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Questions from a Newbie - CPAP treatment (Long beware)

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Albulak +0 points · over 7 years ago Original Poster

Hello ladies and gentlemen, I am writing all the way from Turkey here. I am an obese guy, I've been obese my whole life and it had enforced some limitations over the quality of my life. It's the type of thing that forces you to make decisions you'd not normally make, or settle for much less, or ... or ... or you can imagine how far this goes on.

I made such an introduction because for a while now I was under the influence that my life quality wasn't great due to my weight, feeling tired, waking up tired. However my father had started using a CPAP machine few months ago. We do not live together but I had an idea or two about what sleep apnea was. I thought I may have had this problem but didn't really bother much with it. I wasn't well informed at the time and I figured that I can sleep the entire night and not die or wake up from my sleep due to this problem.

However about 6 months ago I started to work for the first time in my life. I'd wake up in the morning, go to work and return home around 6 pm. I could play a game or two on my computer and then find myself falling asleep. During work after eating lunch I'd get extremely sleepy, to the point of falling asleep. (Would've been nice if I didn't snore, so I wasn't able to get away with it.) I also had this issue that if I drove my car for 1 hour or more my eyes would start to get heavier, and I'd be extremely sleepy. Yet if I switched my seat, got off the driver role to a passenger, that sleep would just disappear and I can stay awake for hours.

After going over my overall energy level, how I do not wake up feeling energized instead feeling tired... I decided to tackle this issue head on. I made my research, talked to my father. He didn't believe it because I am quite young (31). So I convinced him to sponsor my sleep study. As I expected It turned out that I had sleep apnea. (It's written in Turkish so I'm not fairly sure how to translate it properly) Two things were written on it;

  1. Uyku Apne + Obezite Hipventilasyon Sendromu. (Blimey, I can actually translate the first one. It says Sleep Apnea 1.)

So from Sleep Apnea 1 I get the idea that it is Severe Sleep Apnea + OHS (Obese Hyperventilation Syndrome or somesuch) I'm not a USA citizen so I'm unsure how things go over there. But basically I paid around 400$ for the first sleep test. Only 30$ was covered by my Goverment's insurance. The Doctor who forwarded me to the sleep test insisted that one side of my nose is blocked and I need surgery. The hospital I went to also was famos for its aesthetic surgeries. So I was wary of it and so was my parents. It may have simply been a way to get some more money off of me.

My uncle is a doctor and we e-mailed him the results of the first sleep test. He basically said, if you can breathe with your mouth closed then you don't need the surgery. He told me to get a CPAP titration study and I had it last night. The guy who did the test comes from a place who also supplies a particular brand of sleep apnea machines. (Not the brand I'm looking to buy)

I realize I've written a lot and you are all wondering where I am going with this, so I'll try to summarize even more: I was fine with the tests really. At first it felt like I couldn't breathe but then I tried to mediate even though I never meditate. I mean as long as I do not really do tasks that require faster heart beating, I shouldn't have to breathe deeply. Once I was able to convince myself I don't need to breathe deep, I was able to breathe fine.

The mask was a bit rough on my face, its outline was pressing too hard against my face so it got a bit uncomfortable. I just assumed it was strap tough to make sure no air got out. I normally breathe with my mouth so for 10-20 minutes it was a bit hard not to open my mouth but somehow I managed it. It feels like if I opened my mouth it can screw up the entire test (I have a feeling it doesn't as long as it is a 1 or 2 time fluke)

The mask was only covering my nose, it wasn't the full head mask that covers up the mouth. The other irritating thing was while I Was breathing the breathing itself was making annoying whistling as if my nose was full which it wasn't. The guy said it came from the holes where I exhale the carbondioxyde.

I had the sleep test last night, it felt like a great sleep. Although I wasn't full sure of it either. The guy came at 12 pm, 2 hours late and woke me up at 5:30 am. So it lasted around 5 hours. I was still quite sleepy when he woke me up, also it didn't seem like it took a lot for me to wake up when he called for me. Was I not sleeping heavy enough? He said he had handled my issues at being unable to breathe.

So by now you should have an idea about me. 31 years old male,1.83 meters (6 feet height), 165 kg(363 pounds) My questions are;

1- This tight mask thing. I hear that there are many masks out there that I can buy, are they all to tough on your face? I'm not talking about the humidity, just the sheer pressure it makes on your face.

2- Is there a mask or way to take care of those whistling noises coming from the mask whenever breathe and exhale?

