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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Chris O on September 3, 2012, at 20:47:58
Just curious if anyone on these boards is using and benefiting from a CPAP machine (for sleep apnea). I was recently diagnosed with moderate sleep apnea (25 wakings per hour). I'm two months into CPAP use, and don't feel it's working much, if at all. I've upped the pressure twice after a titration study. Basically, I feel like I am awake the whole night when I use the machine. I don't feel paranoid about using it. I just wish it would work and I would sleep for significant periods with the machine on. I also have many sleep interruptions due to anxiety, but the sleep doctor says most of my events in the study where of the airway, not brain-based, type. Anyway, just curious about others' experience with this machine and if it had alleviated symptoms of anxiety/depression.
Thanks,
Chris
Posted by 10derheart on September 3, 2012, at 23:22:14
In reply to Anyone using/benefiting from CPAP?, posted by Chris O on September 3, 2012, at 20:47:58
Not me, but there is a poster....Eric who wrote he was helped a LOT by CPAP.
Posted under LostBoyinNC or LostBoyinNCReturns, I think.
Here's one of his posts:
Posted by viking on September 4, 2012, at 9:38:57
In reply to Anyone using/benefiting from CPAP?, posted by Chris O on September 3, 2012, at 20:47:58
I have been using a CPAP machine for the last 9 months.
I had severe problems in the beginning with falling asleep and often lay awake for the whole night (or at least felt so). The problem was not solved until my doc prescribed time-release Melatonin (Circadin). This made me sleep all night, at least for some time. This is to my knowledge the only sleep med that can be used when you have sleep apnea.
Another problem was that the mask did not fit properly. It must be comfortable without leaking.
I don't think upping the pressure is a good idea until you have learned to sleep with the machine.
Once I learned to sleep with the machine I experienced a dramatic improvement in my daytime fatigue. It also improved my mood. I can't say anything about anxiety as that was not my reason for treatment.
I hope this can help you.
brgds
viking
Posted by phidippus on September 4, 2012, at 16:43:10
In reply to Anyone using/benefiting from CPAP?, posted by Chris O on September 3, 2012, at 20:47:58
Your machine ain't right or your mask doesn't fit you right. Or the breathing the machine is doing is triggering anxiety. You may need BIPAP. I've been on BIPAP for several years and sleep like a baby for the most part. I had benefits to my mood, but not my anxiety(it would make my anxiety worse).
Eric
Posted by Chris O on September 4, 2012, at 23:52:13
In reply to Re: Anyone using/benefiting from CPAP? » Chris O, posted by 10derheart on September 3, 2012, at 23:22:14
10derhart:
Thanks for that reference!
Chris
Posted by Chris O on September 4, 2012, at 23:53:55
In reply to Re: Anyone using/benefiting from CPAP?, posted by viking on September 4, 2012, at 9:38:57
Viking:
Well, perhaps I'll try melatonin with the CPAP. I've tried it before alone and it didn't help me sleep much. The mask, I think it's okay. I had the nose one first, and kept opening my mouth. So, I have the one that fits over mouth and nose. It seems to work okay, though I sometimes still push my mouth out of it. I've already upped the pressure from 10 to 12. I'll just keep trying and see how it goes, I guess.
Chris
Posted by Chris O on September 4, 2012, at 23:57:28
In reply to Re: Anyone using/benefiting from CPAP? » Chris O, posted by phidippus on September 4, 2012, at 16:43:10
Eric:
Thanks for sharing that. I'm not sure if I need BIPAP. It's good to hear that it works for you. I would love to have just one night of sleep more than an hour or two at a time. I'm pretty messed up all around right now. I'll let you know how it goes if I improve. I'll respond to your medication list when I have more time. (I'm a "lifer" when it comes to anxiety/depression. Looking back, I cannot remember ever not having to deal with these feelings. My mom had many mental health issues growing up, grew up in a seriously alcoholic family. Brain damage (me and her), I think.) Hey, appreciate the feedback.
