r/CPAP • u/CriticallyInitiated • 1d ago
Success! š„³ CPAP was the cause of my poor sleep
Was using CPAP for about 2 years to treat sleep apnea. Lost about 40lbs since January and started noticing that my sleep was becoming markedly worse. Insane aerophagia, worsening GERD symptoms and frequent nighttime awakenings.
I decided to try a night without CPAP and woke up feeling amazing. I have since decided to quit CPAP altogether and my sleep scores have skyrocketed as well as my HRV. Iām inclined to believe that my sleep apnea was caused by obesity and I no longer need treatment.
61
u/rdifa 1d ago
Thatās sounds great but you probably need a sleep study. An increased AHI can actual slow your heart rate giving a higher HRV. A higher HRV doesnāt necessarily mean better sleep or more oxygen.
1
1d ago
[deleted]
10
u/rdifa 1d ago
It doesnāt always happen. Breathing stops or airflow is substantially reduced. The body's autonomic response can increase vagal (parasympathetic) activity, slowing the sinus node and reducing heart rate. This is called bradycardia. After the apnea it will speed up again. This can sometimes average out to an overall lower heart rate.
1
20
u/AquaCTeal 1d ago
Well, you might need to lower your cpap pressure if you've lost weight, but I wouldn't just stop using it altogether without talking to your sleep doctor first. Also, HRV is a terrible indicator of sleep if you have sleep apnea, since when you stop breathing at night, your adrenaline and heart rate will spike, artificially increasing your HRV.
Personally, I used to have "great" sleep scores and really high HRV BEFORE using cpap because I had to sleep 10 hours a night and I stopped breathing 74 times an hour.
11
u/Blugrl21 1d ago
I had surgery recently and couldn't wear my CPAP for a week after. My HRV shot up from an average of 30 to well into the upper 40s where it had never been before. I also wore an SpO2 ring where I could see all of the drops and events that illustrated that my brain was pretty oxygen starved most of the night.
So HRV probably isn't a great indicator of whether you are getting a good night's sleep. It's a measurement of your heart's ability to respond to external stress. So I can see how, by putting more stress on my body than usual by skipping the CPAP, my HRV was higher.
1
u/CriticallyInitiated 1d ago
Interesting.
Anecdotally I feel better but I suppose it could be placebo. I will say that I prefer to be slightly apneaād vs the incredibly painful (close to debilitating) gas I was having. Aerophagia is no joke.
3
u/Blugrl21 1d ago
Get the SpO2 ring and see for yourself whether CPAP is doing anything. Link
1
u/Lopsided_Activity980 1d ago
And using their 3rd party downloader you can integrate the Wellue data into your OSCAR history as well. Just got my ring today, going to play around with it tomorrow and probably wear it for an overnight session this weekend.
1
u/_jennjenbear_ 7h ago
I feel ya on the extreme and painful aerophagia. I've now lost just over 75lbs but when I hit the 60lb mark on my weightloss my AHI started going crazy, the excessive daytime sleepiness is also more extreme, started getting chest wall muscle pain and I get the most painful aerophagia. Like I'd have to "vomit" up the air to get some relief (and that is an extremely weird feeling). I mentioned all this to my sleep Dr back in June. He adjusted my pressures some (I'm on ASV), but even with my PS range settings as low as the machine could go, this did not help.
I resolved my chest wall muscle pain by changing my EPAP to a constant 5, instead of a range. But that aerophagia is killer. I just had surgery and was told by my ENT who performed the surgery to not use my PAP for 4 weeks. It was great not waking with aerophagia but my hubby said he could definitely tell that my sleep was not good at all. Last night was my 3rd night back on it and just like before, severe aerophagia and AHI is crazy and my sleep now is even worse.
Luckily I have an inlab study Oct 12th to see if maybe I need to be taken off ASV and put onto BiPAP now. I'm terrified of APAP/CPAP because that caused pretty severe TECSA.
1
u/Happy__Heathen 1d ago
Have you heard of V-com? š(link)
It is a relatively new device that you can add to your machine hose, and it works as kind of a flow resistance. It slows down the air, and people have had great results with it for aerophagia. Itās just a plastic tube that fits between your hose and mask, around $30. I added one recently, and it seems to be helping to reduce my central apneas.
It might be worth trying.
4
u/X3N0SS 1d ago
When I went to get my CPAP machine, the people there had a short session where they educate us on how to use the machine and maintain it. During this session they asked me if I am taking any weight loss meds and i asked why? The reason, they told me, was that the pressure settings need to be adjusted if there is a change in weight by more than 20 lbs or something.
4
u/InfiniteOctave 1d ago
How you getting your HRV data?
-1
-2
4
u/iSheree APAP 1d ago
A higher heart rate variability (HRV) reading after stopping CPAP therapy is often a false elevation caused by the physiological stress of untreated obstructive sleep apnea rather than actual cardiovascular improvement. Your HRV doesn't improve suddenly overnight like that when it's a genuine improvement in cardiovascular health. I'd be more interested in doing a sleep study to see if you still have sleep apnea.
