Dangers of Using a CPAP Machine

[Ghost1958]

The sleep center that I went to has an option available for people who cannot sleep at the center, They send specialized equipment home with the patient and they review the information from the equipment when it is returned. Most people who get any level of sleep provide enough information to allow diagnosis. When I went I tossed and turned constantly and they managed to get enough information.

Yep my wife just had one at home. Said she was an AHI of 4.9. Reason? She never did anything but catnap due to having the test machine on and knowing she was being "tested".
In reality I have for years and am right now as I type as she lays on the couch asleep watching her stop breathing over and over. Snoring. Wake up gasping for air, and at her very best doing heavily labored breathing. But that is minority of the time. The rest is a horror show.

One night with a contraption tied around your chest up your nose etc knowing you have SA badly and trying hard to go to sleep so you measure up to their arbitrary one size fits all number is a guarantee some folks will never sleep through multiple tests. Home tests are not the cure all for that they are made out to be.

[PaytonA]

The sleep center that I went to has an option available for people who cannot sleep at the center, They send specialized equipment home with the patient and they review the information from the equipment when it is returned. Most people who get any level of sleep provide enough information to allow diagnosis. When I went I tossed and turned constantly and they managed to get enough information.

I am not so sure that they managed to get enough information. From some of the things that I have read on this forum, I think that sometimes they make a WAG and at times it is incorrect. Then your doctor writes the prescription from that data and recommendation and any errors get perpetuated.

This is not from personal experience on my part. My in-lab sleep study was very well done and I slept easily and well. i have since found that the recommendation from the sleep group is spot on. I was lucky and my medical group chose a good sleep lab.

Best Regards,

PaytonA

[DocWils]

Now my question. Compared to a fire service SCBA, the total sealing mask that will NOT let you breathe if you run out of air in a toxic enviornment, the higher constant pressure it delivers to make sure no toxic gases get inside the mask, and the fire fighters ability to wring it up or down as he needs too, a cpap machine is a toy.

Yet no medical folks are over seeing or prescribing those or setting them. Or even refilling the tanks. And I have yet to hear of a Firefighter being adversly affected by and SCBA due to the pressures. Run out of air in a burning building your toast yeah but the pressures have never hurt anyone.

They are higher and constant and Firefighting aint sleeping trust me.
So if CPAP machines are so dangerous they need constant highly trained and expensive medical pros to dole them out and over see them, why not the SCBA unit? HUMMMM????

The devices you mentioned ARE regulated rather heavily, within their own industry (fire fighting supplies) and standards. They wear them for very short periods of time for a specific purpose and have been rigorously tested for safety and efficacy for the job they do. They are also awake and under extreme effort the entire time and require much higher pressure levels for those purposes.

You are asleep and requiring a considerably lower pressure and are using something for a medical therapeutic purpose. You are not a man running into a burning building to save a life and then get out again, real fast. You are also not a man who reasonably expects that he may not make it out of that building. Lung ailments are common amongst firefighters, and not just from smoke eating, but form the breathing devices as well.

You are, and the best way I can put this, unless you are well versed in the field or a long time user who has taken the time to learn all the ins and outs of CPAP therapy, ignorant when starting down this road. Deciding that you may have OSA or CSA on your own, based on your own non-medically relevant criteria, then walking into the local chemist's and buying your own machine, setting your own pressures and choosing your own therapy as if buying a band-aid (and you would not believe how many times I have seen those used improperly) would be the act of an idiot. And there are a LOT of idiots out there. It has to be done via Rx for any number of reasons, not least protecting the patient from themselves and of course, for insurance purposes. Sure, there are a lot of people in "the biz" who don't know their uvula from their peritoneum, certainly when it comes to prescribing you the best treatment in this still very young area, but there are a lot more patients who think they know what they are doing, and don't. Plain and simple. I cannot tell you how many patients I have had who think they know better than their doctors. in 99.9% of the cases, they don't. We try and listen anyway, BTW. Hell, most doctors don't know any better either, when it comes to their own health, which is why we aren't allowed to prescribe for ourselves. You need an independent eye to asses the situation.

On the other hand, I don't think mask choices should be prescriptive, but I would guess that without an Rx there would be no insurance reimbursement for the purchase. Certainly that is how it works here - over the counter stuff is on your own nickel, Rx is reimbursed by the insurance companies. So I guess it comes down to if you want to pay for the stuff yourself or not. Here, the mask choice is almost always with the patient, but the mask itself is prescriptive.

