<p>Yes, for some folks, losing weight can solve or improve apnea but for others, it doesn’t make any difference. It is worth considering for those who might benefit from losing a few pounds anyway–there are so many health benefits to be obtained from shedding unneeded weight anyway.
My brother was diagnosed with apnea but insists the doc is an idiot even tho using the CPAP showed significant improvement. He rejects the diagnosis and refusese to follow the doc’s advice & recommendations.</p>
<p>Two problems for your brother- attitude and weight. Weight issues are multifactorial and telling people to lose weight doesn’t help, even when they know they should and want to, sometimes other factors get in the way. Attitude- I guess it is his body and his choice, his problem. All of the scientific/medical knowledge in the world won’t convince people when they block it out. Wish the world was kinder to people.</p>
<p>My husband has a prescription for the testing, but won’t make the appointment. We can no longer sleep in the same room because of his sleep difficulties. The snoring is so loud as to be mind-altering, but attached to it are random periods where he stops breathing and flips himself up and down when that happens. In his case, the doctor begs him to take some weight off because this is often a problem for people who are a hundred pounds overweight. He doesn’t see it and won’t work on the problem. Until this all came to a head a couple of months ago, he swore he didn’t snore at all, till my daughter set up recording equipment. He was so shocked that he cried. But he chose to move into our finished basement rather than make the appointment or begin to work on his weight.</p>
<p>My husband (physician) is using a CPAP now for sleep apnea. I encouraged him to get tested due to the snoring. He adjusted easily (uses the nasal prong things) but even though the snoring is gone he has to sleep in another room because the contraption bothers me. </p>
<p>He says I also have sleep apnea but I am like zoos’ h. --I won’t get tested because I know I would never be able to sleep with stuff strapped on my face or that hose to tangle up with. I can’t even sleep with a necklace or earrings on because they bother me too much!</p>
<p>Thanks for all the information! Wis, I will pm you after a few days when I see how it goes. I brought home a gel nose mask and the Respironics Auto something or other with a heater/humidifier and the ramp option (ramps up the exhalation over 20 minutes to make it easier to fall asleep). I didn’t sleep all that well last night but I think it was a combination of an uncomfortable hospital-type bed, a too-warm room and the equipment. </p>
<p>I don’t know the actual results from last night, but I remember dreaming for the first time in months, and I think I feel better today. Going from 0 minutes of REM sleep to a dream is an improvement in my book. Maybe it’s all in my head, but I really don’t feel as exhausted as usual. I’m going to really give this the old college try because I want to feel better. We sleep with a fan on every night for the white noise, so I don’t think the machine noise will bother us as much as it might others.</p>
<p>The CPAP machine is the greatest medical invention since disposable needles.</p>
<p>It cures snoring and eliminates morning headaches.</p>
<p>There are several styles of mask available. Experiment to get one you like.</p>
<p>Wife tried CPAP twice (lot better masks the 2nd time), and never could get use to it. Fairly typical.</p>
<p>There is also a mouth piece that is available (vs. the machine). It is like a mouth guard that athletes wear. Except, the top and bottom molds are separated. They then offset the bottom teeth to force them forward. A slight adjustment (1/4"?) helps with snoring, and a larger adjustment can help with apnea. Forcing the lower jaw forward helps open the airway. Note: Not for people with TMJ.</p>
<p>Putting up with the inconveniences is a mind over matter thing- you have to figure the results are worth it. They are. Like clear vision with glasses/contacts despite needing to get used to them. Not like wearing jewelry- many happily married people don’t wear their wedding bands because they dislike the feel.</p>
<p>Ah- the sleep lab. All wired up and you have to go to the bathroom- they have to disconnect the monitor hookup and CPAP tubing, make sure you’re set up when you return. I learned that sleep apnea disrupts the normal antidiuresis effect sleeping has, no wonder I was always getting up several times a night, plus my habit of going whenever I woke up- developed from being a former childhood bedwetter. As you can tell from the timing of my post I am also a nightowl, they expect people to come by 10 pm and settle down- not 2 am- it’s hard to fall asleep when you have a different body clock. That’s called poor sleep hygiene, guilty. No reason to be up in the morning, easier to stay up and surf or read/watch tv… than to get up early to do it.</p>
<p>For those trying to persuade other people to deal with both the sleep apnea and weight issues- ignore the weight and work on the sleep. Easier to handle one problem at a time. May be more inclined to lose weight if they feel better after sleeping better. If not, at least the health benefits of CPAP are realized. Sometimes it is easier to do nothing when it seems as though there are an overwhelming number of things one should do. Just picking one thing can be manageable. Show them this thread- they may feel like they are more normal, or at least in good company (I’ve never been considered normal…).</p>
<p>I agree – it really strains our heart and entire body when we deprive it of O2 and/or sleep. I use supplemental O2 for altitude and flying tho it’s HUGELY inconvenient and expensive because I want to keep my heart and brain working as well and long as possible–I “feel” fine but having my oxygen levels drop below where they should be is a strain on the body. It really does make our bodies work much harder than they should when we don’t use the equipment designed to help us. Similar reasoning applies to CPAP and other medical devices for sleep apnea and other conditions.</p>
