Sleep apnea likely increases risk for both excess belly fat and Type 2 diabetes, due to the metabolic disruptions described up thread. Increased cortisol from the stressful waking events/lack of sleep promotes fat storage specifically in the belly. So while it’s not incorrect that there’s a link between apnea and belly fat (and of course that link won’t show up in everyone), the risk seems likely to go from sleep apnea to metabolic symptoms (both T2 and weight gain) when you consider the underlying physiology. Of course, risk doesn’t have to just go one way, and I’m sure it can easily be a reciprocal model with apnea contributing to metabolic sx and those metabolic sx worsening the apnea. But everyone is going to be different, and there seems to be a bias for people pointing to weight gain as the root cause given its social stigma and the (falsely) assumed control people have over it.
Does sx = symptoms? I haven’t seen that before.
Yes, sorry I forget not to use shorthand sometimes—I’m used to typing medical notes, and it’s one you’ll see used in those sometimes.
You’re lucky to have such a low pressure setting. I have a pressure setting of 24. That is why it is so darn hard for me to sleep with the mask on. It also leaks a lot. If I had a lower pressure setting, I have no doubt I could easily tolerate my BIPAP machine. When my machine ramps up to 15 or so pressure, it is barely noticeable for me. But once it hits 24, I feel like I’m suffocating. I only have 20 apneas per hour with my oxygen levels staying under 88 all night long. I get zero stage 4 sleep, and I have over 30 apneas per hour in REM sleep, with REM sleep being like 6 percent of my total sleep time. I don’t fall asleep driving because I used to drive a tractor trailer for a living. I have learned to pump myself up with caffeine and energy drinks to remain alert. I still do this, I just drink diet caffeinated drinks these days. I also have this thing where I’m tired but too wired to sleep and can’t sleep with the mask on. I have driven for over 24 hours straight and was dog tired, had a hotel room, and could not sleep. Wired but tired unless I take a double dose of Nyquil. Then add in chronic leg pain and it makes me even more uncomfortable. I really need to figure out how to use the machine as my BP is high, my sugars are high, and my oxygen sats dip into the 80’s during the day when I exert myself. I might get the hole in the throat and call it a day if my insurance pays for it. But I have 11 central apneas a night. I think the BIPAP treatment revealed these. But even 11 central apneas would be less than 5 events per hour. If I do not sleep a minimum of 10 hours per night, I’m not falling asleep, but I am too mentally spent to even read or type on the internet. That is how the apnea affects me. I also think my weight gain and diabetes comes from my over-consumption of sugary drinks to give me energy because I am not getting the proper amount of sleep. Any how, I hope you get used to your mask. It is very important to control sleep apnea. My doc thinks the apnea has caused all of these health issues in my case.
The quick simple carbs we crave is due to being tired all of the time. I used to weigh 160 pounds 12 years ago. Then I went up to almost 300 pounds in 2009, and now I am 240 pounds. I never really changed my dietary habits when I began piling on the weight. I just seemed to get heavier overnight. I have always been tired, and I have always slept for 10-12 and sometimes 18 hours a night. All the way back to being a teenager. I don’t know if it was apnea or other issues, but I used to have a lot of sleep paralysis. I also have an autoimmune blood clotting disorder that causes fatigue. So it could be related to that as well. I can deal with all these other issues, but I hate the mask. Heck, I can even deal with supplemental oxygen at night if that would help and it would, because I never had low oxygen in the hospital when I had 02 on for seven days. I just hate the mask and trying to swallow and breathe and then thinking about each and every coming breath. I have 1 more month to get compliant or they’re going to take the machine from me. I know I can do it with Nyquil and pain meds. That is how I was able to sleep during the sleep study. I just hate to have to pound Nyquil every night to get four hours of sleep with the mask on. It is too much of a hassle.
Wow a pressure of 24 cm H2O is pretty high. I have what is called an Automatic Positive Airway Pressure (APAP) which has separate pressures for breathing in and out as well as having an automagic adjustment that increases the pressure when it detects that I am experiencing apneas. I start with a pressure of 12/10 cm H2O and then when I have apneas it rises to reach a max of 15/13 cm H2O. At higher pressures I also experienced problems with leaks as well as increased aerophagia.
I have struggled with the mask leak thing a lot. You may not have noticed, but I have a mustache so I actually have to use a full face mask. I probably would need a face mask anyway because I am mouth breather. There are some things you can do to improve your mask seal. First, you should fit your mask properly. It should sit on your face with the absolute smallest tension that keeps it from leaking. If you overtighten you will compress the cushion and actually cause more leaks.
Also I found it helps to clean my face around where the mask will seal. You can use a warm washcloth with a touch of soap or what I do is just buy cheap flushable wipes. Just make sure you let it dry before putting on your mask.
The other thing I deal with is that my apnea is significantly worse when sleeping on my back. So I sleep on my side allowing me to use much reduced pressure. The problem with sleeping on your side is that you can put pressure on one side of the mask pushing it out of kilter. So I got a special pillow from BedBathandBeyond which really helped.
One final thing you can do is see if your PAP machine has a ramp function that will start at a low pressure and build up. If you can use that it may allow you to fall asleep at lower pressures and avoid discomfort and anxiety when the pressure gets higher.
24 seem to be an extreme pressure setting, I was told at the sleep center that 12 was higher than average.