Don't compare apple and pears, please. Firefighting gear, or scuba gear, is simply not the same thing as CPAP.

[Ghost1958]

Now my question. Compared to a fire service SCBA, the total sealing mask that will NOT let you breathe if you run out of air in a toxic enviornment, the higher constant pressure it delivers to make sure no toxic gases get inside the mask, and the fire fighters ability to wring it up or down as he needs too, a cpap machine is a toy.

Yet no medical folks are over seeing or prescribing those or setting them. Or even refilling the tanks. And I have yet to hear of a Firefighter being adversly affected by and SCBA due to the pressures. Run out of air in a burning building your toast yeah but the pressures have never hurt anyone.

They are higher and constant and Firefighting aint sleeping trust me.
So if CPAP machines are so dangerous they need constant highly trained and expensive medical pros to dole them out and over see them, why not the SCBA unit? HUMMMM????

The devices you mentioned ARE regulated rather heavily, within their own industry (fire fighting supplies) and standards. They wear them for very short periods of time for a specific purpose and have been rigorously tested for safety and efficacy for the job they do. They are also awake and under extreme effort the entire time and require much higher pressure levels for those purposes.

You are asleep and requiring a considerably lower pressure and are using something for a medical therapeutic purpose. You are not a man running into a burning building to save a life and then get out again, real fast. You are also not a man who reasonably expects that he may not make it out of that building. Lung ailments are common amongst firefighters, and not just from smoke eating, but form the breathing devices as well.

You are, and the best way I can put this, unless you are well versed in the field or a long time user who has taken the time to learn all the ins and outs of CPAP therapy, ignorant when starting down this road. Deciding that you may have OSA or CSA on your own, based on your own non-medically relevant criteria, then walking into the local chemist's and buying your own machine, setting your own pressures and choosing your own therapy as if buying a band-aid (and you would not believe how many times I have seen those used improperly) would be the act of an idiot. And there are a LOT of idiots out there. It has to be done via Rx for any number of reasons, not least protecting the patient from themselves and of course, for insurance purposes. Sure, there are a lot of people in "the biz" who don't know their uvula from their peritoneum, certainly when it comes to prescribing you the best treatment in this still very young area, but there are a lot more patients who think they know what they are doing, and don't. Plain and simple. I cannot tell you how many patients I have had who think they know better than their doctors. in 99.9% of the cases, they don't. We try and listen anyway, BTW. Hell, most doctors don't know any better either, when it comes to their own health, which is why we aren't allowed to prescribe for ourselves. You need an independent eye to asses the situation.

On the other hand, I don't think mask choices should be prescriptive, but I would guess that without an Rx there would be no insurance reimbursement for the purchase. Certainly that is how it works here - over the counter stuff is on your own nickel, Rx is reimbursed by the insurance companies. So I guess it comes down to if you want to pay for the stuff yourself or not. Here, the mask choice is almost always with the patient, but the mask itself is prescriptive.

Don't compare apple and pears, please. Firefighting gear, or scuba gear, is simply not the same thing as CPAP.

Ok ill never get the ones with fist in the pie to get it. One Ive not said SCBA or SCUBA and Cpap were the same. They arent. SCBA can be dangerous. Its high pressure air running thru a regulator that though rare can fail. Either shutting off air entirely which can be deadly if your in the thick of a fire or If it fails and opens up with no restriction there is enough pressure in that tank to explode ones lungs.

Cpap doesnt have enough pressure to inflate a balloon.

Now all that aside. There are if Docs wish to believe it or not folks that will not show apnea on the home or lab test because they dont sleep or dont sleep soundly enough to show it or show it to the extent a Doc will diagnosis it. Even though that same individual will suffer with severe apnea for years nightly. Its a fact.

Now that leaves the person to either do it themselves or suffer all the damage untreated Apnea causes.
Im all for going the normal route if it can be done but when it cant and the medical and insurance folks wont listen or help then they need to get out of the way.

Just an aside. Ive been nearly killed three separate times by "highly trained professionals". Two gave me heart meds that were flagged plainly to them to interact violently with what I was already taking the same Docs had prescribed. The drugs predictably did interact and almost stop my heart.

The other"Professional" poked a hole thru the outer wall of my heart during an ablation surgery though he was rated as one of the best in the nation at that procedure. 5 days later I got come home once they got the leaked blood off my heart.

Might have something to do with the statistic one is 22 times more likely to die by mistreating or simply blundering by a Doc than they are to die from a handgun gun wound to the chest.

