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Steven B. Ronsen updated their profile
Sep 15
We who are CPAP users all know that it's not a quick fix.. it takes time, patience and most of all, education to figure out how to get well using it.   

That said, we live in an age of instant gratification.  Of high speed internet access, accustomed to getting our problems solved immediately.  

Do we as a culture really have an appetite for CPAP?  Or for Sleep Apnea to really gain the awareness it deserves, do we need a more "quick fix" treatment modality?

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What a good question Mike. Working as a bartender for years I was spoiled with instant gratification. Cash in hand in all. My wife and I have been working to slow down our lives. Instant gratification does not always equal continued gratification. With our current economic problems I believe that society is beginning to learn that as well.
OSA is a chronic illness and CPAP or another form or combination of treatments are pretty much assured in our future.
I don't think with many chronic illnesses there are quick fixes. I spent a lot of years and was on a lot of different medicines for my bipolar disorder before I found the best combination- a knowledgible psychiatrist who knows her pharmacology. Kindey failure is lifelong for most folks, unless there is a translpant in their future, then there are still the anti-rejection medicines. COPD, Diabetes- no one ever finds something (or most folks) that works from the get go and continues to work.
The only quick fix treatment modality I know of for OSA is tracheotomy. And I tell you I would do it now if I could swim. Surely there is some water proof way to cover the stoma- maybe something similar to, but smaller than a colostomy bag..
I think for those of us in our 50's we are used to looking at some illness as long term, requiring multiple tratments and/or doctors visits. Maybe the quick fix mentality is more common to the youngsters. I'm certainly not accustomed, though I wouldn't mind them, to quick fixes.
A good question, Mike,
Mary Z.
I think the "now" generation is passing into the boomer age pretty soon
very interesting. never thought of it as a generational thing. i just assumed that most everyone wanted everything right away. maybe it's just my generation and younger. I'm 36.

Mary Z said:
OSA is a chronic illness and CPAP or another form or combination of treatments are pretty much assured in our future.
I don't think with many chronic illnesses there are quick fixes. I spent a lot of years and was on a lot of different medicines for my bipolar disorder before I found the best combination- a knowledgible psychiatrist who knows her pharmacology. Kindey failure is lifelong for most folks, unless there is a translpant in their future, then there are still the anti-rejection medicines. COPD, Diabetes- no one ever finds something (or most folks) that works from the get go and continues to work. The only quick fix treatment modality I know of for OSA is tracheotomy. And I tell you I would do it now if I could swim. Surely there is some water proof way to cover the stoma- maybe something similar to, but smaller than a colostomy bag.. I think for those of us in our 50's we are used to looking at some illness as long term, requiring multiple tratments and/or doctors visits. Maybe the quick fix mentality is more common to the youngsters. I'm certainly not accustomed, though I wouldn't mind them, to quick fixes.
A good question, Mike,
Mary Z.
That is indeed a great question!

I do believe there is a cultural mentality of instant gratification nowadays and that it is cross-generational. On the other hand, I also think it is more present in younger generations. Beyond the obvious reasons related to technology, the speed of communication and the pace of life accelerating, I think it's also related to how we were brought up.

Although I am an only child, I am 45 and my parents gave me real boundaries. I didn't get anything I wanted when I wanted it as some kids do today. On the other hand, I am impatient by nature and have always been but I have learned to discipline it.

But the complete answer is much more complex than that IMO.

It's funny you bring this up now Mike as, only today I was speaking with a friend of mine who has been diagnosed with OSA a few months before me. He has abandoned his treatment and even returned his machine. He's 40 and had apnea only slightly less severe than mine (I had 42 events per hour, he had 39). In his case there was an element of him wanting to work quickly but, from what I could gather, the way he was counseled and followed by his doctor and DME is appaling. He got no help with his mask troubles and no help adjusting to his prescribed pressure (which was quite low). He told me he'd had a traumatic episonde as a child with strong winds and choking because of it and he was struggling with that. He is bi-polar as well so he's followed by a psychiatrist but I'm not sure that doctor helped him cope with his CPAP treatment.

So, in that case, I think that beyond the patient's attitude and potential wish for a quick fix, the system itself failed him. That makes me realize even more clearly how extraordinarily lucky I am to have adjusted as easily as I did to my therapy. I'm not feeling 100% better yet (memory and concentration still have ways to go) but, in a way, my PAP therapy *was* a quick fix for me. I love my machine, my first mask worked and I have been 100% compliant wearing my mask every night and all night since I started on February 7. My doctor supported my small pressure changes and wrote me a new prescription with my new numbers (6 to 18) after talking with me and my showing him my detailed EncorePro reports.