<p>I woke up twice in the night with water running out of the mask down my face. The first time was after sleeping about 45 minutes. Took an hour to get back to sleep. The second time I had slept about 2.5 hours. I gave up and will just go to work very early. I’ve done some online research and may spring for heated tubing if it will help. We sleep in a cold room in the winter (and would in the summer if we could afford the electric bill), and I understand that’s part of the problem. After the first incident I put the hose under the covers with me, as I had been instructed, but the mask still got so full of water it ran out. Any suggestions beyond turning up the heating?</p>
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<p>CPAP is definitely the gold standard, but for those with compliance issues, a high quality oral appliance like the [Somnomed](<a href=“http://www.somnomed.com/cpap-mas.html”>http://www.somnomed.com/cpap-mas.html</a>) can be quite effective. With this particular device, the amount of lower jaw advancement can be titrated with a home sleep monitor (rather than continually going back to the sleep center). As operadad said, it can cause or exacerbate TMJ or bite problems, but the appliance can be specially modified to try to control this. Since OSA is a pretty serious problem, sometimes the trade-off is worthwhile. The device is fitted by a dentist and may be covered by medical insurance.</p>
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<p>I’m a BiPAP user. Or trying to be…I’ve only had it for a week or two and am having problems adjusting to it.</p>
<p>For some people, it is great. I couldn’t tolerate CPAP at all during my titration study, and I’m still unable to sleep for long blocks of time with the BiPAP most nights. I am hoping that if I keep wearing it for short periods each night I will get used to it enough to sleep properly with it.</p>
<p>I suggest the Sleep Apnea Support Forum for your CPAP questions: [Sleep</a> Apnea Support Forum Index](<a href=“http://www.apneasupport.org/index.php]Sleep”>http://www.apneasupport.org/index.php)</p>
<p>It’s been 5 days and I am definitely sleeping better. I slept 10 hours last night without waking up, and my mouth wasn’t completely dried out like it used to be every morning. </p>
<p>The only issue is that the top of my nose is a little sore and red from the mask. I tried a band-aid at the recommendation of the equipment guy, but it didn’t help. I’ll check out the forum above.</p>
<p>Thanks for all the support.</p>
<p>Turn down the machine humidity if you get condensation in the tube- I vary mine from summer to winter. Watch out for sores/broken skin- I ended up with a staff infection needing oral antbiotics on the bridge of my nose, despite using moleskin padding- I never could get the mask fit well without a lot of pressure on my nose (face shape). The nasal type solved my problems. You may need to change masks or at least get how you’re wearing it checked out.</p>
<p>As some one who works in the insurance industry, DO NOT talk to your doctor about it UNLESS you are going to follow through with the testing AND the treatment.</p>
<p>I have people who light heartedly mention it to their doctor, the physician usually documents this and then if you never test, you have a recommendation for testing on your records with which you did not comply and you are frequently uninsurable, at least for competitive rates, and considered non-compliant.</p>
<p>Same goes for flouting the recommendation. It has been a real problem for some people who did not think it was any big deal to talk about it, then not follow through.</p>
<p>Very interesting somemom.</p>
<p>My husband has had a CPAP for several years and also has to use oxygen with it. If you think the CPAP is noisy try having an oxygen compressor going all night!! He very nearly died 5 years ago from blood clots that permanently damaged his heart and lungs. The specialists said the sleep apnea could have been a contributing factor to the blood clot problems. Wish we had had him tested and on the CPAP before so much damage was done.</p>
<p>After the first few months when it was determined he would be on the CPAP permanently our insurance bought it instead of renting it. Just for laughs try talking while it is on. Well, it will make everyone else laugh anyway :D</p>
<p>My 18 yo son was diagnosed with sleep apnea a year ago or so. He grew from 5’3" when he entered HS to at least 6’4" when he graduated. He was exhausted until he got the CPAP machine, which helped somewhat, but he couldn’t use it if he had a cold or flu and didn’t work if he rolled the wrong way. But, the CPAP never left him well-rested, just not a complete zombie. He gained weight eating to stay away and took Provigil or herbal supplements to stay awake during his last year of HS. </p>
<p>We found a dentist who appears to be the sleep apnea guru among dentists. She looked at my son and said she wouldn’t prescribe a dental device. She gave us the clearest description of the problem and gave us the names of three surgeons in the Boston area. One is the Mass General Guru of mandibular/maxillary advancement surgery, in which they break the upper and lower (usually) jaw in 4 (?) places, slide it forward to open up the airways and put in plates. Liquid diet for weeks. He has a hammer and he will tell you if you are a nail. This is called Stanford Protocol 2, and it has a pretty high success rate (can’t remember, 80% or higher) for the right patients, but it is brutal. She strongly recommended another who is at BU, who looks carefully at the physiology of each patient and does a series of procedures tied to the particular endowment of body parts the patient has. The lesser procedures are called Stanford Protocol 1 and have a much lower probability of success if done individually. For example, they might trim the Uvula and palate (called a UPPP). This has between a 30% and 50% probability of success and then there is slippage over time. However, what the BU doc has done is to do a bunch of procedures that really open the airwaves and has a much higher success rate (e.g., 75% with an average patient and much higher with a good one.)</p>
