Progression of untreated apnea
Question:
Hi folks, About 6 weeks ago, I wrote to this group mentioning that I was gearing up to try BiPAP again. Well, I finally got started about 3 weeks ago. Concurrently with this, (actually, starting about a week before re-starting on the BiPAP) I have been experimenting with Provigil to find the best dose that would help without leaving me feeling too wired. I was hoping that as I began using the BiPAP that my need for the Provigil would decrease, especially since I have been able to keep the mask on all night for several nights. (In contrast, 3 years ago I was able to keep it on all night maybe 3 nights in six months of trying.) I was disappointed at first that it hasn’t resulted in me feeling better. Last Friday night, I got one of those 8-hour vhs tapes and videotaped myself all night on the BiPAP. When I watched it on fast forward, I noticed a pattern: I take 3 or 4 breaths quickly, and then stop for 20 to 30 seconds. It looks like I am still having apnea, even with the BiPAP. That would account for why I still have Excessive Daytime Sleepiness. I called my sleep doctor and left a message for him Monday with this news but he was out of town. When he called me back yesterday, he said he would schedule me for another sleep study in 3 weeks or so to find out what pressure I need. He also asked me how frequently I was having those long pauses between breathing. Well, I sat down and counted them last night. In one ten minute stretch, I saw 17. That works out to 102 per hour. I realize that this is a primitive measurement but now I want to push to get the sleep study done ASAP. Three years ago, my RDI was only 25. Watching that tape at regular speed was spooky. To see the pattern, I had watched it speeded up, i.e., without the sound. With the sound, it just sank in a little deeper just how much this is affecting me. It may be odd to some people to hear but I imagine you oldtimers know what I mean when I say what a relief it is to see a (guestimated) RDI of over 100, which would put me in the category of ’severe’ sleep apnea. Today, I am feeling hope, tinged with regret. Hope, that within in a couple of months I may be experiencing the benefits of truly restful sleep for the first time in 20 years or more. And regret, that it took me 2 3/4 years to realize how important it is to be persistent in finding a solution. Meanwhile, it looks like the severity of my apnea has progressed in those years of not being treated. Thank you for the encouragement all of you have offered me directly, as well as indirectly by your responses to the others who are just starting out adjusting to cpap. I’ll keep you posted on how it goes from here. Bill
Response:
Bill Crutcher wrote: > I even remember my sleep doctor telling me three > years ago that my 2nd sleep study (for titration) > showed evidence of CSA. He said it was the reason > he recommended a bipap for me instead of a cpap.
My last sleep study showed lots of unexplained arousals (along with OSA, CSA and mixed events). When the sleep tech switched to BiPAP the frequency of the arousals dropped dramatically. It was very visible. > My sleep study has already been scheduled for next > Monday night. I’m glad they had an opening so soon.
Yup. Is the best next step. Be certain to discuss problems you had using your BiPAP unit last time. This might uncover other problems that can be addressed. Regards, =jbf= John B. Fisher
Response:
On Thu, 8 Jun 2000 07:41:09 -0700, "Tim W." <nos…@net.com> wrote: >Bill, >From your description, it sounds like you might be having periodic breathing >or central apnea rather than obstructive apnea, unless you distinctly heard >snoring/snorting/gasping sounds on the tape.
I think you are right. I even remember my sleep doctor telling me three years ago that my 2nd sleep study (for titration) showed evidence of CSA. He said it was the reason he recommended a bipap for me instead of a cpap. I didn’t hear any snoring over the sounds of the bipap machine but I did see that my chest was moving VERY slightly at times during the 25-second stretches between full breaths. I’m guessing hypopnea? I don’t know. >The sleep study will sort this >all out for you but if it is central or periodic events, the BiPap itself >can actually be causing some of it if the pressures aren’t right, so it may >not necessarily be true that your apnea has quadrupled in severity.
I’ve wondered whether that might be the case… My sleep study has already been scheduled for next Monday night. I’m glad they had an opening so soon. >Just >out of curiosity, did you trying taping a night without the BiPap for >comparison?
I did, but I haven’t sat down to count the stoppages like I did with this one. I just reviewed it on fast forward and I saw the same pattern: either 3 or 4 regular (or slightly rapid) breaths, followed by a long (15 to 30 seconds) pause. On that one, the sound didn’t get recorded due to technical reasons, so it won’t give me any clues about snoring sounds. >I think there’s an overall sense amongst patients and sleep >doctors that apnea over time does often progress, although it doesn’t seem >there’s much published research on the subject. Good detective work–a >little individual research can go a long way in getting help. >Tim W.