But I know one thing though, even if it hadn't worked this well this quickly for me, I would have fought through it because my doc and the people I know that have apnea made very clear to me the severity of my condition and the potential dire consequences. So, quick fix or not, I never felt I had a choice but to stick with this no matter what as I do care greatly about my own health. But I have so much respect and admiration for people like Mary who make all these efforts to stay with it despite great difficulties. Although sleeping with a mask is not my first choice, I really can't complain...
It is nice to want a quick fix but the truth is that we do not have a good quick fix out there. Surgery is not successful enough for it to be considered a quick fix, and many of these other treatmens have not panned out very well either. The fact is if a quick fix does come along then CPAP will go away because it would no longer be the gold standard.

For right now we will have to settle for what we have.
You are very lucky indeed Stephane to have had such immediate positive results with CPAP. Even still, you're here though, seeking to learn more and to educate yourself. What is motivating you to do that?

Stephane Bergeron said:
That is indeed a great question!

I do believe there is a cultural mentality of instant gratification nowadays and that it is cross-generational. On the other hand, I also think it is more present in younger generations. Beyond the obvious reasons related to technology, the speed of communication and the pace of life accelerating, I think it's also related to how we were brought up.

Although I am an only child, I am 45 and my parents gave me real boundaries. I didn't get anything I wanted when I wanted it as some kids do today. On the other hand, I am impatient by nature and have always been but I have learned to discipline it.

But the complete answer is much more complex than that IMO.

It's funny you bring this up now Mike as, only today I was speaking with a friend of mine who has been diagnosed with OSA a few months before me. He has abandoned his treatment and even returned his machine. He's 40 and had apnea only slightly less severe than mine (I had 42 events per hour, he had 39). In his case there was an element of him wanting to work quickly but, from what I could gather, the way he was counseled and followed by his doctor and DME is appaling. He got no help with his mask troubles and no help adjusting to his prescribed pressure (which was quite low). He told me he'd had a traumatic episonde as a child with strong winds and choking because of it and he was struggling with that. He is bi-polar as well so he's followed by a psychiatrist but I'm not sure that doctor helped him cope with his CPAP treatment.

So, in that case, I think that beyond the patient's attitude and potential wish for a quick fix, the system itself failed him. That makes me realize even more clearly how extraordinarily lucky I am to have adjusted as easily as I did to my therapy. I'm not feeling 100% better yet (memory and concentration still have ways to go) but, in a way, my PAP therapy *was* a quick fix for me. I love my machine, my first mask worked and I have been 100% compliant wearing my mask every night and all night since I started on February 7. My doctor supported my small pressure changes and wrote me a new prescription with my new numbers (6 to 18) after talking with me and my showing him my detailed EncorePro reports.

But I know one thing though, even if it hadn't worked this well this quickly for me, I would have fought through it because my doc and the people I know that have apnea made very clear to me the severity of my condition and the potential dire consequences. So, quick fix or not, I never felt I had a choice but to stick with this no matter what as I do care greatly about my own health. But I have so much respect and admiration for people like Mary who make all these efforts to stay with it despite great difficulties. Although sleeping with a mask is not my first choice, I really can't complain...
I just had the determination to make it work -- with no hand holding. It took me about a month to pretty much be able to sleep OK with CPAP, although I really didn't like it. It took longer to feel great, but I felt a lot better after the first month. I had ZERO support when I started using CPAP; my sleep doctor had told me how to hook it up and the DME delivered it while I was not at home (my now-ex-wife was there). There was no Internet for support. There was a support group at the hospital where I had the sleep study, but it was too far away and with my work hours I couldn't go to meetings..
Mike said:
You are very lucky indeed Stephane to have had such immediate positive results with CPAP. Even still, you're here though, seeking to learn more and to educate yourself. What is motivating you to do that?

Sorry for yet another long post ;)

Several things are motivating me to do it. The first is that, when I'm about to make important changes or even buy something new of some significant importance, I like to know what I get into. I did the same when we purchased our water treatment system a few years back (RainSoft) or our new heating system a while later. I read reviews, forums and anything I could find. But of course, money-wise, these were major expenses (quite a bit more so than a CPAP) so I wanted to make sure what we were buying and the companies behind the products were sound.

Secondly and most important, it is my health that was concerned, my well being. My wife had noticed my snoring and my stopping breathing at night. This had gone on for a few years and she was growing more concerned all the time. On my end I also certainly noticed that my memory and ability to concentrate were degrading... more so than my age and "wild" youth could explain. My energy levels were nowhere near what they used to be. Furthermore, I've fought with my weight for several years now but that was not always the case for me. I used to be in much better shape and, even if I packed on a few pounds (I do have a genetic predisposition for it), I could shed them rather quickly.

But it stopped being so easy and the weight kept adding on. I'm 5' 9" and now weigh 240 lbs (more on that later). That's the heaviest I have been in my entire life and I really hate that. We are already eating very well so I can't cut soft drinks or go to fast food joints less often for example. I never drink those and very rarely eat in those kinds of places. Also, I tried several kinds of exercises in the last few years with disappointing results... and again, I was not looking for a quick fix and often stuck to it long enough for it to work better than it did.

