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Re: OSA treatments not working

Posted by Brian on December 19, 1997 at 21:46:23:

In Reply to: OSA treatments not working posted by Laurie Miller on December 18, 1997 at 17:09:55:

Hi Laurie!
More info about you would be helpful. Do you have a diagnosis of OSA? Do you snore/obstruct/desaturate? Age? Weight? Other factors? Sleepy in daytime? When you awaken at noc, do you have trouble getting back to sleep?
Sounds like you may be having significant central apneas, in which case, BIPAP with a set minimum rate may be the answer.
You are wise to be conservative about surgery. Best to exhaust all non-invasive approaches first before taking the risk.
Meanwhile continue to use what currently works best for you so far, and explore possibilities for a more effective solution.
If current treatment is able to eliminate O2 desaturation, you have made a significant gain, even though you may be awakening several times/noc. Do you have nocturia? What is the state of your sleep hygiene?
The biggest risk associated w/OSA is desaturation. While frequent waking is annoying and damaging to the normal sleep archetecture, it doesn't result in oxygen starvation of the brain. If you have had a long history of OSA, your central nervous system may be habituated to periodically alarming you into wakefulness as a rescue from desaturation by engaging the symapathetic system "fight or flight" response, if the desat episodes are brought to a stop, the waking episodes may gradually decrease as the brain realizes that it is no longer necessary to wake you in order to assure its O2 supply.
In the sleep lab, I commonly see behaviors which are unhygienic in terms of sleep health, such as drinking H2O or whatever before bed or during the night, or watching highly stimulating (action-thriller) movies at bedtime. Take a good look at your sleep habits. Consider your exercise or lack thereof, your consumption of alcohol, daytime napping, all of which have an impact on your ability to sleep.
Good luck to you. Don't give up.
Thanks for the opportunity to respond.
Brian

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