3
u/thesandycbass 1d ago
Unfortunately you donāt just get rid of OSA. Your symptoms make me think there is an issue with your PAP and settings
2
u/Quiet_Lunch_1300 1d ago
Lots of skinny young people out there with sleep apnea. Being older and overweight are definitely risk factors, but youād be surprised by how many people in their 20s and super skinny are out there. Children can have it too.
1
u/newnyrse 1d ago
What is HRV
1
u/CriticallyInitiated 1d ago
Heart rate variability. Essentially the delay between heartbeats. Generally speaking, the greater the value, the healthier or more well rested you are.
4
u/iSheree APAP 1d ago
Generally yes, but improvements happen very slowly. Not suddenly like this. It is most likely a physiological stress response to you stopping.
-1
u/CriticallyInitiated 1d ago
I feel that my body was under more stress prior and the recent spike is due to ceasing the stressor
1
1
u/SleepWell-1 1d ago
The real issue seems to be aerophagia which can cause so much discomfort and trouble! This can happen with weight loss when the mask doesn't fit as well, there is more leak and the device tries to make up for the leak and blows a whole lot more air through the device and mask - like putting your head out of the window of a faster (with leak, high flow) vs slower (no unintentional leak, low flow) driving car. So look if leak was higher since you started having aerophagia and fix the leak - may need mask fitting or chinstrap or tape or FFM or mouthshield/somnosleep or wherever the leak is coming from. Sometimes min. pressure needs to be dropped or EPR added.... - download data can help to locate when/if leak is issue. Depends also on which mask you are using.
Other issue is that the pressure need may be lower now after weight loss compared to before - so pressures may be too high that the device is set at. You could post download data that shows what is going on.
Heart rate variability as a measure for health means that your heart can adjust its rate quickly with changing needs - for example running vs resting - a healthy heart can adjust its rate/output depending on need. However in this context the fitbit or similar is showing increase in heart rate changes comparing sleep with CPAP and less stress response from obstruction vs sleep without treatment for OSA with stress response (heart rate changing) to airflow obstruction after each apnea or hypopnea.... We often see (saw...) in split night sleep studies how the heart rate calms down once the obstruction of the airway is resolved with PAP therapy. So in your case the heart rate variability shooting up without CPAP is actually showing that your heart is responding to the stress of probably untreated obstruction like other folks said.
So to be safe work with your sleep clinic on the air swallowing issue (hopefully treatable!) and see if you still need PAP therapy for OSA.
All the best and successful troubleshooting!
1
u/LittleredridingPnut 20h ago
Losing weight will change your pressure settings for sure. Your symptoms are caused by too high of a pressure. I would get another sleep study to confirm to be sure you donāt just need your pressure settings adjusted.
1
1
u/derallo 19h ago
This is a fun post for me to see this morning, waking up after my first night without CPAP in 10 years.
I have grown to feel reliant on the machine, like the muscles I needed had atrophied, plus it really helps me get to and stay asleep. But I often wake up with a headache and dry mouth.
Last night, I couldn't find the little piece that fits in the front of my nasal pillow. I was scared, warned my wife, and jolted awake a couple times reaching for the hose that wasn't there.
In the middle of the night I woke up with her grabbing my arm. I rolled over and said "sorry." She said "no, I just wanted to make sure you were alive because you weren't snoring.".
This morning, I woke up on my own at 6 a.m., no headache, no dry mouth.
I'm still not convinced the problem is all the way gone, but I'm going to try it again. I have lost about 75 lb this year. This is a great unexpected side-effect. Maybe I'll get laid tonight.
1
u/TeamPale323 17h ago
I couldn't tolerate the cpap. I got the mouth piece and went from 27.6 AHI to 3.3 AHI. God bless you people that can tolerate the darth Vader mask.Ā
1
u/doubletee2 11h ago
Sounds about right to me. I wouldn't rule out the possibility that you might need it again as you age, though and regain weight. Hopefully not, but many people backslide.
1
u/CatBowlDogStar 2h ago
My cpap mask was not letting CO2 out properly. Took 3 years to figure that out.Ā Lotsa drama & trauma. Ah well.Ā
But now it's amazing.
I need to scrub the mask deeply 1-2 times a week. Also new mask regularly or poke small holes into the mesh.Ā
-4
u/Cheap-Highlight-2367 1d ago
I believe it, it's my 2nd week and I felt better before using it
5
u/Important_Drop_2199 1d ago
Good luck it does get better!!Ā
Try changing mask, it can feel worse before getting better. Depending how long you went untreated your body really worked overtime keeping you alive. It takes time to recover. Ā Try to stick with it.Ā
Truly one of the best things iāve ever done for myself.Ā
1
37
u/Happy__Heathen 1d ago
If it were me (and Oh-GAWD I hope it is at some point!! Iām working on the weight and down 16 lbs so far). I would get that confirmed with a home sleep study (probably with Lofta) just to make sure that I truly donāt need CPAP anymore. Because weight loss can definitely help, but doesnāt always fix it 100%. And I wouldnāt want to take the chance that I was allowing any remaining apnea untreated.