I’m a Respiratory Therapist. I was on the first wave of putting CPAP out in the field. RT’s in hospitals didn’t know how to use them. Many physicians were pretty uneducated about OSA. The public was almost completely uninformed.
Insurances often would not pay for them. They were considered ‘experimental’.
Early CPAP were pretty large compared to what they would become. They made a fair amount of loud white noise. Some people actually located them in an adjacent room and put a hole in the wall to run tubing. Those units would handle longer tubing OK. New ones will not deal with much additional length.
Most masks were PVC (polyvinyl chloride), like the disposable masks for O2. Face oils hardened them and for some people they’d petrify in a month, often leading to some unfortunate pressure sores, usually on the bridge of the nose. Fitting was often not very good as there were only 3 mask sizes. There were some silicone nasal pillows. Some people like them, others hated them.
The new systems and masks are vastly better.
Some of the stories I heard from people with OSA ran the range from sad to hilarious. Most wives were very enthusiastic to get their snoring husbands quieted down and hopefully feeling better. The men rarely even acknowledged they had a problem.
Quote from one of the leading OSA researchers at an RT seminar:
“Men don’t have sleep apnea, they only have denial. What they don’t deny is how much their wives bitch about their snoring,”
Wow, we do have all kinds of experts here
I have a question: Will chronic use of CPAP or BIPAP result in dependence, e.g. forgetting how to breath autonomously and independently during sleep?
Nope, breathing is pretty much hardwired.
One of the issues with some, not all, OSA people is that they may be ‘respiratory slugs’. The inherent breathing drive is somewhat lower, and their tolerance for CO2 may be higher. My own family has this tendency. Father used CPAP. My wife comments on my lack of breathing sometimes.
If anything the CPAP may (significantly) improve overall health with improved sleep. There are a host of health issues associated with OSA, not the least of which is dying in a vehicle accident when falling asleep at the wheel. Met a mailman that had wrecked 2 trucks that way, and a jeweler that needed to be driven 3 miles to work.
After 5 years using an S9 ResMed I got a newer A10; both worked well for me/wife(she stopped kicking me in the back to restart my breathing). I use an Alien hatchling face mask. I tried several nose pillow variants. All made my lips do whoopie cushion imitations. No problems re:forgetting to breathe w/o the mask.
Separate sleeping quarters for couple is very common. I’d hear stories of guys that went on fishing/hunting/camping trips with their buddies and they were not happy at all with the poor OSA guy.
I diagnosed a guy on a diving trip. I could hear him snoring 2 rooms away.
Thank you for the explanation, and alarming stories :person_facepalming:
I gained ~30 pounds in the past couple years, and started getting complaints about horribly loud snoring. My airway gets obstructed unless I sleep on the side and with mouth closed. I can still get a good night of sleep with the right posture, so I am not sure if I need a CPAP machine.
FWIW, weight is an additional problem. The ‘pressure setting’ on the CPAP is often a function of how much extra weight you are carrying.
Often men think they will lose weight, then not need the CPAP.
It’s hard to lose weight. I have never, ever seen someone with untreated OSA lose weight. The energy, and discipline simply aren’t available.
I have seen men treated with CPAP lose weight, sometimes without even trying hard. They simply feel so much better they start being active again and burn off the extra. Weight loss is never a guarantee though.
BTW, it’s not the snoring, it’s the ‘stop snoring/no breathing’ that’s the problem. The apnea is where everything goes wrong.
Back sleeping does increase the probably of obstruction. I’ve known people to sew a tennis ball into PJ tops or an undershirt.
I have a ResMed AirSense 10 that I’ve been using for almost 2 years now. I was averaging 23 events a hour so I definitely needed it! It has definitely made a difference for me!
What pressure is your machine set at. Mine hasn’t changed since I first got it at 10psi. A guy I know says his is at 20, seems a lot to me, I would expect sealing issues.
23 is a lot of events, I think. After my nasal RotoRooter (polyps, deviated septum), afib procedure and metropolol meds, I seem to rarely exceed 5-7, mostly less.
A way to envision it is to think of your upper airway as one of those long skinny balloons. Now, put a book on it. To keep the airway open you have to blow up the balloon enough to raise the book adequately. Heavier book requires more pressure.
The book “weight” correlates reasonably well with the neck size and overall weight. OSA people often have short stout necks and are carrying extra weight.
No, it’s not ‘exact’, and the analogy doesn’t fit everyone, but it’s about 75% in the ballpark. You could do a quick and dirty sleep study with a measurement of the neck, and a scale. You could get a starting pressure from there. Then you tweak the pressure based on real world results. In real life we often had to do that even with a sleep study. The study is an odd enough circumstance that it can adversely affect sleep, thus the setting was off.
Some newer CPAP units can measure airflow and adjust pressure if there is no breathing for a predetermined period of time.
I also have a ResMed AirSense 10 with nasal pillows that I’ve just started using. I was averaging 68 events a hour but now it’s less than 2. I have to sleep on my side… If I sleep on my back I get air escaping through my mouth that wakes me up.
