time. Why?
Because anything other than CPAP, including weight loss, is unlikely to do much to anyone with severe sleep apnea, which is the vast majority of my patients. If you have mild or moderate OSA, weight loss or the other doohickeys mentioned in the thread may work.
How is that? The research has borne it out. Study in JAMA in 2012 indirectly answered the question, "Will weight loss make my sleep apnea better?"
The answer: it's complicated. If you lose 25% of your total body weight, you can drop your AHI by 50% (further weight loss will not result in your AHI dropping more). So, if you have an AHI of 60, and you lose 25% of your body weight, you now can hope to have an AHI of 30.
Congratulations! You've gone from having severe sleep apnea to having severe sleep apnea. Weight loss can improve many things, but not always sleep apnea.
I have a feeling if I start answering individual questions I may never see my kids again, so I'll try to keep my comments limited to this post.
One last though: try to love your CPAP, but if you don't, I understand.
HoppyDaze
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Thanks Doc. Exactly what my doctor said.
troy2000
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Thanks for weighing in, kleinstadt.
I know it's stupid, but I've always felt a little silly about the thought of walking into my doctor's office and announcing, "hey... I snore a lot, and flop around at night."
I've also always figured the response would be, "lose weight and stop drinking," in spite of the fact that I had the problem back when I was skinny and didn't drink.
I'm willing to lose weight. In fact, I'm working on it. But there's no way I'm going to give up drinking right now; it's one of the few pleasures I have left in a life that's pretty much been a grind for years now. Maybe after I've retired?
I know it's stupid, but I've always felt a little silly about the thought of walking into my doctor's office and announcing, "hey... I snore a lot, and flop around at night."
I've also always figured the response would be, "lose weight and stop drinking," in spite of the fact that I had the problem back when I was skinny and didn't drink.
I'm willing to lose weight. In fact, I'm working on it. But there's no way I'm going to give up drinking right now; it's one of the few pleasures I have left in a life that's pretty much been a grind for years now. Maybe after I've retired?
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thatjonguy
Now with 57.93% more awesome!
Thanks for stopping in and helping us with the facts!
I appreciate your knowledge and work, hopefully I can keep mine from progressing any further and ward off any consequences of OSA. My wife made me go see someone after her dad had a heart attack that was partially contributed to un-diagnosed sleep apnea.
If you're being good, hotel water at night, then dump in the morning when you get up, and run it with the heater on until dry. I'm not good about this, and my reservoir gets crystalline deposits (which hide corrosion) and is pretty much shot by the time 6 months comes around. I've been thinking about doing a PBW and star san on a weekly basis, but I'm not sure it's a good idea.
Beernik
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Apnea being dependent on neck size makes sense for me. After high school, I could never wear standard 16" choker necklaces because they choked me.
Brewguyver, I do minimal maintenance on my stuff and it lasts forever. I've beed using the same tube and nose cup for 3 months and I've washed them twice. But I also live in a really dry climate and don't have to worry about mold or mildew.
I have thought about the occasional use of sanitizer too. I saw a clean in place system for my machine for over $100 and started laughing.
Brewguyver, I do minimal maintenance on my stuff and it lasts forever. I've beed using the same tube and nose cup for 3 months and I've washed them twice. But I also live in a really dry climate and don't have to worry about mold or mildew.
I have thought about the occasional use of sanitizer too. I saw a clean in place system for my machine for over $100 and started laughing.
haha... I've been known to disinfect my mask and hose with Star San... Actually I use the same spray bottle as I use for brewday... What I'd really like is one of those automatic daily cleaners that use ozone, although they're 300$ which I'd rather put into a new brew rig....Decisions decisions....
ibbones
Well-Known Member
I have had a CPAP since 2009 and I LOVE my machine. I will not go without it anywhere. It made that much difference in my over all feeling. If I go on vacation or just an overnight-er, I take my CPAP. O'h, and I always travel on a motorcycle. That's right. It takes up about half of my saddlebag. Not a lot of room to pack but that is how much better I feel with it.
If I am home and need a little 20-30 minute nap, it's a Pap Nap, as we call it.
Now, when I first got the machine, it was a battle to get used to it. It hurt my face, the hose was in my way, it took up a big part of my nightstand, blah, blah, blah. I stuck it out and just plain feel better. Try it for a while and you might like it.
HoppyDaze
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I bought a generator so I can run my machine while I'm in the woods elk hunting.
Renoun
Well-Known Member
You shouldn't need a generator, just a deep cycle battery, a small inverter, an a way to charge/recharge the battery. You'd want them at home if the power goes out anyway. If you use lower pressures you might even be able to run directly off the battery.
Beernik
Well-Known Member
I've thought about looking for one of those UPS computer battery backups from the 2000s.
HoppyDaze
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That may be the way to go actually. Where would I get an inverter?
normonster
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GrogNerd
mean old man
working on my BMI, way too high, but diagnosed with SEVERE apnea, clocked at 90 episodes per hour. no way to get a good night sleep 45 seconds at a time. was waking up several times a night and it would take forever to get back to sleep. I would start to nod off and the first snore would wake me up.
have been a very loud snorer even when I was thinner. when I was in the navy, got complaints from my shipmates I was louder than the engines (GE LM2500 jet turbines) and aux machinery.
my CPAP - literally and without hyperbole - saved my life. got down to 1 episode per hour and usually have nights where I don't remember waking up at all.
had no problem getting used to the machine
have been a very loud snorer even when I was thinner. when I was in the navy, got complaints from my shipmates I was louder than the engines (GE LM2500 jet turbines) and aux machinery.
my CPAP - literally and without hyperbole - saved my life. got down to 1 episode per hour and usually have nights where I don't remember waking up at all.
had no problem getting used to the machine
hunter_le five
Sheriff Underscore
Is it really a BMI issue, or....
kleinstadt
Active Member
I have one patient who is homeless and lives out of his van, and this is exactly what he does.
The newer devices draw about 80W. I know this because the inverters that come with the devices have a big "80 W" stamped on them.
Beernik
Well-Known Member
So what do you all do when you have a sinus cold? I have my first one since I got my machine. I can barely breath out one nostril with the thing off. I'm not sure I can get a decent nights sleep without it on.
I guess I'm going to be a mouth breathing super snorer tonight.
I guess I'm going to be a mouth breathing super snorer tonight.
