Sleep Apnea CPAP Compliance Craziness

November 10, 2009

One of my biggest pet peeves is how doctors use the word compliance. If a patient doesn’t comply, it usually implies it was the patient’s fault. In sleep medicine, compliance is often used to measure how well patients use their CPAP machines. But compliance is not the same thing as success.


Various studies report CPAP compliance rates at 29% to 83%. The problem is that the definition of compliance changes from study to study. More recently, we’ve adopted the new Medicare requirement for CPAP compliance, which requires that the patients use CPAP at least 70% of the time over a 30 day period, for at least 4 hours every night. Otherwise, the machine has to be returned.


If you sleep 7 hours every night, it comes to 210 total number of hours per 30 days that you’re sleeping. Seventy percent of 210 hours is 147 hours. If you sleep only 4 hours every night, then this figure drops to 88 hours, which means that you have to use your CPAP machine only 40% of the total time that you’re sleeping to be considered "compliant." This doesn’t take into consideration if you’re actually feeling better or if the machine is being used effectively. 


Since CPAP works only if you’re using it, if only 40% of people are still using CPAP regularly 5 years after beginning treatment, then the CPAP success rate is at best 40%. But not all people who use CPAP will benefit, so this figure is likely to be much lower. Many more people are likely to stop using CPAP as the years go by. 


There are many patients that are 100% compliant with CPAP, using their machines 100% of the time they are sleeping, with no leaks and a low AHI, and still feel no better. Sometimes they can even feel worse than when they don’t use CPAP.


From what I’ve seen with CPAP compliance studies or even with sleep apnea surgery studies, they all manipulate the numbers to make their results look great. In very tightly controlled research studies with frequent follow-up and intensive intervention, results are likely to be good. But in the real world, with fragmentation of care, poor follow-up and lack of patient education, true success (the patient feels much better AND the numbers show it) is disappointingly low, no matter which option you choose. 


Despite all these obstacles, there are proven ways to improve CPAP success. With a systematic and formalized education program, along  with intense counseling, follow-up, and long-term support, many more people can benefit from CPAP. Ultimately, a major part of poor CPAP compliance is due to the health care system that’s dropping the ball.


Am I being realistic or too pessimistic? Let me know what you think of this issue in the comments box below.

71 Responses to “Sleep Apnea CPAP Compliance Craziness”

  1. Sara on November 11th, 2009 2:34 am

    This response relates to CPAP treatment for UARS…

    CPAP treatment puzzles me on many levels. I “failed” at CPAP despite working up to a compliance level that thrilled my practitioner. The failure was due to the fact that I never felt better with CPAP use; in fact, I felt worse. I felt like my sleep was more interrupted by the machine, leaks, having something on my face (I am a bit claustrophobic), being “forced” to sleep on my back, getting “rained” on, etc. Eventually, I was avoiding going to bed either because I hated using the machine so much, or because I felt guilty if I did not sleep with it. I know I sound whiny, but I am not a whiny person. I am a health care provider, and typically, I am a compliant patient with a high level of tolerance and adaptability. I was exhausted after years of sleep disruption, so I was highly motivated to do something to feel better. Andy yet, I was feeling worse, so what was the motivation to use the CPAP, and is it really working if that is the case? I did have decent CPAP support when I sought it out, but that did not change the fact that I never saw any improvement. Since the CPAP treatment failed, my diagnosis was altered to include a secondary diagnosis of idiopathic hypersomnia. I was put on Provigil which made me feel great at first, and then the panic attacks set in (and as I reminded my practitioner, the Provigil was just a mask, as my body was still getting beat up by my sleep disordered breathing).

    As a result of “failing” the CPAP, I switched to a mandibular advancement device. I noted significant improvement from day one, as it allowed my tongue to clear my airway. It has changed my life. I won’t go to bed without it, resulting in 100% compliance.

    So, was CPAP the proper treatment? I was always puzzled that the CPAP treatment encouraged sleeping in supine due to the nature of having so much stuff on the face, putting me in the position that theoretically requires more intervention from the machine due to tongue collapse? I was already arousing 29 times an hour all night long and now I am supposed to sleep with this mask and hose and forced air on my claustrophobic face? It really does not make sense to me. I lost another 9 months with the CPAP. My husband has been struggling with the CPAP for 5 months with the same results; his MAD is bogged down in insurance denials/appeals.

    I have followed the blogs on SleepGuide, and I am pained by the number of people who diligently comply with significant effort and report that it took many months to feel better or still do not appreciate much improvement. And yet they battle on.

    If CPAP does not result in a patient feeling better, is it really doing the job? How long is it appropriate for a patient to use the CPAP if they are not feeling better? I was my own advocate for pursuing the MAD; none of my sleep practitioners encouraged it (an ENT did). I had become armed with knowledge through your book, Sleep Interrupted. My heart aches for those patients who don’t know the ins and outs of the healthcare world and are unable to advocate effectively for themselves (mostly because they are so exhausted and vulnerable).

    I would love to see a study that evaluates those who benefit from the MAD versus CPAP and those who benefit from CPAP versus the MAD.

    I agree 100% that education and good support would be critical in facilitating compliance. CPAP is not a simple thing.

  2. Steven Park on November 11th, 2009 4:15 am


    Thanks for your thoughtful comments. You’re absolutely right. At what point do you give up on CPAP and go on to other options? It’s clear from your story and many others I’ve seen that for some people, CPAP just doesn’t work, no matter how long you use it, even with 100% compliance. I’ve have patients with compliance data reporting optimal usage, with no leaks and a minimal AHI, and patients still don’t feel better. Some go on to dental devices and do well, and some don’t. Others try everything and only surgery is able to help them sleep better.

    You do hear about patients struggling with CPAP for 6 to 12 months and finally feeling better, but that’s rare. The vast majority just give up and get lost to follow-up. It sounds like you exhausted all your CPAP options and made the appropriate choice.

    My theory about why CPAP doesn’t help in some people is that the CPAP itself causes more arousals. In general, people with mild obstructive sleep apnea or upper airway resistance syndrome have hyperarousable nervous systems.

    I’m so glad that you didn’t give up and took the initiative to go for the oral appliance. It just goes to show that with sleep apnea, there’s no one best treatment choice. You won’t know until you try different options.

  3. Julie on February 11th, 2010 9:41 am

    Some people who are use their CPAP but feel worse than they do without may suffer from complex sleep disordered breathing where mixed obstructive & central events are seen during the CPAP titration study.  Usually, the obstructive events start resolving w/increasing CPAP pressure then the centrals appear.  I believe this was first identified at Mayo Clinic, Rochester, MN.  There are advanced BiPAP machines designed to deal w/complex sleep disordered breathing & we have had patients successful w/them.  If a patient is not tolerating CPAP, it may be beneficial to see a sleep specialist.

  4. Drew Devlin on July 19th, 2010 5:53 pm

    i would have to agree completely with Julie on her post. All to often the patient goes to the Sleep Lab for all the right reasons, diagnosised with OSA, during the titration portion they dont notice that although they have removed the Obstructive component, they have now over pressurized the patient causing what i beleive to be Central apneas.
    Although there is no significant data to show that APAP is more beneficial to the patient or does a better job, i do beleive it does make the patient more comfortable, less likely to have have leaks, there by allowing the AHI to increase.
    With the newer technologies available, even if a patient uses the unit 100 per cent of the time does not mean they are compliant due to the air leaks.
    further follow up and review of the technical portion of the machine needs to be investigated.
    I also agree that the BI Level maybe an alternative to these patients that continue to have arousals. the pressure of CPAP is usually only needed to over come the resistance of the obstruction and that during the expiratory phase the patient has an increased arousal due to the difficulties of exhaling against the significant pressure.
    the ASV unit has show to be very significant in the treatment of patients with central sleep apnea and should be considered more frequently

  5. Nalani Santiago-Kalmanson, RPSGT on November 29th, 2010 10:43 am

    As a patient myself, first, and professional second, I must bring up my own experience with sleep disorder diagnostics. There are approximately 77 named sleep disorders, most of which all have overlapping symptoms. It is far more probable that someone has multiple sleep disorders than not. This could be one reason that CPAP users find little to no relief in their symptoms even at 100% compliance. This was certainly the case for me.

    I was diagnosed with Moderate OSA, AHI was 27. Started PAP therapy and had zero relief of symptoms. Since the DME company, or my physician, never followed up with me to see how I was doing… after 2 months suffering on CPAP & losing my job (hence lost insurance), I gave up & stopped using it entirely.

    4 years later I had a complete breakdown, released from my job & was told I had some severe Personality Disorders. I knew they were wrong. My new MD was smart & kind enough to listen to me & worked with me to figure it all out. Ends up – I have narcolepsy with cataplexy… and all the signs & symptoms were there at my 1st study 4yrs earlier. Another round of intensive psych testing, after starting treatment for both OSA & narcolepsy, showed no signs of Personality Disorder… I’d simply been extremely sleep deprived.

    I tell every patient I set up with CPAP that if they feel little to no improvement while using PAP therapy after nightly use for 1 month – to call me & or their sleep specialist immediately – but do not stop using CPAP until told by their MD to discontinue. I let them know it’s possible to have more than 1 sleep disorder & the only way to test for more – is to know that the 1st one is treated, without doubt. And most importantly, I assure them that I am on their side to help guide them through this process – their friend, coach, cheerleader or drill sergeant – whatever they need to keep up with treatment, and then I stand by that statement. Basically – I am for my patients, what I wished someone had been for me.