Im not knocking Docs. You get a good one you have something to cherish. But guarding the gate to Cpap like it was some hugely dangerous drug is in JMO a money game by the medical profession, insurance and DMEs.

And it causes alot of folks that need treatment for SA to not get it if they cant fit into the cookie cutter mold laid out. Again JMO. Easily dismissed.

[DocWils]

It is not so much the dangers of CPAP as a reason for the Rx as a) the ignorance of the public so they would buy it for nothing, or a buy a pig in a poke as you Yanks would say, and b) the costs. In and of itself, CPAP isn't all that dangerous, and that is not the reason for the Rx, although misuse, too low or too high a pressure could be dangerous in the long term (we normally don't have patients with settings so wrong over a long term that we can see if there is a long term effect, so that is us being cautious), and if you don't have apnoea at a clinical level, it won't help you at all.

Without the Rx, you would have to pay on your own tod, with it, your insurance pays. For a device that costs 4k, that isn't the worst idea in the world, so it is consumer protection and that alone should be enough for you.

Medical devices above a certain class are all controlled devices, by law in pretty much every country, and it makes sense for any variety of reasons, not least being this isn't quackery you are talking about. And yes, accidents do happen and mistreatments happen in the med profession, and I am sorry you have had a greater share than most of that. Statistically, it is estimated that every doctor will kill one patient during their career from training to retirement due to error or not catching the problem at all. we are aware of it, and train like the dickens so it doesn't happen, and it is our constant nightmare, believe me. No procedure is taken lightly or as routine, every surgical procedure is weighed in the balance of risk vs. benefit exactly because accidents do happen and there is no telling how a body will react to the attack that a surgical procedure is to a body. No doubt it was decided for you that the ablation was necessary (you had tachycardia or some other misfire in the heart, I assume?). Drug interaction is still a real problem in prescription systems, which is why we here suggest for patients to always use the same pharmacy, where the prescriptions of the patient are on record and the pharmacists by second nature check for interactions and question the patients before giving the drug over, no matter what we prescribe.

I am not sure where you get your statistic, I would consider it rubbish, especially in the US where gun deaths indicate that your country is in the midst of a hot war.

I prefer for patients to start with a home test for apnoea, because they are sleeping in their own environment, and then graduate to a lab test if necessary, but the home gear is expensive and not enough of it is available for practical purposes. I have been lobbying the hospital to buy more of them and make the testing that way more routine, and hopefully it will be effective, but we DO see if you are sleeping or not on the read-outs, and from that we can make some assumptions, mostly that you would need to be tested in a different way if you aren't actually getting any sleep at all during the test, or be tested again to see if yo have town bad nights in a row. In the US it may not be as helpful, since your system is, well, crap, compared to ours, so it maybe less likely that further testing will be done due to insurance or expense, where we would give the patient the option of finding another way. BTW, if you don't sleep properly in a home test, it indicates a lot of problems besides apnoea, and you WOULD need to come into the lab to be tested with an EEG to see if it isn't from something else.

There are dangers to using a CPA machine improperly over a long term, and the dangers are the same as not using a machine at all if you have apnoea - early death due to complications from lack of proper sleep, with the added danger that improperly adjusted CPAP devices could increase poor sleep quality rather than combat it. These are long term dangers, and not immediate hazards and cannot be so easily assessed, but, no, it won't blow your lungs out or some such thing, and that is not the reason they are under Rx, nor was it ever the reason.

BTW, it isn't the medical profession that puts these things under Rx, in fact we have no control at all over it, so stop blaming us for it - the federal government in each country decides what should be and what isn't a controlled device, the FDA in the US, I think, and sometimes it seems a bit arbitrary. For instance, here you can buy aspirin in doses up to 500 mg over the counter, but can't buy cardio aspirin (100 mg) without a prescription. I think it is dumb, but the government body that determines this decided that the cardio aspirin is to treat a specific condition, and is for long term use with a risk of internal bleeding, not short term use to treat a headache or fever, and so the risk must be assessed first by a doctor rather than left up to a patient to self medicate. In one or two respects they are not wrong, not least because it does interact with other meds and that then keeps it under control, but I also sort of question it, since I agree with the Yanks on this one - the benefit outweighs the risk in terms of long term reduction of cardiac disease, but nonetheless, whatever I think, I cannot buy it over the counter here, and my GP won't prescribe it for me (I just nip over the border to Germany and buy mine there )- but I AM a doctor and I do know the risks I am taking, and take no other meds that would interact with it, and when I must take something, I leave off the aspirin - how many lay people would know to do that? Not many, I can assure you, and I see people in my practice daily because they choose to self medicate and get sick(er) because of it. I doubt the Swiss are less educated or just dumber than the average American (if one watched Fox News, one would suspect the opposite in fact), but if misuse of non-prescriptive drugs is one of the drags on the health care system here, and we have only 8.5 million people to deal with, imagine what it must be like in the US with its 300-odd million people. So, yeah, if the Gummint decides to restrict something and put it under Rx, it may not make sense to me, but generally there are good reasons behind it, even if I find it inconvenient of dumb.