I was fitted with a nasal mask as my first mask but I’m going to exchange it for a full face mask. I am finding that I have too many allergies causing nasal congestion. I can tolerate my nasal mask just fine until my nose stops up then I find that I can inhale but cannot exhale without opening my mouth. I am still waking a lot just so I can exhale.
look at the ASV from resmed, it should sort you out with your complex apnea. I don’t think a bipap would be the answer for you, even from the little you said.
I would go to the CPAP forums to find more help. They will go through your numbers and most come out better.
Resmed are also bringing out a new system in the next quarter.
I’m on auto-CPAP with 15-20cm and av.1 AHI,
I wanted to try the nasal pillow, but it can’t be used with such a high pressure setting. A twelve is high, but nothing compared to a 24. My biggest issues is trying to swallow with the thing on full blast. I swallow and the machine pauses, then it forces a breath. My BIPAP kind of like takes over the breathing for you so that if you have a central apnea, it forces you to breathe. It stops when you hold your breath, then kicks in fast if you try and breathe out fast. It is very weird. It will force you to breathe if you try and hold your breath. It’s like a fail safe. You can be high on meds and forget to breathe and the machine will force you to breathe. I may talk with my doctor again and get another authorization and just try and use some type of sleeping aid to help me get used to the mask. I have the Quattro Mirage full face mask right now. Another issue is that the mask works well when I am on my back, but leaks air when I am on my side. I’m a side sleeper so I might try just sleeping in a chair for a few hours a night. Just 4 hours of CPAP compliance per night is enough to reap the benefits of feeling more rested as 4 hours of good sleep if better than 8 hours of bad sleep. Any how, I hope you get it all sorted out. I’m glad you can use the nasal pillow. That is way better than a full face mask in my opinion.
I wish they had a machine that only kicked in when the events happened. Maybe they will figure this all out in the future. We are living in the best time in history to receive treatments for our disease. I am on a 21/24 or something like that. I think it is a 21 pressure setting with a high of 24. Or maybe one is EPAP and one IPAP. I’m not too sure. I have the RESMED 10 Aircurve. It is a pretty decent machine. My sleep doc is really good. I don’t know why he didn’t order the ASV, but he feels this is the right machine for me. I also have moderate/severe COPD, or something that is causing me to have very poor lung function and DLCO. I am close to almost qualifying for SSDI just based on my lung function alone, but all X-Rays and CT scans of my lungs are clear from disease. It’s very weird. I even bought a peak flow meter and I blew the same lousy results that I did in the pulmonary function test at home no matter how hard I blew. So maybe it is all tied together. All of these weird issues like the high BP only when sanding. My BP was 160/110 yesterday when cleaning the kitchen. Then it went back down to 118/80 within 5 minutes of sitting back down. I don’t know what to make of that.
[quote=“blizzard2014, post:29, topic:60793, full:true”]
I have the Quattro Mirage full face mask right now. Another issue is that the mask works well when I am on my back, but leaks air when I am on my side. I’m a side sleeper so I might try just sleeping in a chair for a few hours a night.[/quote]
I also use the Quattro Mirage and have done so for years. I sleep on my side and as I mentioned above at higher pressures when sleeping on your side you can get leaks as your pillow presses your mask out of alignment. I mentioned the pillow I have above, but you may actually find a specialty CPAP pillow works even better. In the meantime you might find that using a roll pillow or a rolled up towel at the neck level can lift the lower part of your face off the pillow enough to achieve a better mask seal.
I might even suggest talking to your sleep doctor about an APAP. A CPAP and BIPAP will use the high pressures all night, even when you don’t need them.
It sounds like one problem is you don’t have enough exhale relief of pressure,
I would go to the forums and they will show you how to post your charts from the sleepyhead free program and get some opinions. There are a few that have a wealth of experience in the labs. You can read some old posts to see who knows stuff.
This will give you stuff to talk with your Dr about. I don’t know why you aren’t on O2 with those sats, has the dr explained why he doesn’t think O2 is needed?
An auto ivaps can work for copd and won’t hyperventilate you, It will work within your tidal volume. It’s probably less than the ASV too. My point is there are lot’s of options between your current CPAP and getting a trac.
One problem with my doc is that he is a very good thorough doc, but it is hard to see him. During my last appointment he was dealing with a dying patient and I never got to see him. I got tired of waiting. They were running a bunch of tests on me as well. I have so many other issues going on that it is sometimes too much to deal with. My oxygen was low all night on both sleep studies, but corrected to above 90 percent with the CPAP titration study. I think they aren’t giving me oxygen because the titration study fixed the low oxygen. I might get a different sleep doctor when I get a better insurance. On our last visit he was trying to push another sleep study on me because I lost 30 pounds and I just got the impression he was trying to make money off of me. I hate doctors. He also denied my request for a sleeping aid. I felt like he wasn’t even listening to me when I told him that putting the mask on wires me up. I tend to stop going to doctors who dismiss my complaints.
you said you were desat during the day,?
I’m not clever enough and here isn’t the place, even though it’s a fixed pressure machine, with the card and software, you can minor adjust and check what pressures will work over a few weeks. It’s easier than setting the remote of a video recorder and the clever ones will guide you through it.
even if you don’t adjust, it’s worth using the sleepyhead program just to see your charts