Chris
Posted by jane d on September 5, 2012, at 3:14:58
In reply to Anyone using/benefiting from CPAP?, posted by Chris O on September 3, 2012, at 20:47:58
> Just curious if anyone on these boards is using and benefiting from a CPAP machine (for sleep apnea). I was recently diagnosed with moderate sleep apnea (25 wakings per hour). I'm two months into CPAP use, and don't feel it's working much, if at all. I've upped the pressure twice after a titration study. Basically, I feel like I am awake the whole night when I use the machine. I don't feel paranoid about using it. I just wish it would work and I would sleep for significant periods with the machine on. I also have many sleep interruptions due to anxiety, but the sleep doctor says most of my events in the study where of the airway, not brain-based, type. Anyway, just curious about others' experience with this machine and if it had alleviated symptoms of anxiety/depression.
>
> Thanks,
> ChrisI use one. I don't think there's ever been a detailed discussion here about it. Some posters have posted that it helps them (google poster noa here about 10 years ago).
Could you give a little more detail. Just how much are you sleeping each night? Is it different from before you started treatment? How often are you using the cpap machine? Why did you raise your pressure and from what to what? (It's a little unusual to be raising your pressure at this point.) Do you have a professional helping you adjust?
It's possible the cpap machine is successfully treating your apnea but waking you up for another reason negating the benefit. Another possibility is that it is working just fine but you are waking up for some other reason such as anxiety. That probably wouldn't have shown up in your sleep study. Both can be dealt with.
Now for the testimonial part. Personally the cpap was not a miracle cure for my depression. I did start sleeping through the night almost immediately. It probably helped fatigue a bit. I think if I'd started it earlier it might have made it easier to measure my response to different medications which was confused since I seem to have had fatigue both from apnea and from depression. I believe, but can never prove, that after years of use I'm probably less unhealthy than I would otherwise be in terms of things like blood pressure and glucose levels.
Posted by Chris O on September 6, 2012, at 16:02:43
In reply to Re: Anyone using/benefiting from CPAP? » Chris O, posted by jane d on September 5, 2012, at 3:14:58
Jane:
Great to hear CPAP helps you sleep through the night. There is hope! For me, it's just not happening. I'll answer your individual questions below.
"Just how much are you sleeping each night?"
I don't sleep for more than 1 to 2 hour blocks at one time. So, I'll fall asleep (fitfully) for 1 to 2 hours and wakeup. Then, I'll repeat the same thing three or four more times. This pattern has been going on for a really long time, 10 to 15 years at least.
"Is it different from before you started treatment?"
Yeah, that's tough to answer. In some ways, I think the CPAP is working. For instance, I sometimes feel less headachy or less out of it even if I sleep fitfully all night on CPAP. But I'm just not sure how different this is than sleeping without the CPAP. The CPAP hasn't allowed me to sleep steadily for many hours in a row, so I don't know if it's really helping. And when I sleep without it, I might feel like I am asleep more, but then when I get up, I feel completely crappy, like I have barely slept at all.
"Why did I raise my pressure, etc.?"
Well, they put me at a pressure of 10 (with a plus or minus 2 prescription if necessary) after the test. The doctor said that was just an average pressure number for most people. I tried it for about three weeks and felt like I kept waking up all the time, so went up to 11. Another 3 weeks the same, so I went up to 12. Also, I did the titration study in between. It showed my ideal pressure as 11 (with 95% clearance, or something like that), and 12 as 100% clearance. Yes, a professional did the adjustments for me.
"...waking for another reason such as anxiety."
Perhaps this is the case. I have a very severe anxiety disorder. It's a kind of chronic worry, PTSD, GAD, and depression combined. It's mostly from my mother, my family. It's a lifelong condition as I was raised by someone who was mentally ill. I'm off medication now, after many SSRI failures. I will probably try a TCA or Nardil in the coming weeks.
I'd like the CPAP to work. I was thinking of asking for an in hospital study (if it's possible, probably not with my insurance) so that they could watch me and see what's going on. It just seems like such an effort asking for these things. Even when I have insurance and get treatment, little changes.
