When CPAP Doesn’t Help Your Sleep Apnea
September 25, 2009
Every few days, I hear from a frustrated patient with sleep apnea how they’re at wit’s end with their CPAP machine. Either they just can’t seem to get used to it, or they’re using it faithfully, but find no improvement in their quality of sleep. Some are almost in tears, to the point of giving up. Many of these people have tried various masks, different machines, participated in online and live CPAP support groups, or had multiple interactions with their sleep medicine doctor and their DME vendor. All to no avail.
Granted, there are a number of reasons why you may not find CPAP helpful, but with good support and going through a standard checklist of issues, many of you can usually find a solution. You’re not the only one going through this process. Most people just starting out with CPAP fit into this category.
However, there are others that have tried everything, and still don’t notice any improvement. Even the compliance data from the machine is saying that everything is good, with no leaks and a very low AHIs. What can be done for you at this point?
Unfortunately, many of you fall into the trap of feeling like it’s your fault, that there’s something wrong with you or that you’re doing something wrong. You may ask, many others are able to use CPAP just fine, so what’s wrong with me?
This is a very common situation where typically, most sleep doctors just shrug their shoulders and offer a stimulant like Provigil to take during the day and sleeping pills at night.
From my perspective, there are three issues/options to consider if you ever get to this point. The first is to make sure that you’re able to breathe well through your nose. If your nose is stuffy (and most sleep apnea patients have stuffy noses by definition due to their anatomy), then CPAP pressure have to be higher, and it can become more uncomfortable with more chance of leaks. Many of my patients are able to better tolerate and benefit from CPAP after treatment.
The second consideration is, do you have full compliance data? Most people are given bare-bones CPAP machines that only measure how long you’re using the machine for every night. There’s no information to tell you if there’s any leak within the system, or if you’re having significant apneas or hypopneas. Having a fully data capable model is important to get objective feedback on what’s going on.
Third, at a certain point, after exhausting all the possibilities, you have to look at other options including oral appliances and even surgery. For a recording of an interview I did with a dentist about oral appliances, click here. For a free report called, "The Truth About Sleep Apnea Surgery," click here.
One last thing to consider is that your sleep apnea may be adequately treated (by whatever means), but you still feel lousy. Dr. Jacob Teitelbaum, a world renown expert in chronic fatigue syndrome, explains that due to the massive neurological and hormonal imbalances that occur in these situations, some people don’t feel better with CPAP, oral appliances, or even with surgery, despite optimal treatment based on sleep studies. Go to his website at vitality101.com to find out more information. He has a free online symptom analysis program that will guide you toward various treatment options.
Are you struggling with CPAP? If so, what steps have you taken with CPAP, and what other options have you tried so far?