  6. Benefits of Sleep Apnea Dental Appliances: The Main Pros and Cons | Apnea Treatment Center on June 16th, 2011 2:08 pm

    […] its popularity and high success rate, though, there are still thousands of sleep apnea patients who remain dissatisfied with CPAP therapy and are happier when their doctors recommend dental appliances for getting relief from apnea […]

  7. Cat on February 28th, 2012 9:50 am

    I have been using the cpap machine for over a year. I’m being forced to use it to keep my job. Being a truck driver I have to have 70% compliance on the cpap or I am not allowed to drive. The difficulty I have is I am exhausted after wearing the mask. I get so tired I have to nap during the day, without my mask, and after that two hours I feel so much better! Drivers that are regulated by DOT standards and diagnosed with sleep apnea must meet the compliance of 70% or will be denied a physical card that is required to drive. I am more of a danger now I’m so tired and more cranky, definite mood changes. After reading this article I’m hopeful I can find something to help me.

  8. Eric Bloniarz on April 24th, 2012 3:27 pm

    I have set up hundreds of patients on PAP and currently use Auto Bipap. It took me years to get “compliant”, but I didn’t give up. Maybe it’s because I am in the Home Health Care industry, have access to various supplies and I am a RT. There are many factors that contribute to compliance; patient willingness to accept therapy is first, comfort, and the correct therapy for the patient. Does the patient have complex apnea, what medications is the patient using, what other issues (depression, pain, etc.) is the patient experiencing? Education and follow up are critical. CPAP is tried, proven and safe therapy, but Auto-CPAP, Bipap, Servo Ventilation, Auto-Bipap are alternatives in treating noncompliant CPAP patients. If patients are not “feeling better” from their therapy, did they need it in the first place? I do believe that people that have sleep disorders that are treated with PAP can feel better, but are all the factors being considered? Sure, we can keep your airway open, keep you from desaturating, but if your in pain and having arousals, PAP doesn’t treat that! We need to consider all factors and not just discount the lack of feeling better as the responsibility of PAP therapy.

  9. Wilson L. Hardy on May 15th, 2012 10:01 am

    I have been introduced to the world of Sleep Anpea and my employeer is using it to force me out of the company . i’m not sleepy on the job or tired either but the occupational health department of my company is using it to get rid of alot of workers. now , i have taken every test they have asked me to take and my last test they wanted was a MWT(Wakeful of maintenance test) i passed the test and i feel fine after use of cpap machine doesn’t feel any different than before but i’m trying to keep my life in balance due to the pressure of keeping my job. my doctors have approved me for work and occupational health department of my company has denied it everytime. This problem started for me after i found out i had lead poisoning and no one can give me a answer on how lead effects the patterns of sleep ? Why is sleep apnea being use to hurt employee’s instead of help them ?

  10. Kate on July 17th, 2012 5:46 pm

    About 8 years ago, my physician had me do a sleep study because of my fatigue and difficulty losing weight. I was told I had obstructive sleep apnea, and then I had to come back for a second sleep study with a CPAP machine. It was the most miserable, exhausting night of my life. I couldn’t exhale against the pressure, and if I tried to breath through my mouth the air forced down my throat made me cough and choke. The headgear had to be cinched so tight to get a seal that I had a splitting headache the entire night, which took days to get rid of. I slept only about 30 minutes the entire night. After fighting for every breath the entire night, when I got up I was so exhausted I could barely walk. Even so, the clinic staff bullied me into ordering a CPAP machine before they’d let me leave. After a fruitless day at work (I couldn’t think, remember, or follow conversations), I finally got a decent night’s sleep in my own bed. The first thing I did in the morning was call the health equipment company and cancel the CPAP order. The sales person harassed me for days after that, calling me every day and implying that I was being a baby for not wanting to “give it a good try.” Before seeing the pulmonologist again, I did my research. I told him that I knew there were alternatives to CPAP and I was not going to live in torment every night. I had to be really persistent, but he finally referred me to an ear, nose and throat specialist. The ENT physician prescribed an oral positioning device, which is very comfortable AND effective. I use it all night, every night. I sleep just fine and have no fatigue or sleepiness during the day. I’m 100% positive that if I had caved in and bought the CPAP machine, it would be gathering dust in a closet and I wouldn’t have any treatment at all.

    Because of insurance, I’ve had to give up my really great primary care physician and have started seeing someone new. He’s obsessed with CPAPs and is badgering me to go through another sleep study and buy a machine. Any advice, beyond “just say no”?

  11. Tammy on October 31st, 2012 4:11 pm

    I am a registered sleep technologist and this is in response to Katie. Katie, you obviously were treated by inexperienced poor technologists. Your inability to reathe against the machine indicated the need to Bi-Level therapy, not CPAP. Your mask should not have been anchored to your head. A mask and headgear are to be worn comfortably. A small leak is normal with the mask. If a mask is too tight a patient will experience a headach, pressures sores, etc. This is a primary reason for poor CPAP compliance. I am also a Respiratory Therapist and this is why Ohio mandates that a Respiratory Therapist also be on staff if a Sleep Center is to treat Medicare patients. We understand pulmonary disorders. I hope you do not give up on improving your quality of sleep and treating your sleep apnea, as I can assure you that it will only worsen and the conditions resulting from OSA include: high blood pressure, stroke, and diabetes.

  12. Bobby on March 9th, 2013 10:59 pm

    CDL Requirements are getting tougher and tougher as new tech becomes available No other profession has to go through this even doctors are not required to do drug testing. the government picks on the dirt farmer because they know we do not have the resource to fight them. The use comments is for the kids, for homeland security, public safety or it’s only temp to get things through. Energy kills it doesn’t matter if it’s from a M16 or AK47 they both do damage. A small car can also do damage and they should have the same requirement as CDL’s do for the state to receive Federal Highway and Transportation Funding. We can say it’s for the budget and fairness! My experience with Sleep Apnea doctors are using snoring and anything else they can to call it Sleep Apnea. The guidelines are strict about what is Sleep Apnea which is Hypopnea or Obstructive not snoring! Get your doctor to show you the Standards of what is SLEEP APENA and challenge his claims! I would not hurt to write yearly your congress and senate enough is enough and we want passenger cars to have the same standards to receive federal money

  13. David vasko on March 15th, 2013 10:38 pm

    I.m a safety nut truck driver with 27 years of driving over the road with not one ticket or accident.My DR. gave me a sleep study and now I,m forced to use the cpap or lose my CDL.Now I,m very sick cant stay awake driving and loads are late for the first time.I never had problems with my driving until using cpap.Truck drivers unite quicker and stronger than anybody and we can bring this country to a complete halt if we are pushed.Truck drivers have it hard out there not everyone can do it and make a living please stop the madness.We have a problem its called DOT. REG. overload.Back off and let us feed are families or the brethren will unite and fix this problem the hard way.

  14. Phil Fortin on March 20th, 2013 3:25 am

    On my dot physical renewal they measured my neck at 18 inches so I was told to do a sleep test. So I had one done and they said I had apnea when I sleep on my back and said I needed a caps machine. Got it but I ask for a compliance form from then they refused because they didn’t want to be liable should something happen. So I have to start the process all over again with some one else. Back for another physical for a two month card now my neck is 17 inches. This was all a mistaken measurement in the first place. With 4.3 millions safe miles behind me I’m now in a position were I could loose my job. I’m not tired I sleep great and am the best driver I have ever been. This apnea thing was never an issue before and now it’s a tool to ruin livelihoods . Truck driving is relitivly simple . When your hungry eat something and when your tired take a nap! I don’t need a doctor to tell me that! It’s all a sham.

  15. John on March 27th, 2013 7:14 pm

    I am a psychologist who has specialized training in sleep medicine for insomnia. I work in a neurology practice and my friend is a sleep specialist who did my PSG and I ended up having a AHI of 38 (severe OSA) and was prescribed CPAP. My wife had been telling me for years I snored like a freight train and I guess I was just in denial, being old and fat and all. In any case, I have had CPAP for about 4 months. I hate it. The mask breaks out my skin, there are leaks, I have insomnia using it. I don’t feel better in fact my EDS is worse. I am going to contact my vendor about bpap or another titration but suspect CPAP is not for me. I’m not trying cpap it because I have that much EDS, despite my AHI score. But, I’m not a fool and when I desaturate to 80 during REM, I know I am a heart attack just waiting to happen. I had never seen myself as a non-compliant patient, but cpap sux! If the surgery had good outcome data, I would do that in a heartbeat after my experience with CPAP. But, the one year outcomes are abysmal. I’ll keep you posted.

  16. Linda on April 24th, 2013 2:09 pm

    Don’t know about anyone else but I’ve been totally put off by my insurance not covering the CPAP machine. I have severe apnea and was prescribed the CPAP machine, I understood I would have to be 100% compliant in order for the insurance to pay for the machine. I mailed in a data chip after 3 months so my insurance company could see I was compliant. Even after that they would not pay for the machine. I was told I needed to rent it for 10 months! Of course come Jan 1st insurance doesn’t pay anything on it till I pay my $500 deductible. So in the end I will be paying over $1500. out of pocket for a machine that costs $650. cash. Had I known I would have bought the thing outright back in August when I was diagnosed. Did anyone else have to wait 10 months?