[archangle]

There are dangers to using a CPA machine improperly over a long term, and the dangers are the same as not using a machine at all if you have apnoea - early death due to complications from lack of proper sleep, with the added danger that improperly adjusted CPAP devices could increase poor sleep quality rather than combat it. These are long term dangers, and not immediate hazards and cannot be so easily assessed, but, no, it won't blow your lungs out or some such thing, and that is not the reason they are under Rx, nor was it ever the reason.

DIY CPAP obviously has the risk of failing to treat your apnea. If you try to manage it yourself and fail, you have almost the same risk as going completely untreated.

There's also the risk of trying CPAP, having problems, not solving the problems due to lack of professional help, and quitting.

There's also the risk of pressure induced central apnea, which can be as bad as obstructive apnea.

Sad to say, a lot of so-called professionals allow their patients to get CPAP machines that don't collect efficacy data, or don't monitor the data the machine gives and leave their patients at risk of pressure induced central apneas and don't fix other problems. The followup care is so bad in many cases that all of the above problems happen even with a doctor "involved" in the process.

Another risk is blaming unrelated medical problems on CPAP and ignoring them. "Oh, gee, this CPAP machine is starting to give me chest pain," when in fact it's heart problems.

I agree there are some other risks as well, but I think these are the big ones from an actual statistical point of view.

BTW, it isn't the medical profession that puts these things under Rx, in fact we have no control at all over it, so stop blaming us for it - the federal government in each country decides what should be and what isn't a controlled device, the FDA in the US, I think, and sometimes it seems a bit arbitrary. For instance, here you can buy aspirin in doses up to 500 mg over the counter, but can't buy cardio aspirin (100 mg) without a prescription. I think it is dumb, but the government body that determines this decided that the cardio aspirin is to treat a specific condition, and is for long term use with a risk of internal bleeding, not short term use to treat a headache or fever, and so the risk must be assessed first by a doctor rather than left up to a patient to self medicate. In one or two respects they are not wrong, not least because it does interact with other meds and that then keeps it under control, but I also sort of question it, since I agree with the Yanks on this one - the benefit outweighs the risk in terms of long term reduction of cardiac disease, but nonetheless, whatever I think, I cannot buy it over the counter here, and my GP won't prescribe it for me (I just nip over the border to Germany and buy mine there )- but I AM a doctor and I do know the risks I am taking, and take no other meds that would interact with it, and when I must take something, I leave off the aspirin - how many lay people would know to do that? Not many, I can assure you, and I see people in my practice daily because they choose to self medicate and get sick(er) because of it. I doubt the Swiss are less educated or just dumber than the average American (if one watched Fox News, one would suspect the opposite in fact), but if misuse of non-prescriptive drugs is one of the drags on the health care system here, and we have only 8.5 million people to deal with, imagine what it must be like in the US with its 300-odd million people. So, yeah, if the Gummint decides to restrict something and put it under Rx, it may not make sense to me, but generally there are good reasons behind it, even if I find it inconvenient of dumb.

The government may issue the regulations, but a lot of the blame or credit belongs to lobbying efforts by the AMA and the other doctors' lobbying organizations. Many times when something in the USA is going off prescription, or otherwise being made more available without a doctor's visit, the medical lobbyists ramp up their lobbying efforts to fight it. Similar things happen with many new treatments or procedures that are less profitable.

The lobbyists aren't in the wrong in all cases, but they are almost always working in the direction that puts more money in the medical system's pocket. The doctors do have a seat at the regulatory table.

[Ghost1958]

I am not sure where you get your statistic, I would consider it rubbish, especially in the US where gun deaths indicate that your country is in the midst of a hot war. - Doc Willis.

I got it here in the U.S and it is true. You may consider it rubbish but that does not change that it is a statistical fact.
Other than that Ill leave that alone because this is a SA forum.

Yep I had AFib for which the the drugs given me over a course of four years on two occasions backfired as they were well documented to do and nearly killed me both times.