<p>My son really like this doc and his ENT counterpart and had the surgery in mid-January. There were seven (read them and weep for him) procedures: UPPP, tonsillectomy, turbinectomy (to open the sinuses), septoplasty, hyoid suspension (a critical one in which they move a bone near the Adams Apple forward to pull forward the back of the tongue, which relates to his problem of tongue blocking the airway when he sleeps), a genioglossus advancement (in which they pull out and rotate 90 degrees a bone in the chin that is connected to all of the muscles in the back of the tongue to pull the tongue forward). There are studies that show much higher success rates with when the hyoid suspension is done with other procedures (search for someone named Scher). They took out his wisdom teeth while they were there. The first two weeks of recovery were absolutely awful (lots of pain) and it was tough to get him off Oxycontin. The third week was no picnic. But, we’re in week 5, I think, and he did several college interviews, is going to the gym every night. Every other day, he has more energy than he has had in a long time (better than after a good CPAP night). The next day he is tired. His sleep is silent. No snoring at all.</p>
<p>We won’t know whether and how successful the surgery was until the summer when his tissue is calmed down enough to do a sleep study. You can have sleep apnea with no snoring, though it is a lot less likely. The docs are thrilled with their handywork. He also had a small number of Central Sleep Apneas, though the ENT says that studies suggest that you are more likely to have CSA when you are having OSAs as the body seems to get used to having too much Carbon Dioxide around.</p>
<p>He also saw a medical doctor/acupuncturist who is affiliated with Mass General. He suggested that my son postpone the surgery for 3 months as he though he could prevent the apnea. His treatments did help. But, my son had been told repeatedly that this was only going to get worse. So, he decided to have the surgery during this, his gap year, and do all of the treatments and exercises prescribed by the acupuncturist to increase the likelihood of success.</p>
<p>So, all signs go at the moment, but no definitive short-run or long-run answers.</p>
<p>Well, I am glad that the OP is getting some relief from the CPAP. When it works, it seems to work great and is worth getting used to it.</p>
<p>I didn’t even want to come into this thread because sleep apnea has been a problem in our house for 5 years. DH is on provigil, but is over the recommended dose. Tried CPAP and BIPAP faithfully for 2 weeks each at least, with sleeping pills, without sleeping pills and just about every combination of mask thing. Didn’t really help. In fact I thought it made him worse. </p>
<p>Post 27 mentioned about the mouth piece thing. I thought it helped H, but he was not sure and then found out that it would shift his teeth and got worried about it so gave it up. </p>
<p>OP asked about surgery and no one chimed in on that so here is what my H did.</p>
<p>First, H is a bit overweight 15 to 30 lbs I’d guess. And he does not snore and never did, but the sleep studies claim obstructive sleep apnea.</p>
<p>First up, tonsils out, deviated septum straightened, turbanents (sp??) reduced. Some improvement. Yay, but not a ton.</p>
<p>Next up more tries with CPAP. no help</p>
<p>Next up, uvula reduction, soft palette reduction, and tongue advancement (they pull the part of the tongue that connects to the chin further out by cutting a hole in the chin bone around the tissue and screwing the bone cut out piece to the outside of the chin bone . Gives you a more prominent chin if you wanted one. …no help</p>
<p>Next up, tongue reduction by RFI, basically microwaving the back of your tongue to cause internal scarring which reduces the size of the tongue in the throat. Takes many treatments which hurt every time. But they want scarred tongue, not fried tongue so collect the amps slowly. Didn’t seem to be helping and didn’t finish treatments.</p>
<p>Next up … the BIG surgery. The one they recommended at first, but he was trying to avoid. Bimaxial expansion or something like that. Basically they cut your jaws, top and bottom and move the whole muzzle forward. Makes more room in the throat. Takes 6 weeks of not chewing, semi liquid diet. Jury still out on if it helped or not, but he is starting to chew again. I don’t think it is going to help that much because the Dr. said people usually get immediate relief when it does help although some people need to get used to it. </p>
<p>After turbanents and tonsils were fixed, I didn’t think H had obstruction, but had some neurological problem. Maybe Chiari … </p>
<p>But for those interested in the big surgery, for your sake get the best surgeon possible. Many surgeons can’t save the nerves in the jaw and so you lose all feeling around your mouth. One of the other Dr.s said that he’d only go to about 3 surgeons in the US for this procedure. Fortunately we live near Stanford and one of the surgeons is there. </p>
<p>I wished the CPAP would have worked.</p>
<p>We have, however, met the 7.5% medical expenses to take a deduction for the first time ever…</p>
<p>Oh my goodness. Sounds like torture! I really hope it has worked.</p>