  17. Roy Ijams on May 11th, 2013 12:54 am

    Dr Park I hope you can help those of us that get sick from cpap. Your openness to a slide of hand in making the numbers look good is refreshing. I lost my job and have been told to find other employment. Over 2 million miles safe driving. Now I can’t even be a passenger.

    cpap chemoreceptor air embolism seizure sleepwalk hypoxia

    Post by the scrooge » Mon Oct 29, 2012 10:29 pm
    10/1/12 after trying to sleep all night on cpap I didn’t feel right. Numbness in head like brain fog. Laid down without cpap to clear my head. When I woke up emt’s were at the house try’n to draw blood from me. I Had a seizure which lasted 40min’s. Lost bladder control the tip of my tongue still hurts from biting it. Now I’m unemployed. 6/8/12 I sleepwalked out of semi. My wife and grand daughter yelling at me. I woke up on side of road. Police arrived by to time I was responsive. My wife was driving about 60 and thought I might be just going to check the door. I’ve Never sleep walked before and never had a seizure before using cpap device. Hospital bills and no job. Had frac pelvic frac 3 ribs crushed rt wrist concussion and road rash from 6/8/12 roll down the road. Have found case in GA where 50 investors were scammed by man who said he had a PhD and needed funding for sleep centers. The indictment seeks at least 4 million dollars also 2008 Land Rover. Wire fraud charges carry 20 years in prison. And Dachman charged with 11 counts wire fraud. was a front page story on the Tribune in Oct. I think in 2011. I did not look it up on tribune. I’ve also read they have put newborns on cpap, Cpap industry plans to make billions. Have copy of man who died on cpap during sleep study. Best study I’ve found says people with apnea over age 50 stand better chance of surviving a heart attack. Than those that were on cpap before age 50. Because the body makes more veins around heart to supply oxygen to heart on person with apnea. Person using cpap before age 50 the body doesn’t build the extra veins and has lessor chance of surviving a heart attack. Another report person used cpap 4 yrs had excess air leaking in body changing skin color. It’s grand some people get better sleep. It is not a cure all. It is a money making industry. And people world wide will be put on these devices. I have other posts under the scrooge on site. Have been told I’ll never drive. Now on seizure meds. Last seizure 4/14/13.

  18. Tod Merley on July 18th, 2013 1:57 am

    I think I would call you guardedly optimistic.

    When I can find long term (more than a year) objective (uses data from the machines rather than what the person “remembers”) data it very much looks like actual use of CPAP for more than four hours a night continuing past the one year mark is what most people do not do. Indeed, it seems to be considerably under the 50% mark moving much too close to the 20% or so “placebo effect” rates.

    For most CPAP does not work and for even more it does not work well.

    As long as the medical community has the oppressive attitudes and ways that lead to it’s choice of oppressive terms (e.g. compliance, adherence) rather than dealing with how useable a therapy actually is they will be useless to make the therapy work.

  19. debbie on September 30th, 2013 3:59 pm

    iam going through weight surgery part of the requrements is a sleep test. i was diagnosed with sleep apnea. now i have a cpap job found out and will not let me work with out a complance report.and my cdl is on medical hold.i have not been able to use cpap machine.more than 20 a time i get very claustrophobic and start to panic. what can i do???.

  20. Mike Eacott on January 11th, 2014 4:26 am

    Please do not take the following as a criticism of how my NHS Trust hospital delivers its care for my Obstructive Sleep Apnoea Syndrome. Take what I have written below as some Lessons Learned.
    I have always been and still am very satisfied with the in-patient, out-patient and all other care that has been provided to me.

    These are my observations of the APAP treatment I have undertaking for Obstructive Sleep Apnoea Syndrome for the first 40 days.
    I am 72 years old, had always slept on my back, have a moderate overbite and have had operations twice for a deflected septum and am a “mouth breather”. I snore and was diagnosed after wearing an oximeter overnight as having some 30 sleep apnoea episodes per hour.
    The NHS gave me a ResMed S9 Autoset APAP device and a full face mask 40 days ago.
    I slept on my back for the first two nights. The results after a restless and uncomfortable night showed complete loss of respiratory control with a frighteningly large number of Obstructive and Central aponeas.
    For the rest of the 40 nights I started sleeping on my side wearing a backpack that contained two tightly rolled and taped hand towels to fill the backpack as an attempt to stop me rolling on my back.
    That has been quite successful although I still try to roll onto my back a few times per night when sleeping. At those times I am awoken by the APAP device increasing the air pressure to force open my airway obstruction.
    All nights except for the most recent ones have been uncomfortable, disturbed and shown Central aponeas and some Obstructive ones. Is has been difficult to stay asleep and in bed for more than five hours. The mask fit needs to be tighter than is comfortable so that air leaks are minimised. As such my face ends up a little bruised and one eyelid ends up “drooped” for a few hours in mornings. An unsurprising limitation of my APAP device is that it has a delayed response, certainly to Obstructive apnoeas , by increasing the air pressure and waking me up. After that I often do not fall asleep again or fall asleep after a rather long time.
    The APAP device recorded the details of my sleep for the first 30 days use. After that only summary recording were produced.
    I contend that daily feedback of the data that is recorded by the APAP device onto its SD card is helpful in getting the patient to determine how to change their sleeping environment to minimise aponeas. Currently that does not happen in my NHS Trust nor is feasible with what may be current NHS practice and respiratory professionals time. This should be feasible in the future through technology improvement and effective implementation of internet like information communication and remote computer systems produced analysis and feedback.

    In summary because I am a Physicist and have had a career as a Computer Systems Software professional have been able to monitor my progress on a daily basis and I can see that my night time respiration slowly has improved, Obstructives are rare and absent some nights, Centrals and Hypopnoeas have reduced significantly.
    Last night’s results show an AHI of 3.1 .

  21. PoppaDoc on March 23rd, 2014 5:13 am

    Realistically. I just started and I hate it.

  22. Tim Martin on May 4th, 2014 6:21 pm

    I have severe sleep apnea. I stop breathing as many as 55 times an hour. I’m lucky if I sleep more than three hours a night without awakening. I had a pulmonologist tell me that he didn’t know how I was upright. I suppose that I am the perfect candidate for the CPAP machine.
    I have been trying CPAP for almost seven years, with no success. I have little success in keeping the mask on. The nights I am able to sleep with the mask leave me feeling more spent than I do on the nights I go without the machine.
    In the meantime, my doctors are less than sympathetic. One told me to “Cowboy up”. The other thinks that I fail to comply because I am fearful or claustraphobic as she puts it.
    I’ve tried to explain that because the masks are uncomfortable, because they pond spittle, because they often leak, and because I have great difficulty breathing while wearing the mask (due to COPD and severe chronic asthma) I cannot tolerate the machine.
    Does anyone know of alternatives I can pursue?
    I honestly feel like I am dieing. I am so weak much of the time that I can barely cross the room. I am only 55 and way to young to be sitting in a recliner napping like an old man.

  23. Terry on June 8th, 2014 7:40 pm

    I started using CPAP in May…. the first night I used it I had it on for 9 hours.. when I got up, I felt dizzy, off balance, and as though I couldn’t breathe… I thought to myself what IS this thing doing to me?? now I don’t use it for anymore than 5 hours and I am alright now….Mine is an auto-CPAP machine as I asked for that as I think it is better than a set pressure…sometimes I think it is helping me, but I wouldn’t say I feel totally changed…. I will just have to wait and see.

  24. Mary on June 17th, 2014 7:33 am

    I have been watching my fiancé try to be compliant with his C PAP. I will say the thing is a complete failure.
    Symptoms are…
    Increased depression
    Thrashing and inconsistent sleep pattern
    Nose bleeds
    Sore throat
    Stomach bloating

    Before this infernal machine it took him 30 minutes max to fall asleep. He would sleep comfortably through.
    Now he falls off after about 2 1/2 hours(coughing and choking all that time). His sleep is seriously disturbed. So he ends up loosing sleep.

    The night of his in home study they said he had 20 episodes per hour in an 8 hour period. That night I watched him sleep, at best he may have had 20 episodes over one of those 8 hours. But I assure you NOT the whole 8. Yet it seems what they did was take the highest number and equate that for the whole sleep time. I only wish I had taken video of him during that night to have proof.

    His sleep Dr. said he most likely suffers more from shift workers disease. His original study was done against his “Normal” sleep pattern. His Dr. wants to do another study using his real time sleep pattern.

    I will agree that for a few this machine can be a great thing. For the majority it is not.

