My first post on this forum. I have just been diagnosed with OSA and been prescribed a CPAP device.
My question is....does this device create dependence? Once on CPAP, will I not be able to come off it, if I decide so (regardless of if it helps me or not)? Just like the sleeping pills make you dependent upon them?
Once the upper Air System/Throat gets used to a higher pressure, will it behave worse (than if I had not used CPAP), if I decide to take the high pressure away?
My first post on this forum. I have just been diagnosed with OSA and been prescribed a CPAP device.
My question is....does this device create dependence? Once on CPAP, will I not be able to come off it, if I decide so (regardless of if it helps me or not)? Just like the sleeping pills make you dependent upon them?
Once the upper Air System/Throat gets used to a higher pressure, will it behave worse (than if I had not used CPAP), if I decide to take the high pressure away?
With regards.
Sanjay.
The pressure keeps your airway open so you can breathe while sleeping, since it collapses when you sleep.
As for dependence, I think you are thinking of it as almost an addiction; when in reality, I DEPEND on my CPAP and 12 pressure to keep me breathing freely at night while I sleep. Otherwise, my breathing is interrupted 141 times an hour without CPAP.
In that sense, I have a dependency - I want to breathe - CPAP helps me breathe - therefore I use it. You can come off it; nothing will be better, however. If you need it, and stop using it, you will have apneas - the pressure you are set at is prescribed to help you breathe. If you don't use it, you WILL have apneas. Hence, your 'dependency.'
_________________ From the land of ahhhzzzz...
Sat Oct 31, 2009 3:04 pm
Bill Bolton
Joined: 21 Aug 2007
Posts: 179
Location: World Traveller
To reiterate, no, all a CPAP does is to keep your airway open so that you can breathe. It is completely analogous to wearing glasses so you can see. You are only dependent on the glasses if you want to see.
Vicki
_________________ Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Von Savant
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.
It can create a psychological dependency because you never want to go back to life BEFORE cpap.
Sure, you can stop using it at any time, but then the old symptoms of headaches, BP issues, etc. will return. So in that sense you are not physically addicted to it, but psychologically you never want to live the old way any more.
_________________ Dianne's: Remstar Auto M, C-flex, humidifier, smart card. Mask: Swift LT, AHI- 23, lowest blood ox 80%.
John's: Same cpap, Mask: Respironics Profile-lite mask.
severe apnea, Cpap user for more than 20 years.
This is also my first post on this site. I've recently been diagnosed. I went a second time to test the CPAP. I wanted to take the machine home with me the next morning. I had to wait two weeks for the test results to be sent to my doctor, who went on vacation,and now I have to wait another week for her to sign the papers to get the machine. I NEED THIS MACHINE. I can't believe the difference in how I felt after sleeping with the machine.
My first post on this forum. I have just been diagnosed with OSA and been prescribed a CPAP device.
My question is....does this device create dependence? Once on CPAP, will I not be able to come off it, if I decide so (regardless of if it helps me or not)? Just like the sleeping pills make you dependent upon them?
Once the upper Air System/Throat gets used to a higher pressure, will it behave worse (than if I had not used CPAP), if I decide to take the high pressure away?
With regards.
Sanjay.
Hi Sanjay!
Well lets look at the possibilities as well as we can. If you do not use CPAP every apnea and hypopnea you therefor have will rob you of oxygen, sleep, and increase the carbon dioxide levels in your system. As well, your body will respond with an "emergency stress" reaction raising your cortisol and other stress hormones on a constant basis. In my case the somewhere between 300,000 (events for two years) and/or likely over 2,000,000 events wore my body and brain down to the point where I lost my carrier, my housing, a lot of friends, my normal blood pressure, my normal sugar level control, and my ability to repay my creditors and financially support my children. For that matter, the parts of the brain that are affected seem to be those in use at the time of the oxygen depriving events. The portion of the brain responsible for controlling the muscle tension of our airway passage at night is one of those areas deeply affected. Life without CPAP for a person with OSA is a bit like falling into a black hole except that there is no time distortion as you approach the event horizon. You simply get sicker with increasing speed.