So, when we finally put 2 and 2 together and suspected OSA, I got tested and the results confirmed it. I had severe apnea with 42 events an hour and, many of them lasting a lot more than 10 seconds and my O2 often went down to the low 70s and sometimes the high 60s. I finally had an explanation to why all those efforts yielded so little results on my weight, why I often woke up with a headache in the morning and why I had such low energy. I was also given a relatively easy way to treat the condition and bring my metabolism back up, improve my memory and concentration and stop taxing my heart. All that without taking pills or getting surgery. I was so relieved I actually jumped into researching OSA and CPAP treatment with such excitement that I read anything I could find about it.

The third reason is that I am a true geek ;) If I'm going to get a new technological gizmo, I want to know how it works and I want to be able to tweak it myself. But the more I read about CPAP and other people's experience here and on other similar forums, the more it motivated me to go through this process in the health system armed with the best information possible. I wanted my therapy to be as comfortable as it could be for me and I didn't want to be given misinformation without even realizing it. I pretty much had my mind set on an Auto-CPAP and the PR One even before trying it. I thought I'd need a full face mask as I used to mouth breathe a lot (I now know I was gasping for air) but the lady at the DME made me try the Activa LT nasal mask and, 5 weeks later, I realize how perfect it is for me. If I needed a higher pressure it might now work but the PR One basically stays between 6 and 8 or 9 most nights with very occasional peaks at 10 or 11... so quite a bit lower than my originally titrated pressure of 15.

Lastly, what keeps me motivated to keep learning now is to monitor my progress. I got a lot of energy back right away once I started CPAP but, my memory is far from all back yet and neither is my concentration power. I used to have phenomenal concentration powers and I just hope I will get more of it back.

Going back to my weight, it has not gone down in terms of pounds yet but, about a month before I actually started CPAP, my wife and I started intense weight resistance training so I'm building up muscle mass. My weight hasn't gone down yet but my pants are definitely looser and my wife tells me I look smaller. I certainly feel stronger and have much more energy and willpower to exercise. It's actually not a chore for me anymore and I know it is both because I finally found something I like doing but a lot of it is because I have much more energy and pep. And that is definitely due to my CPAP therapy. So here I am, still wanting to learn more about what has basically given me my life back and how it might keep improving it as the ill effects of apnea are reversed (as much as they can be). As I said before, it's a no brainer to me.
A couple of things on this.

Firstly, I don't consider my OSA problem is a disease. It's more like being short or tall or well-sighted, hard of hearing etc. It's something about our anatomy we just have to live with.

That's not to say it doesn't need treating; it clearly does as it's a quality of life wrecker when it isn't.

Does the NHS take it seriously enough? No; but then the NHS is pretty crap at most things, never providing more than an average service for anything. There's not a branch of the system that works very well and lots that hardly work at all.

Can you get better OSA help privately? No; too many crooks, charlatans and quick money men.

Should people with OSA spend a lot of time thinking about their therapy. No; get a m/c and get on with it. Don't turn it in to a lifetime's obsession. (Although I have to admit to being intrigued by the Resmed S9; a bit of a geek myself like another poster here).

As for instant gratification; I don't think much has changed here except we now expect things to be fixed or fixable. In the past there was an acceptance of things - fate, God's will etc - that we don't have today. If there's something wrong then there must be a solution; and not only do I want it, I am entitled to it, and entitled to it now.

It's more to do with politics - the state will (must?) provide, it's someone (else's) job, that sort of thing - rather than a change in our attitude to instant gratification.
I think the quick fix is elusive because of a lack of research. Doctors could certainly refine the surgical techniques (perhaps something less invasive, such as laser surgery) with enough time and interest. And, yes, I know--laser surgery is already out there, and yes, it doesn't work well. But that's one of the advantages of research. It's sometimes almost miraculous what kinds of treatments are developed, if anyone, ANYONE, chooses to look. With more research dollars, I firmly believe that OSA could be completely curable, but no one is interested in funding such research.

Think about it: OSA is a PLUMBING problem as much as anything else. It's not mysterious like bipolar disorder or cancer. It's just the air hoses screwing up. Surely there's a quick, reasonable, affordable fix somewhere in the future.
I disagree with your premise, Mike. It's too easy to pat yourself on the back and say "Those other people are just looking for a magic bullet." The reason people aren't "compliant" is not because they're lazy, but because they are getting poor results and they either are not getting good advice or they don't know where to turn for assistance. I tried CPAP for 7 months with absolutely no improvement whatsoever, and every time I would call the home care company they would say, "Just keep using it!" Finally I gave up in despair. Was that my fault? Am I just a lazy slob looking for "instant gratification"? Hardly! I am currently using an oral appliance, and unfortunately, I am not getting good results with that either. But at least I have an oral specialist who has stayed with me throughout the process. Now, I am planning to undergo a second CPAP (or better still, AutoPap) trial, in combination with the oral appliance. This time, I will take a much more aggressive (yes, aggressive) role with a different home care company, and hopefully, obtain better results.

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