  25. dan sagen on November 5th, 2014 9:09 pm

    I need a cdl to do my job I have 36 years on the job with no accidents and no vehicle incidents. I have two traffic tickets on my driving record the last one was 17 years ago and both of those tickets were in my personal vehicle with no accidents. Last September I went in to take my dot physical the dot doc measured my neck and figured out my bmi then said by the new government regulations I had to do a sleep study. Well of course I was diagnosed with sleep apnea I asked the nurse while she was connecting up a thousand wires to my body what the percentage of people who take the studies actually have sleep apnea and she told me that she had been working there for the last 7 years that she only seen 2 people who didn’t have it! I have always slept just fine and could work through the day on 4 hours of sleep with no problem if I had to. I always looked forward to hopping in my nice warm comfy bed and getting a good nights sleep, Now after trying to sleep on a cpap for a month and a half I hate even walking in to my bedroom! I did however make compliance to keep my cdl I breath through the cpap for the required 4 hours a night and once in awhile I even sleep on it for a couple hours a too. I feel like crap! I am tired most days and just hate trying to walk in to my bedroom! I lay there and tell myself, self you need to get some sleep on this thing you need to wear it to keep your job your livelihood and self if you don’t do this your livelihood will end! Then just when I start to doze off ill hear a squeak for a leak or my nose will start itching and I need to itch it omg it is impossible to get a good nights sleep on this thing! We need to get together truckers we need to fight this bullshit!!!!!!!! Its a scam ! does anyone know of any organizations being started yet to fight this crap? If you do please email me at thanks and have a great day I would say night but that’s probably not going to happen if you are a cdl truck driver on a cpap lol thanks!

  26. Mary on November 6th, 2014 6:39 am

    I wish more professional drivers would unite with this. As you stated the response from the nurse it would seem to me EVERYONE who got behind the wheel of any motor vehicle should have to undergo a sleep test.

    In the case with my better half he had his original sleep study. The facility booked him for a follow up retest. his second (in lab) test showed what we already knew.
    He had 0 episodes in 6 hours and 3 over the whole 8 hours. However this test was done over month after original. By that time he was seriously sleep deprived. Going from sleeping 8-10 hours a night to less than 4. He would do the same as you wear the contraption for 4 hours (compliance) and then sleep the rest without it. Mind you the 4 hours he had it on was like watching him at battle, thrashing the whole time. He was concerned every time he got behind the wheel for his safety.

    The lack of set standards & guide lines leaves truck drivers at a disadvantage. Trucking companies have a wide range of thresholds. Compiled with the cost to the driver both financially and physically. Also the growing pop up sleep labs knowing this as a cash cow, it benefits them to fail you.

    There are ways to pass this, sleep in your side or stomach, use sinus spray before, don’t go into your test exhausted, we have a tendency to sleep harder at first that way and mostly it is the first 2-3 hours when they hook you up to the cpap.( I find that stupid. ) they should allow one to sleep the whole time to study the changes throughout.

    There are other ways as well, do some homework and demand a retest. If you have a primary Dr. go there and seek some advice and other options.

    Good Luck! Keep me posted.

  27. Tod Merley on November 6th, 2014 9:44 am

    Mary said:

    >>> I wish more professional drivers would unite with this. As you stated the response from the nurse it would seem to me EVERYONE who got behind the wheel of any motor vehicle should have to undergo a sleep test.<<>> In the case with my better half he had his original sleep study. The facility booked him for a follow up retest. his second (in lab) test showed what we already knew.
    He had 0 episodes in 6 hours and 3 over the whole 8 hours. However this test was done over month after original. By that time he was seriously sleep deprived. Going from sleeping 8-10 hours a night to less than 4. He would do the same as you wear the contraption for 4 hours (compliance) and then sleep the rest without it. Mind you the 4 hours he had it on was like watching him at battle, thrashing the whole time. He was concerned every time he got behind the wheel for his safety. <<<

    First of all how dare they call an in lab polysomnogram a valid way to measure how a person is actually sleeping in their day to day life!! We do not sleep in a lab. We do not sleep all wired up. The circumstances of the test often put such things as livelihood on the line and stress changes sleep in major ways. And as if that were not already much more than enough to invalidate the results of such a test it is only a one night “snapshot” of a process which is very much dynamic and simply changes night to night. I myself know this from years of following my air flow and other data.

    As one who for decades employed the “technology of the day” to facilitate broadcasting I do believe that the technology of this day is more than sufficient to facilitate bringing the entire polysomnogram into the home using self applied technology (remotely managed) wireless, comfortable, and checking many nights not a single night. This should have been done a decade ago. We need to change how we do sleep testing altogether!

    But even if they validly find actual consistent sleep apnea which should be treated – of those they attempt to treat perhaps 30% show long term improvement[1]. The thing is that there is more than simple obstruction in play. Arousal threshold, ventilatory gain, and tongue muscle tone at least are there as well[2]. CPAP is unlikely to treat a significant tongue muscle problem and tends to exacerbate both arousal threshold and ventilatory gain. I believe this is why so many find CPAP unusable. And why so many more find CPAP unusable long term. It only works for some.

    What we need to do is to demand that the medical community provide valid sleep testing procedures and proven effective treatments for this disease. Currently they do not.

    [1] Lo Bue et al. Usefulness of reinforcing interventions on continuous positive airway pressure compliance. BMC Pulmonary Medicine 2014, 14:78

    [2] Danny J. Eckert, David P. White, Amy S. Jordan, Atul Malhotra, and Andrew Wellman “Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets”, American Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 8 (2013), pp. 996-1004.
    doi: 10.1164/rccm.201303-0448OC link:

  28. Bob on January 22nd, 2015 4:07 am

    I am just starting out on CPAP therapy. I have had trouble staying compliant. My therapist has fitted me with a full mask since I have a deviated septum. I simply cannot fall asleep with this thing unless I take a few too many sleeping pills.

    When I do fall asleep with it on, I awake to see I have torn it off my face.

    I have contacted my sleep therapist twice in the 4 weeks I have tried to do this, and each time he just emails me the Fisher&Paykel video of “How to correctly fit your mask”. He assures me I will get used to it.

    The fact of the matter is I’m not getting use to it, and have asked my therapist to consider other masks that I may be able to fall asleep while wearing. So far he has refused.

    I am unable to remain compliant and no amount of begging or pleading is getting the therapist to help me be compliant, which I’m pretty sure is what my insurance company and I are paying him for.

    It’s ridiculous that we can land on a comet in this day and age, but can’t come up with a CPAP device that averages over 25-30% compliance.

  29. Tarun on February 6th, 2015 5:02 am

    CPAP is the worst possible solution to OSA. I was diagnosed with OSA( as I complained of snoring heavily and was overweight)last month and had an AHI of 30 and was told by Doctors to use CPAP. Since then I lost a lot of weight and my snoring has stopped completely but CPAP triggered central apneas and hyperarousals in me which never existed prior to this diagnoses. I have stopped using CPAP and believe that unless you are old and or chronically obese, CPAP should not be offered at all as the first choice. Now I don’t snore at all and sleep better although the arousals (due to central apneas) still continue thanks to a month of CPAP use. The medical community has not studied the impact of pumping pressurised air in a person’s brain and neuro chemical response system which makes a common treatable problem like OSA much worse by triggering central apneas. They only prescribe this device as they get a cut from companies on every CPAP device sold. Weight loss and or surgery(where an airway abnormaity exists) and oral devices should be the first line of treatement for OSA.

  30. Mary on February 6th, 2015 4:47 pm

    In my investigating and own personal working experience. I have found that weight is not the only indicator of SA. In working at a sub acute rehab facility I have seen some of the thinnest people snore the paint off the walls and have SA in some form or another. On another note, one thing hospitals’ look for in newborn babies is episodes of apnea.
    Seems to me we are born with the probability of having apnea episodes. Our sleep is a varied as the weather, it all comes down to the kind of day we have. Doing the one night test is clearly flawed. At that it is not even a whole night. Once you start, say 1 or 2 hours in to sleep they hook you up. Hardly a study of any kind of pattern and more of an excuse to sell another machine. And if you are a truck driver, well then your future is tied to that machine regardless of its negative impact on your health.

  31. Steven Park on February 7th, 2015 8:01 am


    Thanks for sharing. You are right in saying that you don’t have to be overweight to have severe OSA. Since sleep apnea starts off as a craniofacial problem, it starts when you’re born.

  32. mike obrien on February 26th, 2015 1:35 pm


  33. Tod Merley on February 26th, 2015 4:31 pm

    Mike Obrien –

    I am sorry for your loss..

    I lost a career I loved. I lost a lot more. I am glad I did not do this loosing by planting my forty ton truck into say a couple of school buses filled with children!

    Dr. Park recommended “The Promise of Sleep” by William C. Dement, M.D., Ph.D. In that book the doctor relates that “AFTER OVER NIGHT SLEEP STUDIES FOR 200 LONG HAUL TRUCK DRIVERS – “well over 70% were diagnosed with sleep apnea and 13% had a very severe condition.”

    If you are able you are welcome to drive. If you are not able we have a right to live.

    I am sorry for your loss..

  34. Mary on February 26th, 2015 4:35 pm

    To the best of my knowledge there is no Federal Requirement. I understand it was a recommendation and from there it took off. In short, the term “LIABILITY” was thrown out and now…well it’s obvious more and more drivers are being forced to tie their livelihood to the compliance with the CPAP. Even to the detriment of their own health. I watched my better half deteriorate over the course of 7 weeks before he demanded another study. With that it was found he fell well within normal standards (normal being the optimal word here, what IS normal sleep anyway) In the trucking industry’s part in this, that just simply does not exist,

    Trucking companies vary in their own individual standards it ranges from 2 episodes to 15 per hr. during a sleep study. The one night study is clearly flawed.
    Also the trucking industry is huge and getting bigger.