Thanks for responding.
Chris
Posted by TemporarilyBob on September 6, 2012, at 22:53:33
In reply to Anyone using/benefiting from CPAP?, posted by Chris O on September 3, 2012, at 20:47:58
When I had my first sleep study, I averaged over 60 disturbances an hour, including one incident where I stopped breathing for over a minute. There is NO way I could consciously hold my breath that long! My blood oxygen dropped as low as 68% during the evening. CPAP wound up working wonders for me. Prior to it, I would have "sleep attacks," kinda like narcolepsy, where you just fall asleep in the middle of the day but I usually had about 10 seconds warning. It did take some time to adjust and, fortunately, I was never one for tossing and turning -- I always slept flat on my back, which helps considerably. If you do toss and turn, try blocking your head upright with pillows on either side, or even block the sides of your body to keep you from rolling.
The thing that helped me the most, and the thing that was the hardest to achieve, was losing about 60lbs, about 20-25% of my max body weight. I've had no need for CPAP ever since.
(my quick weight loss secret? PTSD. Sorry, I don't recommend it for even my worst enemies!)
Posted by Chris O on September 8, 2012, at 11:43:37
In reply to Re: Anyone using/benefiting from CPAP? » Chris O, posted by TemporarilyBob on September 6, 2012, at 22:53:33
Bob:
Thanks for responding. That's great that you treated your apnea with weight loss. I'm not sure if I can do that. I'm 6' 1", weigh about 190 now. I was closer to 200 lbs when I had the sleep study a few months ago. It said I was waking 25 times an hour. (Also had a study eleven years ago at about the same weight, said I was waking 10 times an hour, so things are getting worse.) But even though I did lose some weight since my sleep study a few months ago (I skirt the mid-180s on the scale in the morning), I don't notice much difference. Maybe if I weighed 170, like I did in my 20s (45 now). Also, my anxiety level is considerably high, so much so that I am not working. I function, but at a low level. It's possible that if my anxiety/depression were sufficiently treated, I'd get some relief. Of course, that would likely involve gaining more psycho-pharmaceutical weight back. (Lovely! Thanks, mom, for your completely humiliating dysfunction.) Anyway, I too have been diagnosed on the PTSD axis, though it hasn't helped me lose weight. Guess we're all different in that respect. Thanks for sharing, man.
Chris
Posted by TemporarilyBob on September 8, 2012, at 12:46:35
In reply to Re: Anyone using/benefiting from CPAP? » TemporarilyBob, posted by Chris O on September 8, 2012, at 11:43:37
I must have forgotten to confirm my response ... Oh well, here we go again....
Chris, it does sound from what you said that weight loss is totally out of the question for you. But don't put the cart before the horse. I don't think you're indicating that your mental issues are the cause of your apnea and even given that, maybe they are. But the specialist I worked with always told me that structural problems in the airway could give someone rail-thin apnea. He wouldn't consider any surgical options until I had returned to a decent BMI, and it sounds like that is where you are.
Are you seeing your family doctor for your apnea or a specialist? An otolaryngologist would know what measures could be taken. I know there are even out-patient laser procedures that could provide the relief you need. It seems to me that CPAP is most effective for people like I was where fatty tissues created the airflow obstructions and so could be kept in place with the high air pressure CPAP provides; which given your weight might explain why it is ineffective for you.
I don't know your insurance situation, so I can't even guess if any such procedure would be covered. But it sounds to me like you need to be seeing a specialist, if you are not already. The otolaryngologist who helped me is somewhat of an expert in the area of apnea's affects on mental functioning, and from what he told me time and again improving your apnea will improve your mental condition. The brain simply isn't meant to function well with your blood oxygen below 95%. It truly can be a life threatening condition, so you need to seek out the best, most specialized care you can.
Posted by Novelagent on September 13, 2012, at 15:01:44
In reply to Re: Anyone using/benefiting from CPAP? » jane d, posted by Chris O on September 6, 2012, at 16:02:43
You can try switching to biPAP if you haven't already, but usually, when you don't notice a night-and-day difference with CPAP, it's because your sleep apnea index wasn't high enough to be anything to notice a betterment from.
