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I'll preface all this by saying SleepGuide.com is probably the only place on the internet where you can have an intelligent discussion about anything that might cast CPAP in a negative light, given the financial interests of the other venues out there for education and support (read: people who want to sell you CPAP).  But I went to my doctor the other day and we got into a debate about whether if my next sleep study shows that my weight loss has reduced my AHI to acceptable levels, whether I should get off CPAP.   I argued against it, since my perception is that everyone has obstructed breathing at some point when they sleep and that positive airway pressure can only help keep the body oxygenated and healthy, even if the level of obstruction does not rise to the clinically approved definition of an apnea or hypopnea event.  The doctor disagreed, saying that reliance on CPAP reduces muscle tone in the tongue and that it can actually make you worse off.  He likened it to wearing a cast on your foot that keeps the foot immobilized -- sure that is needed at times, but when you don't use those muscles, you lose them.  

What do you all think?

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I agree with you. I can't even imagine not using my CPAP at night. I can't sleep soundly at all if I for some reason don't use it, which is not too often. I go into panic mode at just thinking that I may stop breathing; my snoring even before I started using CPAP (around 13 years now) was to the point that my wife could not sleep in the same room, so I know that it has been a life saver.

I don't believe it has weakened my tongue or muscle tone in that area. Yes, I am overweight, but am working on losing, but even before I gained this weight, I relied on the CPAP to breathe, and yes, maybe, peace of mind!

I don't think I will ever discontinue my CPAP, and I don't have a problem with that at all.

Well, here's my non-medical perspective...

I wasn't diagnosed with restless leg syndrome during my study, so I figure my feet, limbs, etc. are mostly immobile when I sleep. So what if my tongue is too?

During the day when I'm awake, I'm exercising my muscles, including my tongue muscles. That should be helping the tone.

I'm not saying there isn't any impact on tongue muscle tone, but it seems to me you also have to balance that against the negatives of the remaining apneas.

Most medical treatments have at least some risk of side effects. However, people generally accept them when/while the benefits exceed the risks.

Mike, Is your doc just flapping his tongue or does he actually have some evidence to back up this statement? Sounds like it is something he made up.

Anecdotally I can say CPAP made my tongue stronger. CPAP gave me renewed vigor and energy to stay awake longer and interact more socially which meant more exercising of my tongue. haha

If I didn't know any better, Id thought that I was listening to General Ripper from the movie Dr. Strangelove. With that said, I've been using cpap for 16 years and my tongue is as strong as it was then. Don't ask me to prove it :-)

uh oh.  need clarification of the reference to Dr. Strangelove.  Not to date you, but I'm 38 years old, and that's a little before my time.

Jeffrey Donaldson said:

If I didn't know any better, Id thought that I was listening to General Ripper from the movie Dr. Strangelove. With that said, I've been using cpap for 16 years and my tongue is as strong as it was then. Don't ask me to prove it :-)



Banyon said:

Mike, Is your doc just flapping his tongue or does he actually have some evidence to back up this statement? Sounds like it is something he made up.

Anecdotally I can say CPAP made my tongue stronger. CPAP gave me renewed vigor and energy to stay awake longer and interact more socially which meant more exercising of my tongue. haha

Flap, flap.  Thanks for the laugh.  After almost 6 years of using a CPAP,  I think my tongue is as strong as ever.  My guess is that when I'm running my mouth, some people would be happier if it was weaker. 



Rette Tyrrel said:

Flap, flap.  Thanks for the laugh.  After almost 6 years of using a CPAP,  I think my tongue is as strong as ever.  My guess is that when I'm running my mouth, some people would be happier if it was weaker. 

Banyon said:

Mike, Is your doc just flapping his tongue or does he actually have some evidence to back up this statement? Sounds like it is something he made up.

Anecdotally I can say CPAP made my tongue stronger. CPAP gave me renewed vigor and energy to stay awake longer and interact more socially which meant more exercising of my tongue. haha

Flap, flap.  Thanks for the laugh.  After almost 6 years of using a CPAP,  I think my tongue is as strong as ever.  My guess is that when I'm running my mouth, some people would be happier if it was weaker. 

A cast is on 24 hr/7 days a week, CPAP is not. Without some evidence, the similarity seems silly.

Well, this article seems to agree with the doc - well, sort of. The news is excellent, BTW!

FWIW, I'm seeing a speech therapist on Monday for the exact mouth, tongue, and throat issues. Can't wait to see what happens then!

I'm afraid to sleep without my CPAP. I've learned of three sleep apnea deaths since my June, 2011 diagnosis.Put me on Mike's side of the line on this.

BUT I would love to learn what your doctor says, Marcia. The article was intriguing. I'm going to start doing the exercises: I'd like to be able to take short naps without "suiting" up and might consider doing so if these exercises were truly effective. Or even just effective.

Marcia Herman said:

Well, this article seems to agree with the doc - well, sort of. The news is excellent, BTW!

FWIW, I'm seeing a speech therapist on Monday for the exact mouth, tongue, and throat issues. Can't wait to see what happens then!

I will attempt to remember to post what happens at the visit! I don't want to sleep w/o my machine either; I hate waking up with 02 levels in the low to mid 80s. Ugh.

And interrmittant hypoxia weakens your cardiovascular system, metabolic system, heart and brain.  Personally, I'd rather risk weakening my tongue than my heart and brain.  Plus a single apnea will kill you if it lasts long enough. 

I'll keep my APAP machine, thanks.  I consider it my best friend and saviour and wouldn't dream of leaving home without it.

Sarah Gorman

P.S. Was that your PCP or sleep doc? ( Scary either way.)

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