    With the new “recommendation” we have pop up sleep labs with one thing in mind, to see that every person who crosses through those doors for a sleep test will leave with a purchase. The stories I have been told is unbelievable. Drivers have told me they were given sleep medication, forced to sleep on their backs, tested against their normal sleep pattern even in one case the driver fell within normal limits and the sleep lab somehow talked him into purchasing a machine and now he is in a sleepless nightmare. Yes this system is seriously flawed.

  35. Roy Ijams on February 26th, 2015 8:06 pm

    I didn’t keep track of how many times I was cut off. I was hit head on by a car. Part of driving the 40 tons was being safe. I never had seizures before cpap. I should have right to know real risk of cpap. I could of been in a coma from oxygen toxicity. People become dependent on cpap. Not room here to go into the fancy words I’ve learned trying to understand cpap. Air force used a mouth piece years ago. Blood oxygen level not the same in lungs as finger tips. Cpap has blinded some infants. Medicare has been charged millions in fraudulent billing. One man set up clinics was not a Doctor filled bankruptcy and did the same thing in Chicago IL area. Was a Huffington post story. Cpap caused me to have paulups in sinuses. Got cleared up off cpap!

  36. susie on March 25th, 2015 4:35 pm

    I was diagnosed with SA the day before Thanksgiving. I was also suffering from Adult Onset Asthma. Dr. said I had 57 episodes in 2 hours. Cpap machine is set at a pressure of 11. I got the machine Christmas eve. The surgical supply company, the middle man for the insurance company or the insurance company themselves have checked to see how I have been doing. Oh I sent in the SD card. I’m not compliant because I only use the machine 2.7 hours a night although I use the machine every night.
    I do take off the mask in the middle of the night. I don’t however, LOOK AT THE CLOCK to see how long I have had it on. Really….I am losing more sleep using it, worrying about how long I am wearing it than before I had it. My 60 day report is coming up. If I’m not compliant I will lose the machine even though the DR. ORDERED IT!!!!! I would say if I’m using the machine every night for a few hours then that should suffice. Who sets the compliance rules anyway?

  37. Roy Ijams on March 30th, 2015 5:26 pm

    Sleep labs get grants to do research. I have found where researchers altered data to get desired result.. In trucking, cvsa adopted the sleep guide lines in the name of safety. Cpap and sleep clinics is a world wide billion dollar industry. Sleep folks in my experience will not addmit any fault in sleep testing. Billions have been paid out in sleep clinic fraud. Congress has several cases just with medicare and Medicaid. Clinics paid People to take sleep test and charged Medicare Medicaid and never put on cpap. Congress knows of the fraudulent billing. Compliance doesn’t mean successful usage. Some become dependent. Cpap devices become door stops.

  38. Mary on March 31st, 2015 3:17 am

    Roy, I have discovered the same the thing in my months of delving into the pros and cons of SA, cpap diagnosis/compliance.
    I find it disturbing that the truck driver is singled out when it seems to me that the percentages, if the “studies” are somewhat close would fall across the board to the entire human population. And you are right, most sleep labs will never admit to fault or fudging the numbers. Why would they. When millions of dollars could be made, with little or no checks and balances.

  39. Carlton E DeWolff on April 22nd, 2015 12:10 am

    I was a 84 year old architect with more ambition that my employees and even my own sons. I started falling asleep at my desk and was exhausted when I woke up.
    The Doctors could not diagnose me.I went to bed one night and laying down I heard the loud rattle in my chest. Went to the doctor and he said my lungs were filled up with fluids. he sent for smbulance to take me to the hospital.
    At the hospital they tried 8 antibiotics and did not work. They put me in ICU and and they told my wife that I may not survive if they can not get rid of the fuids. I was having heart failure. This one pulminary doctor asked if I had anything abnormal in the last few months, I said I had a sleep ahnea test. He asked what were the results. I said that I did not know because the after test appointment was three months and due in a few days.
    He immdiately search my medical records and cME BACK AND SAID “I THINK WE GOT IT” you were diagnosed with severe OSA and you stopped breathing 80 times an hour. He said that is dangerous.
    They immediately put the CPAP on me and the next day I was feeling better and the Nurses were amazed. With heavy doses of torsemide the fluid decreased over the next week.The Doctors said that I was very closeto death.
    I was able to make a remarkable recovery but I could hardley walk. I was on oxygen all the and at night with the CPAP I was pleased that I was feeling so much better, When my oxygen stablized at 98 they took oxygen during the day away but continued oxygen with my CPAP.
    I have gotten used to my Cpap and I do not mind it as it was a good fit.
    My kidneys were elevated due to the torsemide. They cut that down. I had lost 27 pounds when I left the hospital.
    It has been three months now and was feeling good but in the last three weeks I found I was getting up tired and exhausted just like I did before I went into the Hospital. The sleep disorder doctor gave me the test where you wear the computerized oxygen meter one night. The resuts were left on my phone and he said that I was good and he is thinking of taking me off the oxygen.
    I was surprised because my oxygen had gone from 98 to 92 the last few mornings.
    I feel that my lungs feel empty and need oxygen. I still get up exhauster. I can hardley go up stairs like I did after the hospital.My eyes have a problem with focus when I look down at the step but they focus ok in distance. I have noticed that my musceles ache and bones. At 84 I am sure that is expected but I do not remeber it being this severe. Having almost died I was relieved that my mind is still sharp and I am designing projects now but get tired.
    I have read your articles and I am more confused as to what to do..I will have a discussin with my Doctor about this. He did mention when I tod him that I was exhusted that he daid that I am in control and he thinks it ay be something else.
    Any adbice would be very much appreciiasted
    Thank you Carlton “Bud “DeWolff

  40. Steven Park on April 22nd, 2015 11:19 am


    Thanks for sharing. You’re fortunate that sleep apnea was picked up. Unfortunately, years of untreated OSA can have lasting effects. Additionally, CPAP, although very helpful, doesn’t usually address all your breathing pauses. I recommend you keep working with your doctors. Good luck.

  41. Roy Ijams on May 5th, 2015 4:11 pm

    To Carlton. I have used hypnosis for healing. Have you heard of Reki therapy? I feel energy and have had success in people working on me as well as laying hands on others. I don’t have to touch the person. I feel the energy increase when my hands pass over an area that needs healing. Barbra Ann Brennan has a book Hands of Light which goes into great detail on healing. I used herbal remedies to clear up a rash on my foot. Used energy testing to find the product. Have you ever done anything to help get the palace out of your veins? Here is the web site for person that helped me with my energy and cleansing. I have been doing business with her for over ten years now. And by doing energy testing over the phone she has helped me. The product I use on my feet is Purification by Young Living which I get through Ann. Mega-Chel is a product that helps support circulatory system. I think it is a product that has helped me in my over all health. She is honest and her personal story is on her web page.

  42. Roy Ijams on May 5th, 2015 4:25 pm

    To: Carlton “Bud “DeWolff
    The journal Sleep has retracted the 2003 study, titled “Anatomic and physiologic predictors of apnea severity in morbidly obese subjects.” The research-integrity office said Fogel’s changed or falsified nearly half of the sleep data “so that those data would better conform to his hypothesis.” He also fabricated about 20% of anatomic data that supposedly came from CT scans, the office said, based on information that Fogel volunteered. when I entered that link several other stories came up.

  43. Tom on May 9th, 2015 1:46 am

    I have been a truck driver for 20 years. I have never had an accident in a commercial truck during my entire time of driving. My sleep pattern varies as any truck drivers sleep pattern would. I only stay local now. A month ago i went in for my dot physical. I passed the physical with flying colors. My high blood pressure is controlled with medication and was actually 125/60. Which i was happy about. Then the Doctor looked at my height, my weight and then measured my neck. She told me that I was a high risk of sleep apnea. I cornered the doctor on the law that supposedly orders us truck drivers to submit to these sleep studies and compliance with a cpap machines. The doctor went from being nice to a Hitler like attitude. Even when i showed her the current FMCSR with the dot physical requirements. She still denied me my card unless i do the sleep study.

    So, I done the sleep study. Did I get any sleep doing this sleep study? Not a freaking chance of sleep the entire time I took it. Yes this was an in home sleep study. I was feeling pretty good before i took the sleep study. By the end of the 5 hour mark as they requested. I had come down with a serious sinus infection. But, I had absolutely no sleep!!!!!!! Every night when i crawl into bed, I fall asleep in 5 minutes of hitting the pillow. Here it is, a week after i took the sleep study. The Doctor called me and told me that I had stopped breathing 35 times an hour the entire time i was doing the sleep study. Ummmmmmm. Excuse me? I was awake the entire time and did not stop breathing at all. She said the machine even picked up my snoring and i was an extreme snorer. Immmmmmm? How can that be when i did not sleep??? Now she has ordered me to be on APAP and it totally screws with my commercial drivers license. Now i have to deal with the “Hitler” doctor to get my med card extended longer so i can show i am being compliant.