With CPAP you are likely to stop this destructive speeding spiral in it's tracks. At the least you are likely slow it down, and give yourself the needed energy and focus you need to fight back. I have met a couple of people who testify that they went on CPAP, and used this increased energy to help loose their excess weight and increase their muscle tone and were apparently otherwise healthy enough that they no longer needed the CPAP at that point. When I make my goal weight I do not expect to be able to go off of CPAP. Frankly I was very much too long without CPAP so the airway passage controller is probably too damaged to ever go off of CPAP.
I very well know that untreated OSA will increase your dependency on others to help you. Strangely CPAP gives you the best chance of not needing CPAP.
If CPAP does not work for you and your apnea is getting worse, I would consider whatever it takes.
Incredible Feedback. I wish I had come across this forum before seeing my sleep specialist, 500 Km away.
I belong to a small town which has no sleep lab and and nothing called Sleep Medicine Deptt. in local hospitals.
When I came back with CTs of my Nose & Throat (PNS region, whatever that is) & Sleep Study and of course, the knowledge that OSA is a throat related problem, I took the reports to a school classmate of mine, who is now an ENT surgeon in my town. My report says although I am getting some REM sleep, I am not getting even one minute of Sleep 4 & 5 (what they call Delta wave or deep restful sleep). My idea was that he would be best suited to select the best possible CPAP machine.
He is the kind of Doctor who does not like to prescribe too much medicine (one of the sane ones...maybe) but his response was quite surprising (after my chat with my sleep specialist). He was quite forceful and told me to get sane and reduce my food intake (i am a compulsive eater and obese) & exercise more to turn vicious circle to a virtuous one (and I am too tired to exercise). He asked and I quote "Do you want to sleep with a machine tied to your face for the rest of your life.....you have just got some fancy jargon from specialists who make too much money from selling expensive treatment, to excuse your bad habits & from doing what has to be done".
I then asked him if Fat people don't have restful sleep and if my Sleep 4 & 5 missing was the real cause of my being tired, he again asked if instead of making slow and steady progress by hard control over food & diligent exercise, I wanted to go to psychiatrists?
Thats what caused my search on Internet and landed me on this site....hence my original post.
Comments?
With best regards to all and much...much Thanks.
Sanjay.
Wed Nov 04, 2009 5:55 pm
SleepyToo
Joined: 17 Sep 2009
Posts: 64
Location: North of Philadelphia
I have some thoughts about the ENT _surgeon_ you went to see, but I will keep them to myself. If you are getting good sleep, you will have more energy, and be more motivated, which will help you lose weight, and possibly control the compulsive eating. I am slightly over weight (according to the BMI calculations), but not obese (I still fall well below the waist measurement definition of obese). I have moderate to severe sleep apnea. I know I have an eating problem - see food and have to eat it. When I have a good night with the machine stuck to my face, I feel like I want to eat less. So if being tied to the machine does that for me, bring it on!
Also, if the fancy machine that is too expensive the way insurance companies pay for it, it is still a lot cheaper than even a few days in hospital as a result of accidents that can happen because of sleep apnea. From my reading on this forum, and elsewhere, I know that SA is a life-threatening illness for which the most effective therapy is xPAP (if you get the proper mask!). Not only life-threatening for the patient, but possibly for others as well.
Exercise and diet alone are probably not going to 'cure' your apnea. Surgery alone is probably not going to (permanently) cure your apnea. Maybe the machine will help you address the exercise and diet question. Read more about the surgery option before deciding whether that is for you.
Finally, do some research on an exercise program called pace. It is interval training. You do very short bursts of high intensity exercise followed by short periods of relaxation. I am just getting started with it, and boy, does it work. Of course, you need to check with your regular physician before starting any exercise program. However, this one works, and takes an incredibly short amount of time each day. If you can't find it, PM me and I will send you a link.
_________________ SleepyToo
Philadelphia Area
Newly diagnosed, Respironics M Series Pro w\ humidifier
Zest nasal mask, also have Full Life ff mask, and FlexiFit 407
(Also have a FlexiFit 405 that damaged the bridge of my nose)
This is also my first post on this site. I've recently been diagnosed. I went a second time to test the CPAP. I wanted to take the machine home with me the next morning. I had to wait two weeks for the test results to be sent to my doctor, who went on vacation,and now I have to wait another week for her to sign the papers to get the machine. I NEED THIS MACHINE. I can't believe the difference in how I felt after sleeping with the machine.