The sleep was good but since it was only 5 hours I found myself desiring to sleep more. Yet may it be mental or physical, I felt more energetic today. I've been thinking of this CPAP or BPAP machine much like a magic wand that will fix most of my problems. However when I fell asleep at work today it made me somewhat sad.

3- Does the first test night's sleep matter at all? Like would we see obvious change the next day? Am I feeling more energetic psychologically?

4- How long does it take for CPAP treatment to show itself?

5- Being an obese guy the person who did the test kept saying CPAP would be too weak for you, you need BPAP. However since their company is also the provider of a BPAP machine it made me question his sincerety. Would CPAP be just as fine for patients with OHS?

6- Will CPAP treatment mean that I can finally drive my car for hours without falling asleep? Despite waking up and having to feel energetic?

7- I've read on internet that the CPAP treatment causes obese people to lose weight by burning the calories the body is supposed to. I'd love NOTHING more than a magic wand making me thin, but we all know it's a fairy tale. Can this machine actually get me to lose weight? Even if limited I'd take it.

Thanks a lot for sparing your time. I just want to regain some control of my life and my health. If I can muster some energy from a proper sleep to be able to work out after work, maybe I can finally do some exercises to lose weight.



Edit: I'm sorry I totally forgot to input the results from my first tests. My arousal was not examined/observed, I guess the Muslim community doesn't think it's a good idea to monitor that aspect of the sleep apnea. Also my heart rate was nonexistant. Who needs a heart anyways huh?

Well those two lacking parts aside I'll give these information; The recording lasted 5:01:23

Total sleeping time: 05:01:04

Total Sleep time: 4:46.5

Sleep activity(%): 77.6

Times woke up: 14

Latench for Falling asleep: 23 minutes

Rem Latans(Not sure what latans is but it is in minutes) 128.5

Being awake during sleep period 58.5 minutes

Rem Phase - 33 minutes (11.5% Of the entire sleep time)

Phase 1 - 65 minutes (22.7% Of the entire sleep time)

Phase 2 - 100 minutes (34.9% Of the entire sleep time)

Phase 3 - 88.5 minutes (30.9% Of the entire sleep time)

There is a diagram below it, seems like I keep trying to reach REM but I fail.

SaO2 Percentage while Awake: 93%

Lowest SaO2 rate: 61%

Average Sa02 Desaturation: 4%

Lowest SaO2 Rate: Rem Supin 0, Rem Non-Supin 61, Non-Rem Supin 91, Non-Rem Non-Supin 81, During sleep time 61.

Average Lowest SaO2: Rem Supin 0, Rem Non-Supin 81, Non-Rem Supin 91, Non-Rem Non-Supin 92, During sleep time 91.

There are few more stuff like the Hypopne or something. I guess it isn't really relevant to my questions and I'm too lazy to translate it all :D

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DanM +0 points · over 7 years ago Sleep Enthusiast Support Team

Hi Omer, and welcome to MyApnea.Org. I am happy to hear that you were persistent with your concerns and have received testing and treatment. It sounds like you possibly received 2 diagnoses: Obstructive sleep apnea and Obesity Hypoventilation Syndrome. I will try to answer your questions as best I can.

  1. There are many mask brands and styles available for purchase. The comfort of each mask is specific to how well the mask fits your face. If the company that is selling you a mask has options, you should try several of them on and see what type feels best. All masks usually take time to get used to, and there is some amount of pressure on the face when wearing a mask. However, a mask should not be so tight that it causes skin problems. The mask should be snug enough to prevent significant air leak.

  2. Each mask style will sound different because the holes that allow exhalation of carbon dioxide are going to be made differently on each mask. This is another thing to consider as you try different masks. How comfortable is the mask? Does it seal well, or is there a significant amount of mask leak? How much noise do you hear and will that noise disturb your sleep? If possible, you should try various masks on and wear them in the same position as you normally like to sleep.

  3. Some people experience a change after their first night on CPAP. For others, it may take several weeks to notice a difference. The key is to persist and wear your treatment whenever you sleep, including when you nap.

  4. See number 3. For some people, the results of treatment are quickly noticeable, while others may not notice significant changes right away. If you continue to feel sleepy or tired after two or three weeks on treatment, I encourage you to talk to your doctor about other reasons you may be tired.

  5. Patients with OHS sometimes require treatment that is different from CPAP. Generally, all equipment providers in the US who sell CPAP also sell BiPAP. The treatment you are provided should be based on the doctor's recommendation. It is not uncommon for OHS patients to use BiPAP, but the only way to know your needs is for your doctor to review your sleep study results and to continue to follow you to make sure the prescribed treatment is working.