I had an apnea index of 4, and saw a hospital research doc that saw everything as a vague manifestation of sleep apnea. He didn't tell me 4 meant borderline apnea, and that most people have a 4 or so, certainly some apnea is natural.
Instead, I tried all his stupid adjustments and machine switches and did a overnight sleep study. He was convinced borderline apnea caused ADHD. He's wrong. It turns out, I was sleepy because I had atypical depression, and after taking selegiline (now sold as emsam) along with DLPA, I no longer felt tired at all.
Over prolonged use of CPAP, you will wake up when you don't breathe for the first few nights of not using it. That's because your brain needs to adjust to not using it anymore, but it goes away. I'm not so sure waking up alone is an indication of apnea. What's your apnea index? If it's in the lower digits, I wouldn't bother with CPAP, you're not going to notice anything.
Most people have sleep apnea, one doctor said, because they don't sleep enough. I snore when I haven't slept enough, an indicator of sleep deprivation-induced apnea.
The second biggest reason: they're fat, and CPAP just becomes a crutch for being fat, along with insulin once fat people eventually get type II diabeties. I'm sympathetic to fat people, and my heart goes out to them, but if they only placed a similar level of interest and mental energy into exercising and eating healthier as much as they spent time researching sleep medicine, they wouldn't need sleep medicine.
I wish you all the best, and hope CPAP works for you. But it's not a replacement for a healthy diet and vigorous exercise (and no, walking is cute, but it doesn't shed pounds-- note thin people run, and fat people tend to walk, and notice the pattern).
I'm not saying your fat, you might not be fat. Some people might be upset I'm not using a sugar-coated term for fatness, but I think part of the reason why we have a fat epidemic is because we comfort fat people too much, and do them a disservice.
> Jane:
>
> Great to hear CPAP helps you sleep through the night. There is hope! For me, it's just not happening. I'll answer your individual questions below.
>
> "Just how much are you sleeping each night?"
>
> I don't sleep for more than 1 to 2 hour blocks at one time. So, I'll fall asleep (fitfully) for 1 to 2 hours and wakeup. Then, I'll repeat the same thing three or four more times. This pattern has been going on for a really long time, 10 to 15 years at least.
>
> "Is it different from before you started treatment?"
>
> Yeah, that's tough to answer. In some ways, I think the CPAP is working. For instance, I sometimes feel less headachy or less out of it even if I sleep fitfully all night on CPAP. But I'm just not sure how different this is than sleeping without the CPAP. The CPAP hasn't allowed me to sleep steadily for many hours in a row, so I don't know if it's really helping. And when I sleep without it, I might feel like I am asleep more, but then when I get up, I feel completely crappy, like I have barely slept at all.
>
> "Why did I raise my pressure, etc.?"
>
> Well, they put me at a pressure of 10 (with a plus or minus 2 prescription if necessary) after the test. The doctor said that was just an average pressure number for most people. I tried it for about three weeks and felt like I kept waking up all the time, so went up to 11. Another 3 weeks the same, so I went up to 12. Also, I did the titration study in between. It showed my ideal pressure as 11 (with 95% clearance, or something like that), and 12 as 100% clearance. Yes, a professional did the adjustments for me.
>
> "...waking for another reason such as anxiety."
>
> Perhaps this is the case. I have a very severe anxiety disorder. It's a kind of chronic worry, PTSD, GAD, and depression combined. It's mostly from my mother, my family. It's a lifelong condition as I was raised by someone who was mentally ill. I'm off medication now, after many SSRI failures. I will probably try a TCA or Nardil in the coming weeks.
>
> I'd like the CPAP to work. I was thinking of asking for an in hospital study (if it's possible, probably not with my insurance) so that they could watch me and see what's going on. It just seems like such an effort asking for these things. Even when I have insurance and get treatment, little changes.
>
> Thanks for responding.
>
> Chris
>
>
>
>
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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