    My primary care doctor has been wanting to put me through the sleep study for the last year. I am dealing with him for High blood pressure. But he could not find a reason to order a sleep study. The more i studied OSA, the more i found out that it is a freaking sham to line doctors pockets. My doctor never once “listened” to me. Key word is “Listened”. I get up at 2:30 am and commute 45 minutes to work where i start at 5:00 am. I work until 3:00 pm. Some times longer. He says i show signs of fatigue. Well no DUHHHHHHH. Did you not listen to me? When i saw him, I had been up for 36 hour straight dealing with work and family issues. Anyways, he looks at my belly and tells me I am extremely obese. I asked, What do you call your nurse? She is way shorter than I and out weighed me by 200 lbs. he changed the subject. So he spent a ton of my money trying to find out why i have High blood pressure. Here is where OSA comes in to play. He tested me for diabetes. Test came back negative. He tested my metabolism. The test showed that my metabolism has Just about shut down. Did he treat me for this? Nope! He tested my kidneys. Test came back telling him that I am normal there. He threw 5 other tests at me. And they all passed. Then he says, Sleep apnea can cause high blood pressure. I asked how so. He could not answer me. But he kept at the sleep apnea as the cause. Now let me give you a run down on my life over the last 20 years. I am sure some smart doctor will see what my doctor has yet opened his eyes too.

    18 years ago, I took a nasty fall from the top of a lumber flatbed that was fully loaded. I was 14 feet up and out on a construction site. Ok. So, I “was” (key word here) on top. Until that slick board cost me my footing and i ended up laying on a pile of 12X12 beams that broke 3 ribs, both wrists and gave me a hellacious concussion. On adrenaline, i drove the truck back to the lumber yard. When i parked the truck, I passed out and woke up in the hospital 8 hours later. Fast forward 2 more years. Someone who i thought i could trust, waited until i was drunk in my own home (no she did not live with me and i do not know how she got the key to my place as i never gave her one.) Shows up one night and took advantage of my drunk status and had unprotected sex with me. I never once had unprotected sex with her as i did not want a child with her. So she waited until i was drunk so she could get away with it. For the last 16 years she has drug me back to court lying to the courts about my pay and that i am threatening her and so on. When i tried to tell the courts the truth. The courts and the lawyers all shut me down and called me another pissed off father. She has sent a former boyfriend to try and cause me bodily harm (failed miserably for him). She has sent her adult son to my home to threaten my life on a fathers day because her attempt to extort money out of me failed (she makes $50 thousand a year. I make $40 thousand tops a year. And I am the one paying 80% of everything). Then most recently, My mom underwent back surgery that still has complications. When they done the blood test to figure the right meds for the surgery. They found she had breast cancer. Level 4 breast cancer. We are 4 days from her 5 year mark to be classified as cancer free. Then last june, I was at work when my brother called me. He was in the emergency room with my mom. She was diagnosed with a level 10 stroke and not expected to live out the day. She was put on TPA and by the time i got to the hospital, she was put in the ICU and could not talk, see or move her left side. 3 hours later (lunch time) She had gotten her sight back and she was getting some movement on her left side and then choppy speech. By 3 pm, she was holding a conversation with no problem, she could read and see everything and her movement on the left side had increased dramatically. She told me to go to work the next day. So i went home and went to bed. I was in bed by 6:30pm. She called me and told me she had been downgraded to level 5 on the stroke scale. I called the next morning from work. She was downgraded to level 3. By the time i got home around 7pm. She was downgraded to level 1. The next morning she was kicked out of the hospital as she was miraculously cured in 3 days. Oh and to top it all off, I come home and play world of warcraft to relieve stress after dealing with the idiots in seattle who think they know how to drive.

    You say you see a ton of stress? I totally agree with you. I have told my doctor that I have been under and extreme amount of stress. His answer? Oh no no. You have sleep apnea!!! You broke bones when you fell? No one ever asked me if i have any side effects from the broken ribs. I would answer, yes i do suffer from pains. My back is screwed up from that fall. I can not sleep on my back, I can not sleep on my stomach. I can not sleep on my side. But with a pillow under one rib cage, i can sleep in between side and stomach. If i sleep any other way, my back will be screwed up all day going as long as weeks.

    Anyways, If anyone is doing a study to see what doctors are ordering sleep studies. All three of the doctors i am dealing with are Group Health doctors. I am not happy. I want blue shield back (i can not afford their premiums)…

    Good luck drivers. We have been rail roaded by a government and a panel of doctors that are trying to prove a theory that they can not even get a factual study done.

    Maybe if they actually pay us truckers more money. We would not have to cheat on the log books to make an honest living. In washington state, I am in the high end of the poverty level that the government will not help. They just keep taking from us and forcing us to take every little job that comes along that takes away our sleep.

  44. C.Stan on June 21st, 2015 8:11 am

    What I do not understand is , I only sleep from 4 to 6 hours in a day but it may change from day to day. This is my hours of sleep for years. They need to understand that not all people sleep the same hours and that the machine is not going to change a sleep pattern . So in my opinion if I have to sleep more than my normal hours , they can keep the machine . I have lived with out it till now I can live the rest of my life the same way. Dr’s. along with insurance companies need to remember that each person is their own person and no two people are alike . When they quit wanting everyone to be treated the same the person receiving the treatment will be treated based on themselves not the norm.

  45. Tom on June 21st, 2015 12:39 pm

    Update to my “ordered” cpap. I have been on the machine for a little over a month now. My employer can physically see that I am a lot more exhausted when I get to work. My sleep pattern went from being 7 to 7.5 hours a sleep a night down to 4 to 5 hours a sleep a night. I have had to play with the humidifier settings on a nightly basis. I went from having 2 sinus infections a year to 3 sinus infections in one month. The doctors still say they are adding years to my life and lowering my blood pressure. Oh the topper to this. They say they are lowering my blood pressure. The occupational doctor refused to give me my extension to my med card until I showed 30 days compliance. Furthermore she said I had to have 80% usage at least 5 hours a night. When talking to the sleep doctor, she says 70% at least 4 hours a night. When I looked up the “Proposed” law concerning sleep apnea. It sides with the sleep doctor. So my med card was set to expire on 6-20-2015. I had to use the machine from 5-15-2015 to 6-15-2015. According to Washington state regulations, I am suppose to have my re-ceritification in 10 days before my med card expires. I have kept tabs on my blood pressure for that entire month. It stayed at 180/ 90. So we all know I was under stress from there BS. I run to apria on the 15th. I get a hard copy print from the card and had them fax a copy to the occupational doctor. Which they never got on the 15th. Thank god I do not trust people at all. Then the receptionist told me that I had to be in on the 16th before 4 pm to get my med card as the occupational doctor was going on vacation for 3 weeks. Knowing full well that they were screwing with my job. The emails they have sent me all said they were going to give me a 1 year med card. What did I receive? A 9 month card to finish off my year that they knew they were screwing with.

    Now, I am currently working on a letter to the FMCSA as they are currently chasing the doctors who are taking advantage of something that is not a law. As of right now the trucking industry only has 30,000 drivers and shrinking drastically. Drivers are leaving and or being forced out of their jobs because of the doctors playing god with something that is not even a proven illness. Has anyone ever died from snoring? Has anyone ever proven that sleep apnea is the cause of high blood pressure? Hell no!!! All they are basing things on are studies that are done in colleges by wannabe doctors trying to make a name for themselves.

  46. Roy Ijams on June 22nd, 2015 8:28 pm

    10/1/12 I had a seizure on cpap and after a seizure you can’t drive a semi till you are seizure free and off meds for 10yrs. You are up against a billion dollar industry. The government has paid out millions in Medicaid fraud alone. Congress knows. We need a web site that brings all the drivers together that have lost job do to this cpap scam. I also sleep walked out of semi @ 60 mph while my wife was driving. 6/8/2012. Sleep folks deny any side effects. My sinuses were messed up. have that on record from accident. Quit using cpap and no more sleep walking or sinus problems. On seizure meds and disability now. Had 3 seizures 6/8/2015. I drove otr for 20yrs 2 million safe driving award. My first study was at a sleep clinic. Worst night sleep I’d had in yrs.

  47. Tod Merley on June 22nd, 2015 10:47 pm

    I do believe that the current way of handling the issue of OSA risk with truck driving is likely creating hazard rather than reducing hazard.

    What we need is full time vigilance monitoring for those at risk as they drive.

  48. Jim miller on June 23rd, 2015 12:53 am

    I am having problems last year I lost a month of work due to not meeting with the compliance guide lines by anaverage of 13 minutes a night . I am now having morepproblems with using the machine I wake up stuffed up nose so off comes the mask , alsoi am using an old machine due to the fact my insurance company will not cover the cost at all and I need this for my job or I cannot work ! So once again someone who sits behind a desk dictating on something they don’t understand the true financial affect of regulations . Sure you can say that the person is healthier but I actually sleep better without the damn machine and now I am STUCK in the red tape and will have to change carrier’s if I can’t figure out a solution !!!!!!!!

  49. Joy Noyes on July 9th, 2015 3:20 pm

    Both ben on machines 7 years,no problems at all, we cant sleep without it, but years up,so got new machines with test to get them.Even use for naps, could tell needed new ones. Now its a round 40 miles to Dr.They insist go in,ask question,and leave, A total waste of my time,my money,my wear and tear on vehicle. and waste of government medicars money. If not working right I would be tired,not breathing good at night,etc.a body can tell. what can I do to stop all these trips. have regular Dr,Heart Dr foot dr,lung dr,pain dr. come on we are doctered out,money goes just so far how can we stop this madness,just to make a Dr over a hundred dollars. 7 years on it setting never changed for either of us.