So yeah, I'm already dependent after one night.
I was the same way. After my sleep study I was morerefreshed than I had been in 10-15 years...I wanted one right away.
I only had to wait a week for my doctor and got my CPAP 2 days later. But that week did me some good. I did some research on machines, what my insurance would cover...And found this site!!! Which is loded with great information
Thu Nov 05, 2009 12:27 am
jball1954
Joined: 03 Nov 2009
Posts: 11
Location: Columbus, Ohio
I can understand your doctor recommending diet and exercise, but that shouldn't preclude combining that with using CPAP. Diet, exercise, and CPAP would seem like a good combination. I do wish doctors who work with sleep disorders would explain results and some of the information I've learned here in more detail. This forum, in just a few days, has proved very informative to me. It has tied together the whole process from when I was diagnosed through the sleep study process and prescribing the CPAP machine. I've had it almost week now but only now am understanding all this by reading information here.
Thu Nov 05, 2009 9:07 am
Vicki Moderator
Joined: 31 May 2005
Posts: 4528
Location: Southern California
Your friend is completely uninformed in the area of sleep apnea. Additionally, while a few ENTs understand and support the use of a CPAP as first line therapy, most are trained as surgeons without experience in sleep medicine and are completely dismissive of using a simple, noninvasive CPAP.
To be so discouraging and unsupportive is completely unacceptable and inappropriate. To address his ignorance of Obstructive Sleep Apnea (OSA), being overweight predisposes you to OSA, but your anatomy plays a big role. There are many members here who are not overweight, middle aged men. We've got fit women and men, kids 6 months old, etc. Unfortunately, the stereotype that you have to be an overweight middle aged man to have apnea has lead to years of misdiagnosis for many people, including myself.
There are several physiological reasons why untreated OSA causes weight gain. First, because of the extreme fatigue, our energy levels decrease and we are less active. Secondly, some people eat more and eat more unhealthy foods in attempts to increase our alertness and metabolism. Untreated, I couldn't figure out why I ate spoonful of raw sugar at 4 PM. Finally, sleep disruption raises the level of the hormone ghrelin, which increases appetite and decreases the utilization of fat stores and it lowers the level of leptin, which decreases appetite, increases the utilization of fat from fat stores and increases base metabolism.
Most likely losing weight will decrease the pressure required to keep your airway open but it will not eliminate your OSA. So of course being a healthy weight id ideal, but if you have untreated apnea, the way to do it is to treat the apnea along with incorporating healthy lifestyle changes.
The more I think about what he said, the angrier I get that he is so ignorant. You are not prescribed a CPAP unless you need it. All is takes is a copy of your sleep study to prove it. To suggest your problems are psychological shows great ignorance. I was dismissed like that too and I changed doctors faster than lightening. You should stick with your sleep doctor and send your not-so-much friend a print off of this thread before they give any other OSA patient such poor and damaging advice. After all the first role of a physician is to do no harm and he is doing harm.
Vicki
_________________ Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Von Savant
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.
Incredible Feedback. I wish I had come across this forum before seeing my sleep specialist, 500 Km away.
I belong to a small town which has no sleep lab and and nothing called Sleep Medicine Deptt. in local hospitals.
When I came back with CTs of my Nose & Throat (PNS region, whatever that is) & Sleep Study and of course, the knowledge that OSA is a throat related problem, I took the reports to a school classmate of mine, who is now an ENT surgeon in my town. My report says although I am getting some REM sleep, I am not getting even one minute of Sleep 4 & 5 (what they call Delta wave or deep restful sleep). My idea was that he would be best suited to select the best possible CPAP machine.
