Sleep Apnea question, CPAP, high scam potential ???

[Deschodt]

Apparently this sleep apnea deal is pretty prevalent - bad for your heart etc... I am starting to wonder if there's a scam going on...

I was snoring a lot and my wife reported "occasional" bouts of apnea freaking her out when she heads them (no snore for a bit, mega catchup snore), so I had a home sleep study done. You sleep with a Pulse oxymeter, and a device strapped on your chest measuring your breathing.

Over 5 episodes per hour is considered bad. I had 40 avg ! peak 44 - spent 20 min at 83% oxygen only (not great). "Supposedly." They pull the #s, you don't see them.

As a result I'm now on a CPAP machine and slowly getting used to it, been 3 weeks using it every day, down to 0.5 -1.5 incidents per hour, which are awesome results, no snoring which is also awesome for my wife...

What is weird to me and raising suspicion is a) the doctor's attitude with the initial paper survey of symptoms (tiredness, waking up), and I quote" we're gonna have to bump up those responses of yours or you won't get approved by insurance". Hmm, fishy.

Then, everyone on CPAP reports how "refreshed" they feel on the therapy. They were super tired before. Falling asleep at the wheel. Now they sleep and it's wonderful. blah blah...

Me? Zero difference. None. I wasn't tired before, I'm the same now. I am seriously wondering if they might have also fudged my test results to write themselves a new customer, and sell a Cpap machine, get a cruise to the Caribbean...Seems easy to do.

Is there a way to get an independent sleep test done at home where YOU get the results? (same device strapped on your chest) If I was really averaging 40 sleep apneas per hour for many years, I'd think I'd have been a complete wreck. And feel different now. Anyone on CPAP notice a significant difference or not ? How long after ?

Seems like an easy scam to pull. TO be clear I don't doubt the condition or the effectiveness of CPAP, just the test results.

[ted]

I say the C in C-pap stands for Celibacy because no one is getting lucky when they have a C-pap mask on.

My wife said I should be checked for sleep apnea 20 years ago while I was still working and had to maintain a Class 2 physical.
At the time a Sleep apnea diagnosis would of made it difficult to keep the Class 2 and keep my job.

5 years after I retired I still had the typical symptoms needing a 1 hour nap before lunchtime.
Then it got worse as the apneas caused my back and face muscles to painfully contract or tighten in my sleep as I fought to breathe.
That led to muscle tension and facial pain so severe it was painful to yawn or eat a french fry.
My Dentist actually suggested my muscle pain might be apnea related so that is when I finally got checked and have been on the C-pap since.
Since wearing the C-pap all symptoms have disappeared.

Nothing fun about wearing the C-pap.
But the muscle pain from apneas was worse before the C-pap.

[McLovin]

Apple iWatch monitors and records blood oxygen levels. Around 15 times per night.
After a while or so you build up a decent database.
I wore a cpap for 3 or 4 years. After having 2 overnight sleep studies done.
After the iWatch for a month or so, after 500 readings and never seeing a reading below 93% (and that very rarely, the vast majority is 95+) I stopped wearing the cpap.

[Deschodt]

Originally Posted by McLovin

Apple iWatch monitors and records blood oxygen levels. Around 15 times per night.
After a while or so you build up a decent database.
I wore a cpap for 3 or 4 years. After having 2 overnight sleep studies done.
After the iWatch for a month or so, after 500 readings and never seeing a reading below 93% (and that very rarely, the vast majority is 95+) I stopped wearing the cpap.

Good idea that, thank you. I will buy one.

[masraum]

Originally Posted by McLovin

Apple iWatch monitors and records blood oxygen levels. Around 15 times per night.
After a while or so you build up a decent database.
I wore a cpap for 3 or 4 years. After having 2 overnight sleep studies done.
After the iWatch for a month or so, after 500 readings and never seeing a reading below 93% (and that very rarely, the vast majority is 95+) I stopped wearing the cpap.

I think you need a series 6 watch to monitor blood oxygen. It may work on older models, but definitely NOT on series 3. Which is odd since the way that it determines heart rate is supposedly by using an oximeter.