  50. peerinto on September 20th, 2015 8:10 pm

    Just want to know, how do you know you really do need the C Pap. After all you go to sleep and when you wake they tell you anything. Think about it the more patients they get the better.

  51. Jennifer on September 30th, 2015 8:19 am

    I have been using a CPAP for over a year now, and I love it. I had a bit of an adjustment period at the beginning, but now I find I don’t feel ready to sleep unless I’ve got my mask on. I started using nasal pillows earlier in the summer, and now I hardly notice there is anything there. One thing I have found is that I don’t seem to sleep quite as long – it seems I get 7-7.5 hours per night instead of 8-9 hours. When I’m not working I tend to sleep a bit longer. I wonder if it’s because I am getting more deep sleep. In any case, I feel for people who can’t adjust to CPAP. It’s been a very good thing for me. So it is not all doom and gloom!

  52. Kim helton on October 8th, 2015 6:08 pm

    I wasn’t sick until I was force to be on the cpap thru crete carries. I’ve suffer facial injuries plus I’m experience real bad side effects now and in order to keep my job I have to endure this. Both of my bmi are 31.9.i am deteriorate as I speak

  53. Tom on October 8th, 2015 9:48 pm

    I was forced onto the cpap machine 4 months ago. The first 30 days was a battle for me to adjust to it so I could get the remainder of my dot med card. Since I have been on the cpap, I have noticed that my elbows that were in severe pain since I started with the company I am with now, has long since stopped hurting. But over the summer I battled to adjust to it more as every time I find a setting to let me sleep with the humidifier the next night I could not sleep. If I did sleep it was not for long.

    I have repeatedly asked Group Health for the proof that I have sleep apnea. They keep telling me I have it and they are extending my life by putting me on the cpap. I have had extensive sinus surgery and the doctor made sure that I would never have any problem breathing when I sleep. I use to get 8 hours of sleep a night. Now I am down to 4 or 5 hours of sleep. I have found myself hyperventilating in the middle of the night when using the cpap. I have also noticed that I am way more tired at work than I use to be.

    Group health doctors swear I have sleep apnea. How can that be when I did the test, I never once fell asleep. I am currently writing the FMCSA to get more information on whether or not that what group health has been doing to us drivers is legal.

    Oh and now I am feeling the old pain I had before the doctors went in to rebuild all my sinuses and nasal passages. Am I heading back to go through the pain from all that surgery again? If so, I am going to sue group health for being the cause and they will pay for all surgery done by a non group health doctor.

    My brother just underwent a procedure to run a camera down his mouth to look for another hernia. During the procedure, my brother started coming out of the anesthesia and started coughing and choking on their tool. So they hit him with enough drugs to knock out an elephant. After the procedure they told him that he has sleep apnea (group health doctors). I told him that it is a lie and they are trying to cover something up. Think about it. You have a freaking camera down his throat blocking off his airway and you knocked him out so far that half his organs started to react to the lack of oxygen. Next morning he woke up and his eyes no longer had any white to them. They were all full of blood. He went into the clinic who done the procedure and cornered them on what happened. It was not until 24 hours later that they told him that they had screwed up so bad that they caused him to wake up, cough and gag and vomit so hard that he had ruptured every blood vessel in the eyes. It took 2 months for that to clear up. To this day they keep hounding him to do the test to diagnose the sleep apnea.

    Oh another piece of information I found on my paperwork. I never claimed I have a problem sleeping. Not once! Stress? A ton of it. Strain? A ton of it. I have no time to do what I want as I am taking care of my elderly parents and working damn near 18 hours a day. But the doctors state that I have a problem sleeping. How the hell would they know unless they have been in my bedroom when I sleep.

    The DOT doctor at group health stated that I looked exhausted. Geeze Really? I have been up since 2 am and had to be at work by 4:30 am and then ran 10 hours for my job to her 3 hours of her job. She never once asked me what my schedule was. She just assumed I was a 9 to 5 worker.

    This is just a scam for doctors to make money. Since I have been dealing with this. I have spent $4000 dealing with appointments and freaking group health falsifying billing and I had to pay bills I had already paid and showed them proof of it. They have gone as far as charging me for supplies I get for the cpap machine. I pay apria for the supplies. Not group health.

    I can safely say that when child support is done in 18 months. I am telling the trucking industry and group health doctors to take a long walk off a short pier. I am done jumping through hoops that are not even there!!!!!!!!!!

  54. Roy on October 20th, 2015 6:53 pm

    Tom, would like to be a part of a suit. I’m on seizure meds after using cpap. On 10/1/2012 I tried to sleep all night on cpap woke to EMT’s.

  55. Tod Merley on October 20th, 2015 9:43 pm

    The industry really does need some help toward looking the respiratory gain issues[1], induced through the pressure of xPAP, in the face. If hypocapnia is induced through the increased “motor” gain from the pressure of xPAP – well now – damage to the brain is likely I would think.

    I think a modified version of EERS[2] should be provided with all xPAP units to help prevent intermittent hypocapnia while using xPAP. That would likely save brain cells and lives.

    But at the base of it you really need to determine the case of the respiratory gain issues. More about that in my “blog to be”.

    Go team!!!

    [1] Eckert DJ, White DP, Jordan AS, Malhotra A, Wellman A. Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets. American Journal of Respiratory and Critical Care Medicine. 2013;188(8):996-1004. doi:10.1164/rccm.201303-0448OC.

    [2] Gilmartin G, McGeehan B, Vigneault K, et al. Treatment of Positive Airway Pressure Treatment-Associated Respiratory Instability with Enhanced Expiratory Rebreathing Space (EERS). Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine. 2010;6(6):529-538. [mods outlined in my “blog to be”]

  56. Marcus Miller on November 9th, 2015 6:42 pm

    I went to a sleep clinic and was told I only had apnea when I was lying on my back. The fact that I always roll onto my back didn’t seem to factor in to the diagnosis that I do not need a cpap prescription,

    The thing is, I already have a cpap machine which I used for about 15 years, when I originally was diagnosed. So I just need masks and filters, which used to be provided by my HMO. Now that I no longer have a prescription, I can no longer obtain those items. The sleep clinic did however recommend using a special belt to keep me from rolling onto my back(why would I want to be restricted that way?), or surgery. Surgery over a cpap machine?!

  57. Sleepy Bob on November 11th, 2015 5:47 pm

    I lasted 3 nights on the CPAP (full mask), was exhausted from lack of sleep, followed by PVCs at a level that endangered my life. Spent the next 8 years devising and testing a suite of airway exercises that I now offer to seniors who attend my lectures. Should have it all finished by early summer 2016, along with a model of a asleep terrain designed to manage ofter issues such as sleep position.

    Can post a feqw graphics here as I trudge along.

    Sleepy Bob

  58. Christina McEneaney on November 13th, 2015 12:14 am

    Well in July I was diagnosed with obstructive sleep apnea and the Dr really scared me to the point that I can’t get any good sleep. He told me when I sleep at night that my apnea is so bad that I needed to sleep sitting up and if I didn’t I could actually die in my sleep he said when sleeping I only get 38 % oxygen and he said that’s not good at all. So now Im afraid to sleep and iv been waiting since July to receive a machine. And it’s almost mid Nov now and it’s not comfortable to sleep sitting up at all. The reason I come to find out why I haven’t received my device yet is because my dr and insurance company don’t agree on the method of obtaining the device in the first place. Stupid I know the insurance company says all I need is for my dr to write me a prescription and the Dr says no I need to do another sleep study and the insurance company won’t pay for that and my dr won’t write a prescription so here I am trying not to die while I sleep . Can someone help me please.

  59. tom on November 14th, 2015 10:32 am

    Think about this. Dr. Wants you to do another sleep test. Insurance already paid for 1. Dr. Won’t write a prescription. Why? The Dr. Just got caught by insurance by fraudulently claiming you have something you don’t really have. If you did have apnea he would have put you on a cpap machine right away.

  60. Tod Merley on November 15th, 2015 4:57 am

    Christina perhaps it is time to do some Google searching and get some help to sort things out.

    Search for:

    medical ombudsman [your state]

    insurance commissioner [your state]

    medical licensing commission [your state]

    And find those who you can talk with to help yourself.

    I hope you do find good resources.

    If you really do have your blood oxygen levels going down to 38% to leave the matter without treatment for an extended time is irresponsible wherever it may come from.

  61. Roy Ijams on November 15th, 2015 10:21 am

    Christian. Tod has some good thoughts. I wonder how all these people lived for years with out cpap. Air force used a mouth piece for apena years ago. I have read that data for sleep studies was manipulated. Years ago I learned self hypnosis to relax. Meanwhile I’d suggest deep breathing. Breath In healing energy and breath out or let go of the stress. Book by Barbara Ann Brennan Hands of Light gets into healing. Published in 1988. I also use herbs for healing. Roy

  62. Jim Henderson on November 21st, 2015 2:09 pm

    I’ve been using my cpap machine for 6 months or so. Have no problem using it but it’s just not helping. Sleep test showed over 40 episodes per hour and cpap brought that down to under 5. Until now. Sometime over the last month my episodes started averaging 30 per night w the machine. Dr. accused me of drinking too much but I drink no more than I did first 4 months. Now to my question. Over the last few nights, I’ll wake up around 3 and check my machine and it will tell me I’ve had an average of 4 to 5 episodes but when I check it in the morning, it says I averaged 27. Why would that be? Could the machine be defective? Doesn’t make sense to me. If alcohol caused the high readings, shouldn’t the numbers go down through the night?