Thanks for your help. I’m sure I’ll be needing more input on congestion problems if/when I get a new pressure Rx. Later. – Hide quoted text — Show quoted text ->Bill Crutcher <billcrutc…@telocity.com> wrote in message >news:trksjskankbfnvcf2fa816grjphet27r7i@4ax.com… >> Hi folks, >> About 6 weeks ago, I wrote to this group mentioning that I was gearing <snip>> >> Thank you for the encouragement all of you have offered me directly, >> as well as indirectly by your responses to the others who are just >> starting out adjusting to cpap. >> I’ll keep you posted on how it goes from here. >> Bill
Response:
Tim…off-topic message here…did you see my previous post to you? The subject began "Thanks Tim W." and was posted Sunday or Monday. Regards, Tim * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!
Response:
Wayne Jones wrote: > I was overweight, a heavy drinker and snored loudly. I’ve > been trying to lose the weight and have stopped drinking > altogether. I’m hoping that my situation will improve but > realize that it may not be a total cure. I’m curious to know > if your apnea is getting worse despite similar efforts or if > you are still overweight and snore etc.
Know you didn’t ask me specifically, but if you don’t mind, I’ll chime into the conversation… Being overweight makes the apnea worse. Getting to ideal weight may not eliminate the apnea, but it should reduce the severity of the apnea. Drinking is a real ‘no-no’ for someone with obstructive sleep apnea. It just makes the apnea much worse – it relaxes the throat muscles as well as others. It also impacts the parts of the brain that coordinate things like our breathing. Once you get past the initial reaction and change to not drinking, it should reduce the apnea. There is the possibility you drank to help you get to sleep. (Not unknown). Get the obstructive sleep apnea treated, and you’ll start to wake up feeling like a youngster again. It’s nice to be able to think clearly when you awaken. So, though reducing weight and stopping drinking isn’t a cure (as you note), it really should make your life much easier. Regards, =jbf= John B. Fisher
Response:
Hi Wayne, On Thu, 08 Jun 2000 15:18:44 GMT, "Wayne Jones" <wrjon…@home.com> wrote: >Bill, >I’m new to this. I just got the results from my first sleep test and the >number of apnea events per hour was 26 with lots of PVC’s. I have another >test with CPAP scheduled in 2 weeks. >I was overweight, a heavy drinker and snored loudly.
I hardly ever drink. (The computer is my drug of choice. ;-) ) I have always been told that I snore VERY loudly. At 6′3" and 211 lbs., I’m not particularly overweight, though I have lost about 20 lbs. since last November. >I’ve been trying to >lose the weight and have stopped drinking altogether. I’m hoping that my >situation will improve but realize that it may not be a total cure. I’m >curious to know if your apnea is getting worse despite similar efforts or if >you are still overweight and snore etc.
Losing weight might help the apnea and has for some. Drinking has an especially negative impact on us apnea sufferers, in that sleeping while under the influence of alcohol leads to an increase in apnea events. Something about depressing the central nervous system more than it already is during sleep. I’m beginning to adjust to the idea that there is no cure for apnea — just management of it to minimize the negative health and quality of life impacts it can have. Good luck to you. As others in this group have said before me (and far better, I might add), dogged persistence in finding what works for you is what it will take to find relief. Yes, it can be found. Keep reading this group. Bill – Hide quoted text — Show quoted text ->Thanks >Wayne Jones >"Bill Crutcher" <billcrutc…@telocity.com> wrote in message >news:trksjskankbfnvcf2fa816grjphet27r7i@4ax.com… >> Hi folks, <snip> >> Thank you for the encouragement all of you have offered me directly, >> as well as indirectly by your responses to the others who are just >> starting out adjusting to cpap. >> I’ll keep you posted on how it goes from here. >> Bill
Response:
Bill, From your description, it sounds like you might be having periodic breathing or central apnea rather than obstructive apnea, unless you distinctly heard snoring/snorting/gasping sounds on the tape. The sleep study will sort this all out for you but if it is central or periodic events, the BiPap itself can actually be causing some of it if the pressures aren’t right, so it may not necessarily be true that your apnea has quadrupled in severity. Just out of curiosity, did you trying taping a night without the BiPap for comparison? I think there’s an overall sense amongst patients and sleep doctors that apnea over time does often progress, although it doesn’t seem there’s much published research on the subject. Good detective work–a little individual research can go a long way in getting help. Tim W. Bill Crutcher <billcrutc…@telocity.com> wrote in message