[Sooner or later]

Read up on accuracy.

[john70t]

Originally Posted by ted

But the muscle pain from apneas was worse before the C-pap.

Try taking calcium magnesium zinc. It's great for joint pain. Back off the dosage if diarrhea.
Some diets and allergies can cause GI tract cramping during the night.
Get a bite guard if you are grinding your teeth. (it's a $500 piece of plastic which will hopefully save more than that later on)

[wdfifteen]

Originally Posted by Deschodt

Then, everyone on CPAP reports how "refreshed" they feel on the therapy. They were super tired before. Falling asleep at the wheel. Now they sleep and it's wonderful. blah blah...

I've been using a CPAP for 5 1/2 years. I can't say I initially felt a lot different during the day than I did before starting the CPAP. But I did immediately feel better at night. I used to have nightly dreams of not being able to sleep. I would wake up several times a night. It was like torture.

Initially I was having 18 events per hour. Now it's about one a week.

Now, 5 years in, I feel like crap if I go without it. One night without it and I wake up with the back of my throat raw and feeling swollen an I just generally have a bad day.

Bottom line - my days better with the CPAP, but I don't often wake up feeling "refreshed." Sleep is still an issue, but no longer because of breathing difficulty.

I go to a sleep specialist, not a GP, for my sleep issues.

[jcommin]

Originally Posted by wdfifteen

I've been using a CPAP for 5 1/2 years. I can't say I initially felt a lot different during the day than I did before starting the CPAP. But I did immediately feel better at night. I used to have nightly dreams of not being able to sleep. I would wake up several times a night. It was like torture.

Initially I was having 18 events per hour. Now it's about one a week.

Now, 5 years in, I feel like crap if I go without it. One night without it and I wake up with the back of my throat raw and feeling swollen an I just generally have a bad day.

Bottom line - my days better with the CPAP, but I don't often wake up feeling "refreshed." Sleep is still an issue, but no longer because of breathing difficulty.

I go to a sleep specialist, not a GP, for my sleep issues.

Quite accurate. I have a CPAP for 20 years - it does make a difference for me. Not glamorous or sexy but I'm better with it. And totally agree on the specialist.

There are other options more aggressive - the machine does take getting use too and my sleeping habits have changed as well. I'm a back sleeper with firm pillows that elevate my head.

[cabmandone]

My oldest brother has been on a CPAP for a few years now. There's a definite difference for him. Honestly though I think if he'd lose some weight he'd be about as well off.

[pavulon]

Not all sleep apneas are obstructive and oxygenation isn't the entire picture. If people don't breathe, not only do they run short of O2, they can't get rid of CO2 either. While oxygen supports life, CO2 accumulation can cause both acute and pernicious cascades of physiologic changes. Chronic changes take a fair bit of time and treatment to unwind.

Long story short, take the time to fully consider all issues of sleep apnea before making decisions.

[Mahler9th]

The consequences of untreated severe sleep apnea are real and the medical devices that are employed as part of therapeutic regimens are regulated by the FDA.

Folks should consider care when using OTC tools like smart watches and cell phones to try to assess the quality of their sleep.

For example, there can be a big difference in the quality of information provided by $10-30 OTC pulse ox devices and those that are used in critical care settings. Every aspect of development, commercialization and ongoing support of medical devices is regulated by FDA. Lots of details that make a difference.

One of the modern "approaches" used by Apple and others is to NOT make sales and marketing claims about certain products that would result in a need for FDA regulation.

Here is an article that might help:

https://www.theverge.com/2020/10/7/21504023/apple-watch-ekg-blood-oxygen-fda-clearance

A large part of my professional background has had to do with developing and commercializing medical devices and equipment.

One of the companies that figures prominently in the history of pulse oximetry commercialization was called Nellcor (now part of Medtronic). I have worked with two of the three founders of that company.

In any case, sleep apnea can be very serious and folks should do their homework with respect to diagnostic and therapeutic tools and procedures to ensure optimal results.