He is the kind of Doctor who does not like to prescribe too much medicine (one of the sane ones...maybe) but his response was quite surprising (after my chat with my sleep specialist). He was quite forceful and told me to get sane and reduce my food intake (i am a compulsive eater and obese) & exercise more to turn vicious circle to a virtuous one (and I am too tired to exercise). He asked and I quote "Do you want to sleep with a machine tied to your face for the rest of your life.....you have just got some fancy jargon from specialists who make too much money from selling expensive treatment, to excuse your bad habits & from doing what has to be done".
I then asked him if Fat people don't have restful sleep and if my Sleep 4 & 5 missing was the real cause of my being tired, he again asked if instead of making slow and steady progress by hard control over food & diligent exercise, I wanted to go to psychiatrists?
Thats what caused my search on Internet and landed me on this site....hence my original post.
Comments?
With best regards to all and much...much Thanks.
Sanjay.
Hi again Sanjay!
I have been fascinated and awestruck by the beauty, complexity, and intricacy of the human body all my life. It is amazing inside and out. I very much enjoyed my time as a Broadcast Technician but my recent studies of the body in my quest for better health makes me think that I might well have been happier in medicine.
I think I can understand, therefor, why many physicians become impatient with their clients and even friends. Certainly I am saddened at my own lack of care for the awesome tabernacle of skin and bone I dwell in. I would accept your friends encouragement to do better in that regard.
He does speak many words without knowledge, however. May I suggest a book by an ENT - "Sleep, Interrupted" by Steven Y. Park, M.D.
Your friend is completely uninformed in the area of sleep apnea. Additionally, while a few ENTs understand and support the use of a CPAP as first line therapy, most are trained as surgeons without experience in sleep medicine and are completely dismissive of using a simple, noninvasive CPAP.
Vicki
Ah, Vicki,
You obviously lack in the knowledge of the first rule of surgery: a chance to cut is a chance to cure. At least that is how I learned it in my medical school training! Sad thing is, I didn't learn anything about sleep medicine -- and I'm not that far out of school --1995, residency training in 1999. In fact, I keep promising myself that I am going to go to a continuing education class on Sleep Disorders as soon as my life settles down. I did get married 5 years ago, and had 2 kids in the past 3 years and all. Now I finally know why I'm always so tired, and feel like I can never catch up on sleep. Being diagnosed with OSA as well as a component of CSA and trying to adapt to cpap in the past month has probably been the fasted crash course I've had in anything other than parenting recently. This site has been such a wonderful resource.
I don't mean to poke fun, or justify for Sanjay's friend, either, but when you don't know enough about the topic at hand, and probably would be mortified to tell your friend who comes to you for assistance that you never learned about sleep apnea during your training... It's so much easier to turn it around and say it's all about diet and exercise. Because we know that every single person in the world who is obese "just" has problems with diet and exercise right? (okay so my humor can be a bit on the sarcastic side most of the time).
Of course, this could all be a bunch of psychobabble, me being a psychiatrist and all. I'm betting if Sanjay asked his classmate that is now an ENT surgeon how much he learned about sleep apnea and knows about the stages of sleep and the treatments for OSA, or even what AHI, SDB, or any other common abbreviations used on this site are, he'd be further surprised by the doc's lack of knowledge, or angered by his further attempts to humilliate him and turn the focus off the docs short comings and back on the "lack of control" over himself Sanjay has shown thus far.[This may also be consistent with what his classmate experienced in training to become that surgeon, so it is a technique he would fall back on fairly easily].
So Sanjay, does this sound like your friend at all?
The moral of the story and one that many have already learned on this site is:
Learn as much about your illness, the science behind it, why your feeling bad, and what will help you feel better. Learn to be persistent in your search for the right mask, and adjust and be patient -- wrong, have patience -- a new habit takes 21 days to become routine. Learn what the research is behind whatever anyone recommends. And make sure you know why they recommend it.
I'm sure Sanjay's ENT friend is making good money, as good or better than the sleep specialist -- particularly if a neurologist.
My ENT recommends UPPP but he admits he doesn't really know that much about cpap machines. I actually am considering it, because I think I might be a good candidate based on my anatomy. I have the knowledge that if it doesn't cure my OSA I'd be okay with that. I know it won't cure my CSA. But in the long run, it may be the best first choice for me.
If I may be so bold as to pirate a line from Todzo:
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