My life has significantly improved in the last month thanks to a CPAP machine treating my obstructive sleep apnea. If you are tired all the time or think you are having trouble breathing when you sleep, please read this post. Sleep apnea is a dangerous condition that ruins your quality of life and may lead to early death. You might be able to greatly improve your life with simple treatment. If you’re looking for more information, Apnea Board has been helpful to me.
For the past year and a half I’ve been really tired. Sleeping 8 hours a night and a 90 minute nap in the day, still falling asleep in my chair. I chalked it up to Covid lockdown or something and ignored it for awhile. As far as I knew I was sleeping fine; Ken said I was snoring a lot and sometimes struggling for a breath but he didn’t seem concerned. Finally it clicked and I realized it was not normal. Now I’m using a CPAP and I’m sleeping well and am full of energy.
Diagnosis starts with your doctor, who refers you to a sleep specialist, who listens to your story and takes a look at your airway and orders a sleep study. You can do the study at home, you just borrow a small monitoring kit for a night and they collect and analyze the data. It’s very simple, they produce a score called AHI which quantifies any breathing problems. Most insurance will cover the testing.
Before the test I learned a lot myself with a pulse oximeter that records my blood oxygen every few seconds. It showed me my oxygenation was dropping very low every 50 seconds, all night. That is not normal. Then I took a video of myself sleeping and saw that basically I was not breathing at all normally, just getting the occasional gasp of air. It’s a wonder I’m still alive. The sleep test confirmed severe OSA.
Treatment comes after diagnosis. There’s a bunch of treatment options; my doctor recommended a CPAP machine. These work by pumping higher pressure air into your mouth and nose; the pressure keeps your airway inflated and lets you breathe. A simple CPAP is not a ventilator, it’s not breathing for you, but it’s similar. You turn on the machine, put on a mask sealed to your nose (and mouth if needed) and sleep.
I’ll he honest: a lot of people have a hard time with CPAP, there’s like a 50% rejection rate from people who hate the idea or find the machine uncomfortable. I was highly motivated and literally from the first night the improvement was so enormous that I’ve taken to it enthusiastically. I sleep fine with it, much better actually. My blood oxygen is now well above 90% all night and I have very few breathing incidents any more. I don’t love the thing; the mask is a nuisance, there’s some mild side effects like more farting. But I dislike suffocating in my sleep a lot more than the hassle.
Benefits for me were immediate and enormous. Literally the first morning I was dancing to music while making coffee. I can read in the afternoon without falling asleep. If I take a nap it’s a 10 minute snooze, not a 90 minute snorefest. My blood pressure is lower. (OSA basically creates panic all night and is a terrible strain on your body.) No luck on weight loss yet, that’s a benefit many OSA sufferers report. More energy to exercise though. One thing I’ve noticed in CPAP users; they tend to get very attached to their machines and can’t imagine going a night without them. I didn’t understand that before. Now I do.
Equipment was a bit of a mystery to me at first and the medical system is not great at advising patients. By far the best CPAP machine for basic OSA is the ResMed AirSense 10 AutoSet. The "AutoSet" is key; the machine automatically adjusts to its sensing of your breathing so you don’t have to guess at the right pressure. It’s a really nicely designed piece of equipment. If you’re data-minded be sure to put in an SD Card and get OSCAR to get very detailed second by second info on your breathing while you sleep. The AutoSet goes for about $800 now. Insurance should cover it but they are notoriously a pain in the ass about it. Do not let your insurer bully you into getting inferior equipment. For me it’s the best $800 I’ve ever spent.
The other half of the system is the mask. My first mask was the AirTouch F20, a basic full face mask. It has worked great. After my first month I switched to a smaller AirFit F30i, the way the hose comes out of the top of your head is a big improvement. Note these are both full face masks; if you don’t breathe through your mouth (much) you can probably use a much smaller nasal mask or pillow. A full mask kit is about $150 and again should be covered by insurance.
The medical system wants you to buy all this stuff from a "Durable Medical Equipment supplier" and the quality of those vendors varies enormously. Some are outright scams, including doctor kickbacks. I ended up skipping insurance and buying from CPAP Direct. In theory my insurance will reimburse me but so far that hasn’t worked out. The big pieces require a prescription but you can buy a lot of components and replacement parts, on Amazon without a prescription for much cheaper.
Maintenance is a bit of a hassle. I have to refill the humidifier tank every day. Also clean parts of the mask, other parts need weekly cleaning. The mask is intended to be replaced on a regular schedule; every month for the "pillow" (the part in contact with your face). That’s where ordering cheap replacements on Amazon can save a lot of money, maybe even if you have good insurance.
Conclusion I can’t emphasize enough what an improvement to my life CPAP treatment has been. Obstructive sleep apnea sucks. I encourage anyone reading this who wonders if they have a breathing problem at night to talk to their doctor, or maybe try a pulse oximeter on their own, or address it somehow. CPAP treatment isn’t so hard! It works! I’m enthusiastic enough about it to be writing this blog post and am glad to discuss it privately with anyone who asks.
PS: a special thank you to Obama and the ACA for making it possible to treat and discuss this problem without rendering yourself uninsurable.