  6. CPAP or BiPAP treatment may improve your energy level so that you are better able to stay awake. It is not possible to say whether you will be able to drive for hours, as there may be other things that are contributing to your tiredness or sleepiness. I was originally tested for sleep apnea because I did fall asleep while driving. Thankfully, no one was injured and I woke up before causing a serious accident. I can say that my treatment with CPAP has improved my own level of fatigue, and I no longer worry about falling asleep while driving.

  7. There is evidence that CPAP can contribute to both weight loss and weight gain. This is specific to each person. For some people, weight loss occurs because they have more energy and are able to exercise and be more active. CPAP alone is not likely to cause weight loss.

As for your sleep study results, the AHI is what is usually used to gauge the severity of your sleep apnea. It does appear that you had 33 minutes of REM sleep. Hopefully, with treatment, your sleep and your blood oxygenation levels will improve. Please let us know how things progress for you, and I do encourage you to continue to be followed by the sleep doctor to make sure your conditions are treated properly. Best wishes!

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Albulak +0 points · over 7 years ago Original Poster

Hello, it appears it has been 13 days since I wrote my forum post. I'd have loved to express how the past 13 days have gone with CPAP, how my life has changed etcetra. However the machine itself isn't very cheap, and I just managed to gather the money to buy the machine. (1200$ for both the machine and mask)

I will however keep updating this thread to share my experience with my new machine as days go by.

What happened?

I did go for a second sleep study, this time with a machine. I was told to be there at worst 9:30 pm so that by 10 we'd start recording and I'd be asleep. Amusingly enough the guy who was going to be doing the sleep test on me did not arrive until 12:30. How was the test like? Many people explain how they feel like they are suffocating, cannot breathe. It's purely your brain playing tricks on you. I've had the same problem, which is only natural because you are expected to breathe out the Carbondioxyde from the very same breathing machine that supplies you with air. So there will be a pressure forcing, yet you will get the job done, even if it feels like you won't.

I felt like I had to breathe deeply, but I can't do that from my nose. I was panicking, and then I just calmed myself down. "You did not move a bit to require deep breath, you did not consume energy. Just relax, don't breathe in and out too fast. You have the air you need." I kept telling myself and soon enough I did slow down and guess what? Even though I did not need to breathe deeply, I managed to do it on my own without purpose through my nose. The key point at the sleep study with the machine is to controlling yourself, you are laying down on the bed, not running a marathon so don't freak out. Breathe like you would while typing on your keyboard.

The sleep study lasted 6 hours and I can't tell you for sure if it was a psychological affect on me or a physical one, but I was truly energetic even though being woken up at 6 AM felt bad, like I had to sleep more. Yet like I said, may it be psychological or actual physical difference, I felt like I wasn't tired. When I was talking I did not feel my body pulling me back, my legs being too heavy, instead I felt light and I was walking much faster without truly tiring myself out. Boy I missed being energetic like that.

So this was last week and I got the results. Turns out they only recorded 3 hours, I noticed that towards the morning I went into REM sleep phase and stayed fully in it until I was awakened by the guy. So after rallying the required money, and discussing with my Uncle who is apparently a doctor that oversees this type of issues... We decided to buy Philips Dream Station. It has a humidifier and applies automatic pressure based on your breathing.

I just got the machine, I'll be sleeping with it tonight. I will also be posting how I feel like, as well as any other details about my sleep quality if I can get my hands on it.

Ps: MY uncle was really mad with the results and the entire sleep test with the machine. He said 2-3 hours isn't anywhere good enough to get a decent reading from. He also mentioned that there are no pressure differences, that I slept in the same position throughout the test. The test result simply stated that my sleep issues were solved and that I should buy X named BPAP machine which conveninently enough, they are selling. Which is why you can imagine we went with a CPAP machine that has Automatic pressure.

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DanM +0 points · over 7 years ago Sleep Enthusiast Support Team

Hi Albulak. Congratulations on completing your sleep study and on finding a way to relax yourself during the process! If you purchased a machine that automatically adjusts to your breathing, the hope is that the machine will detect any respiratory issues and attempt to correct them. Monitoring your progress by looking at the data from the machine will help. You may find helpful information on doing so by searching for Sleepyhead discussions on the Forum. Many CPAP users seem to like the software because it provides detailed information on your breathing during treatment. Best wishes, and please come back and let us know how you are doing!

Please be advised that these posts may contain sensitive material or unsolicited medical advice. MyApnea does not endorse the content of these posts. The information provided on this site is not intended nor recommended as a substitute for advice from a health care professional who has evaluated you.