  63. Tod Merley on November 21st, 2015 4:18 pm

    I have to admit the tendency of doctors to accuse the patient of causing problems with CPAP use causes me to both disrespect and loose trust in them. If you told him “alcohol levels have not changed” and he still insists “it is alcohol” you probably need a new doctor. If he asked no questions about stress levels in your life, about how you are sleeping, about how you are eating, about exercise levels, about diseases (flu/cold etc…), and regarding possible sources of toxins in your life but simply goes into the “accuse the patient” mode you definitely need a new doctor.

    As for why a reading early in the night may not tell the whole story of the night well consider that each event ratchets up your stress hormone levels – which increase inflammation levels – which increase the tendency to have more apneas – which, when they occur, increase stress hormone levels. So the basic tendency is that if you have events early in the night there will tend to become more and more of them as the night proceeds. And the stress hormone axis is only one of many which have this similar tendency to cause more and more events as the night proceeds. I am not shocked to hear about the numbers you name.

    What I would recommend is that you establish “data feedback” using, perhaps, such as SleepyHead software to see what is going on. Whatever software you use should show actual air flow waveforms and show the events as they occur over the course of the night. For years I have used this to see problems as they occur and adjust my lifestyle so that CPAP will work for me (note the issues the doctor should have asked about – more about that in my “blog to be”).

  64. Jim Henderson on November 21st, 2015 6:10 pm

    Thanks for the reply. I wouldn’t know how to use the software you mentioned. I am lucky to even be able to access the information I do have access to. My doctor never bothered to tell me that the number of episodes per night was available for me to see. I thought I had to wait 2 months to see him and have him tell me how badly I was doing. But then I was reading the owners manual and saw that the machine could give me immediate results so I went in and had the nurse show me how to do it. So as I said, I would have no idea how to get the kind of information you are talking about and I doubt the doctor has any interest in showing me. His only interest is getting out of the room as fast as possible to get to the next patient.

  65. Tod Merley on November 22nd, 2015 3:27 am

    What I would really like to see is the doctors and manufacturers working with the actual users of CPAP to produce a system which uses the data gathered from the sensors in the CPAP machine. The system would report the nightly data to a central server. The incoming data would there be analyzed in the server (a computer dealing with the data) and any apparent problems would result in “alarm” e-mails or calls or letters to the CPAP user and/or the doctor of the CPAP user. But at any rate the data would be available to either via a website where one could see what is going on night by night.

    Using what is available I have been able to correct problems before they became serious. If this had not happened my health would have been affected.

    I know that my CPAP data is never the same any two nights. I have found that it can and does indicate problems which do need to be addressed. I do believe that much of what drives people away from CPAP[1] can be attributed to the problems that do come up but which are never noticed because they were never looked for. And so they were never effectively addressed. In such a case I believe it is possible for a CPAP machine to do more harm than good but at any rate the user comes to understand that it is not helping and drops it by the wayside as useless.

    [1] Usefulness of reinforcing interventions on continuous positive airway pressure compliance. Lo Bue et al. BMC Pulmonary Medicine 2014, 14:78

  66. james hurt on January 23rd, 2016 12:15 am

    losing my cdl due to non-compliance with apnea treatment. cannot take any device on or in my face trying to sleep. cpap was a nightmare. mouth piece felt like it was stretching my jaw. dr. said last resort is surgery(breaking my jaws and setting my jaw forward). I loved my job, and was a safe driver 37years. it really is a money scheme. have to find something else to do. I would rather die in my sleep than to smother in their devices.

  67. David Vasko on January 23rd, 2016 9:55 pm

    I am so sorry for your loss James I am also a truck driver and also 30 years with no ticket , accidents, or incidents, I posted a blogged a couple years ago on this site I want to let you know that there is now a oxygen on finger sensor to see if you are one of us who have been scammed. I did not use this however as I found away around this career killing scam in the name of the almighty dollar. I am a independent inventor and built my own breathing gismo. Most truckers just wait tell the last month and a half to suffer the mind altering cpap and then take the chip to be read by the DOT physical Doc and pass that way. I want my brain to work so I use the later. Its looking like there scam is exposed after talking to my doctor I am sure if you can find another Doc who is younger and not part of this plot you can get your CDL back. We need pro drivers then ever and we need you so fight for your rights even if you need to scam the scammers you are important to our country and its economy so do the right thing and show them that we run the show not them. What happened to the BRETHREN. We really should unite but I am afraid its to late as the most safe and experienced drivers are run off to bring in low paid younger blood to bring up profits. More deaths on the highway is happening now when will we wake up oh wait a minute I am using a Cpap ooops.

  68. Roy on January 23rd, 2016 11:46 pm

    To David Vasko Adverse Effects in the Lungs Providing the airways with a constant level of pressure can also lead to some adverse effects in the lungs. If the alveoli at the end of the airway are distended too much, they block the flow of blood which normally passes nearby in order to pick up oxygen and drop off CO2. Blocking this bloodflow results in gas which does not participate in the exchange of oxygen and CO2, commonly known as deadspace. Excessive deadspace interferes with oxygenation just as surely as does ineffective ventilation. In addition, too much pressure in the lungs can result in trauma to the airways. The alveoli can be damaged, causing air to leak into the tissue of the lung, thorax, or skin. This can lead to potentially fatal complications such as pneumothorax.
    Other Adverse Effects Excessive pressure delivered by CPAP can also cause complications outside of the airways. Increased pressure in the airways translates directly into increased pressure in the intrathoracic cavity, which can interfere with the function of the heart. The return of venous blood to the heart is accomplished, in part, by the negative intrathoracic pressure which occurs during inspiration. “Principles of Critical Care” states that interfering with this negative intrathoracic pressure with positive pressure can result in decreased cardiac output which can be potentially hazardous for people with pre-existing cardiac conditions. This also decreases blood flow to the kidneys and liver, potentially causing problems for patients with diseases of these organs.
    I hope to find someone that would take my case. Using cpap causes me to have seizures. I had all the symptoms of oxygen toxicity. Have also found cases of fraud.

  69. David Vasko on January 24th, 2016 12:13 pm

    I am so sorry for all the pain and suffering you have to put up with so the fat cats can get richer. I have noticed a up take of gout in drivers who are forced to strap on these needless death machines and wondering if there is a strong link. I just lost two very close trucker friends to blood clots in the lungs and they were Cpap prisoners as well. I was told that the truck seats were to blame and the clot made it to there lungs just food for thought.

  70. Tod Merley on January 24th, 2016 1:36 pm

    For the many truckers who do suffer from sleep breathing and other sleep disorders I must say that the sorry state of sleep medicine currently makes them a very ineffective indeed completely unreliable source of help to keep the rigs on the road and people safe. Their track record simply stinks. Doing a quick sleep test and sending a person back out on the road with a new untested and acclimated CPAP device seems downright irresponsible to me. Yet I hear about it all the time.

    We need a different direction here I think. Make smart driver monitoring. We currently have technology which could drive the rig. How hard would it be to use this technology to make systems that would see that the situation is getting dangerous and set off the alarm? We have the technology to monitor mental vigilance real time all the time. How hard would it be to make systems for those at risk and show how much risk actually exists?

    To Roy: .. Roy, I am not a doctor. However I have read several books and many many dozens of medical papers concerning how CPAP works and affects the body along with hundreds of abstracts. I have also read over 10,000 sleep apnea web forum posts (back in the day before excessive trolling destroyed this resource) contributing over 2,000 myself. As well I have used CPAP for over a decade.

    Much of what you mention I have never seen. So please provide citations for your points. Document your work please.

    As for how use of CPAP might well relate to seizure activity I have come to believe that the hypocapnic excursions during ventilatory (loop gain related) instability which does occur in at least a third[1] of us who use CPAP is a likely contributing source. But that is just my suspicion. I do not believe that they really want to look into that as it is not a selling point for CPAP.

    Perhaps you should look into EERS[2] which I find helps stabilize my breathing during CPAP use and makes the nights go better. I also find that neck exercise helps as I mention in my blog to be.

    I do hope we find what we really do need to get better and stay safe.

    [1] Danny J. Eckert, David P. White, Amy S. Jordan, Atul Malhotra, and Andrew Wellman “Defining
    Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets”, American
    Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 8 (2013), pp. 996-1004.

    [2]: Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ. Treatment
    of positive airway pressure treatment-associated respiratory instability with enhanced expiratory
    rebreathing space (EERS). Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of
    Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA,

  71. David Vasko on January 24th, 2016 2:49 pm

    Unfortunately for the Cpap pushers any ailment that may manifest its self while under the influence of Cpap use may be suspect to the root cause. I smell a class action law suit right around the corner and one the likes that no one has ever seen. when the smoke clears there will be big reform in how the medical and DOT work together in making laws that are suppose to protect us all.

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