Sleep Apnea progression

[jdbeck]

Can the condition of sleep apnea worsen even though you use a CPAP or would it stay as it was when you first prescribed the machine. Not that you would notice because you are being treated but would  the settings need to be changed for more effective treatment?

[mesenteria]

Not worsen necessarily.  It would be better to state that it is likely to evolve or to change over time. 

I have atrial fibrillation that was eventually traced to previous history of OSA.  Atrial fibrillation, once you have it, is indeed a progressive disorder.  But, like OSA, it can be controlled rather well.  And unlike AF, OSA doesn't necessarily get 'worse'.  It CAN get worse, but it needn't.  While my AF has gotten worse, and I have now had two isolations of the pulmonary vein ostia in the left atrium to control the undesired extra signals, my OSA has remained rather stable.  I am on straight 6-8 cm H20, and have been since being diagnosed.  But, other factors can be poor sleep, weight gain, pulmonary problems and other co-morbidities that can crop up with aging or with precursors, and so on.

I think that you should feel secure once you get the beast tamed with PAP therapy, whatever that becomes from time to time.  The therapy may change, but there's no particular reason your condition will deteriorate more than it would with natural aging.

[jdbeck]

Mesenteria Thanks for your great response. I also have Afib which led me to discover a diagnosis of Sleep Apnea. Since I began CPAP therapy in August of 2018 I literally have not missed a day of use. When I began using the machine I was having Afib episodes every 3 weeks. I feel the CPAP has helped limit the Afib  episodes drastically. I also retired in 2019 which has probably affected things. The reason I questioned the progression of SA is because in the last year my average AHI numbers have slightly risen and I don’t know if I should attribute this to a personal change or a switch of machines from the Dream Station One Recall  to the Dream Station 2. Possibly it reads things differently.  It is not a great concern as my health is still the same, I’m just being curious as to how Sleep Apnea works.  

[mesenteria]

Our skin sags, and so does the connective tissue in the mass under it.  In fact, the skin's own underlying connective tissue is what causes it to sag.  We lose muscle mass and the tone of it changes.  We gain weight (you probably know that a circumference in the neck of more than 17" is highly associated with sleep apnea, or so my cardiologist told me).  

Sleep apnea is caused by unsupported tissue that collapses on itself or around other tissue, and eventually we end up with flow limitations or outright obstruction. The other kinds of apnea, central apnea, and the combination of 'complex sleep apnea,' are out of the discussion for now.  So, yes, if you gain weight, or simply age, even if your testosterone levels drop and you lose muscle mass, develop chronic inflammation anywhere rearward of the epiglottal tissues, or in its proximity, you are liable to experience changes in your apnea and probably require at least a temporary change to the pressures.

I'm not an expert here, and have only experience now with one type of mask and two successive models of RESMED machines.  I know almost nothing about any other supplier/importer's products. It wouldn't surprise me if new models, even if close replacements and named the same, will have small alterations to them, new suppliers, new components, new or updated algorithm...that sort of thing. My own AHI varies between 0.0 and a whopping (by comparison) 2.3, but my average over time is still well under 0.7. I have endured runs of over 1.0 for several weeks, and then they'll suddenly revert down to something less scary...for me.

If you were to post some properly configured data/tables per the freeware OSCAR in the black marquee above, we have some very savvy memberss here who would be happy to help you to minimize the changes and to hopefully improve your therapy.