news:trksjskankbfnvcf2fa816grjphet27r7i@4ax.com… – Hide quoted text — Show quoted text -> Hi folks, > About 6 weeks ago, I wrote to this group mentioning that I was gearing > up to try BiPAP again. Well, I finally got started about 3 weeks ago. > Concurrently with this, (actually, starting about a week before > re-starting on the BiPAP) I have been experimenting with Provigil to > find the best dose that would help without leaving me feeling too > wired. > I was hoping that as I began using the BiPAP that my need for the > Provigil would decrease, especially since I have been able to keep the > mask on all night for several nights. (In contrast, 3 years ago I was > able to keep it on all night maybe 3 nights in six months of trying.) > I was disappointed at first that it hasn’t resulted in me feeling > better. > Last Friday night, I got one of those 8-hour vhs tapes and videotaped > myself all night on the BiPAP. When I watched it on fast forward, I > noticed a pattern: I take 3 or 4 breaths quickly, and then stop for > 20 to 30 seconds. It looks like I am still having apnea, even with > the BiPAP. That would account for why I still have Excessive Daytime > Sleepiness. I called my sleep doctor and left a message for him > Monday with this news but he was out of town. > When he called me back yesterday, he said he would schedule me for > another sleep study in 3 weeks or so to find out what pressure I need. > He also asked me how frequently I was having those long pauses between > breathing. Well, I sat down and counted them last night. In one ten > minute stretch, I saw 17. That works out to 102 per hour. I realize > that this is a primitive measurement but now I want to push to get the > sleep study done ASAP. Three years ago, my RDI was only 25. > Watching that tape at regular speed was spooky. To see the pattern, I > had watched it speeded up, i.e., without the sound. With the sound, > it just sank in a little deeper just how much this is affecting me. > It may be odd to some people to hear but I imagine you oldtimers know > what I mean when I say what a relief it is to see a (guestimated) RDI > of over 100, which would put me in the category of ’severe’ sleep > apnea. Today, I am feeling hope, tinged with regret. Hope, that > within in a couple of months I may be experiencing the benefits of > truly restful sleep for the first time in 20 years or more. And > regret, that it took me 2 3/4 years to realize how important it is to > be persistent in finding a solution. Meanwhile, it looks like the > severity of my apnea has progressed in those years of not being > treated. > Thank you for the encouragement all of you have offered me directly, > as well as indirectly by your responses to the others who are just > starting out adjusting to cpap. > I’ll keep you posted on how it goes from here. > Bill
Response:
Bill, I’m new to this. I just got the results from my first sleep test and the number of apnea events per hour was 26 with lots of PVC’s. I have another test with CPAP scheduled in 2 weeks. I was overweight, a heavy drinker and snored loudly. I’ve been trying to lose the weight and have stopped drinking altogether. I’m hoping that my situation will improve but realize that it may not be a total cure. I’m curious to know if your apnea is getting worse despite similar efforts or if you are still overweight and snore etc. Thanks Wayne Jones "Bill Crutcher" <billcrutc…@telocity.com> wrote in message
news:trksjskankbfnvcf2fa816grjphet27r7i@4ax.com… – Hide quoted text — Show quoted text -> Hi folks, > About 6 weeks ago, I wrote to this group mentioning that I was gearing > up to try BiPAP again. Well, I finally got started about 3 weeks ago. > Concurrently with this, (actually, starting about a week before > re-starting on the BiPAP) I have been experimenting with Provigil to > find the best dose that would help without leaving me feeling too > wired. > I was hoping that as I began using the BiPAP that my need for the > Provigil would decrease, especially since I have been able to keep the > mask on all night for several nights. (In contrast, 3 years ago I was > able to keep it on all night maybe 3 nights in six months of trying.) > I was disappointed at first that it hasn’t resulted in me feeling > better. > Last Friday night, I got one of those 8-hour vhs tapes and videotaped > myself all night on the BiPAP. When I watched it on fast forward, I > noticed a pattern: I take 3 or 4 breaths quickly, and then stop for > 20 to 30 seconds. It looks like I am still having apnea, even with > the BiPAP. That would account for why I still have Excessive Daytime > Sleepiness. I called my sleep doctor and left a message for him > Monday with this news but he was out of town. > When he called me back yesterday, he said he would schedule me for > another sleep study in 3 weeks or so to find out what pressure I need. > He also asked me how frequently I was having those long pauses between > breathing. Well, I sat down and counted them last night. In one ten > minute stretch, I saw 17. That works out to 102 per hour. I realize > that this is a primitive measurement but now I want to push to get the > sleep study done ASAP. Three years ago, my RDI was only 25. > Watching that tape at regular speed was spooky. To see the pattern, I > had watched it speeded up, i.e., without the sound. With the sound, > it just sank in a little deeper just how much this is affecting me. > It may be odd to some people to hear but I imagine you oldtimers know > what I mean when I say what a relief it is to see a (guestimated) RDI > of over 100, which would put me in the category of ’severe’ sleep > apnea. Today, I am feeling hope, tinged with regret. Hope, that > within in a couple of months I may be experiencing the benefits of > truly restful sleep for the first time in 20 years or more. And > regret, that it took me 2 3/4 years to realize how important it is to > be persistent in finding a solution. Meanwhile, it looks like the > severity of my apnea has progressed in those years of not being > treated. > Thank you for the encouragement all of you have offered me directly, > as well as indirectly by your responses to the others who are just > starting out adjusting to cpap. > I’ll keep you posted on how it goes from here. > Bill
