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Sep 15, 2018

When do I need to get a new sleep study after weight loss?

I am losing weight, finally! 21 pounds so far. I am wondering when I will need to have a new sleep study? I was going to wait until I lost all my extra fat, but then started thinking that even a little weight change might make a difference in my CPAP settings. Thoughts would be appreciated! bee

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Bee, i just read this and felt compelled to congratulate you on your impressive accomplishment.  21 lbs is not easy.  i lost ~12 lbs since Thanksgiving and i'm hugely proud of myself.

 

my answer to your question would be to keep things status quo if you feel good and you're comfortable with the pressure you have.  and save yourself the hassle and expense of a sleep study.  worse comes to worse, you're getting slightly more pressure than you really need.  so what?  

Hi Mike! Thanks! I feel a lot "lighter"...:>D I didn't know I could eat so many green vegetables....lol

 

That really was my question, is more pressure than you "need" dangerous?

 

So I guess I can wait until Sept until I hit my goal weight and see if I need to be re-tested. I am still holding out hope I might not have to have my CPAP....but I am mentally prepared to have it for the rest of my life. I know there are 2 schools of thought on this issue.

BeeAsleep, congratulations on the weight loss.  I agree with Mike.  Unless you have a compelling reason to want/need to lower your pressure I would leave it as it stands.  If you check your daily AHI and AI if they start to get worse I would get in touch with my doc and see about an adjustment.  Every change in pressure does not have to be dictated by a sleep study.

Thanks Mary.

 

I think I can find something else to spend my time and money on besides a sleep study. I just didn't want to be blowing out my lungs with my pressure. It is set pretty high as it is. lol!

You can tweak your settings yourself if so inclined.  Just watch your numbers that they don't get worse.  Yeah, if I had a high pressure (and I have previously)  I would want to get it down, too.

As to more pressure than you need being dangerous, I don't think so.  There is a lot bandied about too high of a pressure causing centrals, but you probably don't need to be concerned with that  I think the danger is grossly overstated. 

we're not doctors, of course, but i know that one of the most prominent/ famous sleep docs -- Christian Guilleminault out of Stanford in California -- is a big proponent of the more pressure, the better approach -- all other things being equal (like no respiratory disease, etc.)

 

I'd like Rock or a Respiratory Therapist to weigh in on this too.  seems like an issue up their alley.

@Bee, Wow Bee! That is wonderful! My hat is off to ya. We need to do lunch now that my life has calmed down.

 

Anytime you gain or lose 10% of your body weight you should be eligible for a new study. This is pretty standard but may vary by insurance carrier.

 

Good job!

Mary Z said:

You can tweak your settings yourself if so inclined.  Just watch your numbers that they don't get worse.  Yeah, if I had a high pressure (and I have previously)  I would want to get it down, too.

As to more pressure than you need being dangerous, I don't think so.  There is a lot bandied about too high of a pressure causing centrals, but you probably don't need to be concerned with that  I think the danger is grossly overstated. 


Mary, Bee is on Colorado. I can't be sure but Im assuming that her house sits at around 6000 ft up. At this altitude apnea and respiratory function is a very different beast. I see a great deal more complex and CSA than anywhere else that I have worked. I would not suggest that anyone tweak their pressures without some sort of guidance.

 

Important technical note. On PAP apneas are minimized. Hypopneas or flow limitation become the standard breathing events on therapy. It is important to remember that with hypops or flow limitation you are still gettting some air into the lungs. If you induce centrals into this pathology flow limitation becomes a cessation in flow and more importantly effort. Is this phenomenon going to killl you instantly? Most likely not. It does however revearse or cancel out any benefits from your therapy.  
Mary Z said:

You can tweak your settings yourself if so inclined.  Just watch your numbers that they don't get worse.  Yeah, if I had a high pressure (and I have previously)  I would want to get it down, too.

As to more pressure than you need being dangerous, I don't think so.  There is a lot bandied about too high of a pressure causing centrals, but you probably don't need to be concerned with that  I think the danger is grossly overstated. 

Bee, you're my new hero!  Ideal body weight would resolve most OSA in the US, including my own.  You are on your way!

 

I understand your concern about too much pressure on the lungs, but you are most unlikely to experience such a problem with a properly functioning PAP device set at your currently prescribed pressure.  And I am not aware of central apneas being caused by remaining on a previously optimal PAP after weight loss.  While your optimal PAP may be lower now, I say as long as long as your OSA symptoms stay away, wait until your weight has stabilized before considering expensive & inconvenient retitration. 

 

Congratulations on your terrific progress!

 

Rock

Well said Mr. Conner!

Rock Conner said:

Bee, you're my new hero!  Ideal body weight would resolve most OSA in the US, including my own.  You are on your way!

 

I understand your concern about too much pressure on the lungs, but you are most unlikely to experience such a problem with a properly functioning PAP device set at your currently prescribed pressure.  And I am not aware of central apneas being caused by remaining on a previously optimal PAP after weight loss.  While your optimal PAP may be lower now, I say as long as long as your OSA symptoms stay away, wait until your weight has stabilized before considering expensive & inconvenient retitration. 

 

Congratulations on your terrific progress!

 

Rock

Thanks so much you guys for all your support. I never thought I could lose the weight I needed, but one day at a time...one bite at a time I am on the road. I should be at my goat weight by September. I have a new A1C test scheduled for July. I am seriously fighting to NOT get diabetes, and I was dangerously close. So the weight loss was to improve my health overall.

 

You know, I have an APAP, with the bottom set at 9 and the top at 11 so I thought I would do a reading this weekend and see if the top numbers were at the bottom end. If they were, I might "tweak" my settings down a bit. But I will see what the numbers say. 

 

Hi Rockland! Yes, you still owe me a cup o' joe! There is a great new little coffee shop in Gunbarrel. The owner makes the lattes for me with a little foamy heart on top. YUM! Let's set a time and share some joe and catching up!

 

(PS I do live at 5, 280 feet above sea level. :>D)

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