There is a difference between "health and wellness" and medical Dx and Rx.

[Deschodt]

Instead of buying an Apple Watch which was a little expensive and took measurements every 15 seconds or so, I bought a continuous pulse oximeter on Amazon - for a lot less money - that connects to the phone and upload the info the next day. Pretty cool actually. That clearly showed that under the CPAP my oxygen was at 98% all night and my heart rate was at 60... after I yank the mask off around 5 AM, the oxygen can lower to the mid 80s in spikes and my heart rate increases to the high 90s at the same time. That is clear proof that i have sleep apnea and cpap is working well. Science FTW

[mattdavis11]

I don't feel scammed, but I don't any money in it. My dad gifted one of his old machines (Remstar Pro M series) with new accessories. I have to calibrate the machine though. As it is now, it's difficult to exhale. I'm comfortable with the mask, and do feel better in the morning when I wear it, but I sometimes I forget to put it back on when I get up to take a piss.

[Mahler9th]

l believe that it is always best to have trained professionals determine settings for CPAP. DME businesses sell them and supplies. My wife's DME only sells sleep apnea equipment and supplies. Nursing background. She trains on the use of the machine. The doctor designs the settings based on the results of sleep tests.

Her husband is an ENT with a PhD in physiology-- specializes in DX and RX of sleep disorders and has sleep apnea himself.

Untreated long term severe sleep apnea can lead to all kinds of medical issues that folks may not realize could be related. And can substantially shorten life expectancy.

Again, be careful with OTC pulse ox. If I were to buy one, I'd look at something made by Nonin. They have both OTC products and regulated medical products. When I looked back about 10 years ago, the only difference between some of their OTC and prescription products was (regulatory) labeling.

[wdfifteen]

Originally Posted by Mahler9th

l believe that it is always best to have trained professionals determine settings for CPAP.

+1
I'm on medicare, so cost isn't a big issue, but the machine I have now uploads data to the mother ship and my doc can see how it's working and adjust the machine from her computer. I don't have any problems.
If you have an older machine, I think there are web sites out there that tell you how to adjust the settings on them.

[PorscheGAL]

Your wife says you are having apnea. No matter what you think of the risk of scam, she is telling you it is an issue and she is scared for you. Wear the CPAP.

If the CPAP bothers you, consider looking into Inspire. They are having some pretty good results.

Good luck

[Deschodt]

I'm now a believer... This is the results of the pulse oxymeter measuring all night (cool little device, that).

I had the Cpap machine OFF and On at various times of night, OFF circled in Red.
With significant corresponding drops in Oxygen levels and elevated heartrate. Damn !

Can't argue with self administered science ;-) (thought that doctor still feels shady to me, always bumping up symptoms, probably to deal with insurance co). At the same time the CPAP machine - which also reports to the mothership - says I went from 41 episodes an hour to less than 1 while in use. You could say that's a measure of success too ;-)

[Tobra]

Low 80's on the oxygen sat is bad for your brain.

Originally Posted by pavulon

Not all sleep apneas are obstructive and oxygenation isn't the entire picture. If people don't breathe, not only do they run short of O2, they can't get rid of CO2 either. While oxygen supports life, CO2 accumulation can cause both acute and pernicious cascades of physiologic changes. Chronic changes take a fair bit of time and treatment to unwind.

Long story short, take the time to fully consider all issues of sleep apnea before making decisions.

^this^

Simple answer is not always the right answer

[Cajundaddy]

Sleep apnea is real and long term it has pretty serious health consequences. A CPAP does a good job of treating the symptoms but does nothing to address the causes of obstruction. No one is really focusing much on the causes of obstruction and in an ideal world the CPAP should be a temporary solution while a long term remedy is developed. The Mayo clinic has a pretty thorough read on OSA and it is a worthy read. https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631

The bottom line: 90% of those on CPAP have a BMI greater than 25. Smoking and excess alcohol are also contributing factors. These are all lifestyle issues so if you want to get off the machine, you have a very good chance by simply improving Overall fitness. Docs rarely have these conversations with their patients.