And no actually the risks vs benefits of that particular surgery were weighed entirely by me. However had I known that what it would ultimately amount to was the equivalent of being stabbed once internally in heart and then immediately thru the chest with no anesthesia either way Id probably have not done it. I should have taken a nurse feeding me a spicy cheesburger while strapped on the operating table to jump start the afib as a hint things werent going to plan I suppose.

Nor would I have had Afib in the first place had ANY Doctor and I have seen many over the years even thought to test for SA. After I am on cpap it has went away. In less than three months.


I do not have a problem with RX for a cpap until I get things like DMEs trying to say its a Federal crime to change my own pressures which is outright lie.
Manufactures putting in notes NOT to include the clinical manual with a machine Im paying for. The other host of little white lies told to patients about how only medical pros are ALLOWED to turn on a comfort option etc etc.

No my biggest problem which not being from the U.S. isnt that there is a RX needed for one though I think its useless personally.

Its that many folks suffer untreated severe apnea they plainly have because they cannot sleep soundly enough with a home test or a sleep lab test. I did not have that problem. But I know folks who did and I KNOW from camping, spending the night at their homes or them ours that they have SEVERE Apnea but cannot sleep well enough in a sleep test for it to break the magic number the bean counters tossed out to be covered by insurance or have no insurance to afford to see the highly trained pros to start with.

Not being from this country you obviously do not understand how our FDA works which is for the most part who has the most political deep pockets, the patient or the Medical lobby. Like I said my opinion. One of the great uneducated unwashed. Easily dismissed. With that I will leave the discussion to the medical professionals on this particular subject.

[funkdoobiest]

I'm a professional firefighter and let me tell you that the effect is very similar however th y are very different. The difference is that you're asleep when using the cpap.. I have no problem wearing my scba whereas some people have claustrophobia and freak out. Probably the same wi h cpap but i dont know. I have a very hard time using my cpap as i sometime wake up suffocating,, actually feel this thing could kill me, especially if i used some sleep aid o. O her cns depressant. I have fairly severe osa with some csa. I dont know what the problem is and no one has been able to explain it. I stooped usng it for 2 years because of the suffocating but i am trying it again as my sleep has been worse than usual.

[me50]

I'm a professional firefighter and let me tell you that the effect is very similar however th y are very different. The difference is that you're asleep when using the cpap.. I have no problem wearing my scba whereas some people have claustrophobia and freak out. Probably the same wi h cpap but i dont know. I have a very hard time using my cpap as i sometime wake up suffocating,, actually feel this thing could kill me, especially if i used some sleep aid o. O her cns depressant. I have fairly severe osa with some csa. I dont know what the problem is and no one has been able to explain it. I stooped usng it for 2 years because of the suffocating but i am trying it again as my sleep has been worse than usual.

How long has it been since your last sleep study? If you have complex sleep apnea and not OSA, you may not have the right machine and that could be why you felt like you were suffocating and that caused you to stop using your machine.

not using it can give you so many other health problems that can kill you. do whatever you can to get the right machine if the one you have isn't and do whatever you can to keep using it. you don't want to end up like some people that were not diagnosed or who did not use their machine and they had heart trouble, heart attacks and a lot more health issues and some woke up dead!

I was given a machine in the 90's and it was miserable and I quit using it. Nobody told me what could happen if I didn't use it. I did not understand exactly what was happening to me and I asked a lot of questions but I did not get sufficient answers and I didn't know enough about it to know where to go for answers.

I get better answers here than from the medical field.

[archangle]

I'm a professional firefighter and let me tell you that the effect is very similar however th y are very different. The difference is that you're asleep when using the cpap.. I have no problem wearing my scba whereas some people have claustrophobia and freak out. Probably the same wi h cpap but i dont know. I have a very hard time using my cpap as i sometime wake up suffocating,, actually feel this thing could kill me, especially if i used some sleep aid o. O her cns depressant. I have fairly severe osa with some csa. I dont know what the problem is and no one has been able to explain it. I stooped usng it for 2 years because of the suffocating but i am trying it again as my sleep has been worse than usual.

What are your pressure settings? There are several things that cause that reaction. The most common thing is using an auto CPAP with the minimum pressure set too low. Using the "Ramp" function can also cause this.

You need to get the SleepyHead or ResScan software and learn to read it and there's a good chance you can figure out the problem. That's a real good idea if you have CSA anyway.

If you decide to pursue the problem, you should probably open your own thread.