Bummed out ... Sleep apnea

I got diagnosed with OSA this time last year started Cpap in August 2012... I was 345lbs when diagnosed. I have lost 101 lbs since my diagnosis. I went to my medical supply company to talk to the pulmonary lady and she uploaded my card and informed me 95% of the time I am staying at a 9.5  pressure and my min to max was 6-10 so I still need my Cpap machine she said 40 lbs usually sometimes causes the OSA to resolve I've lost more than that. She seemed more on the conclusion my sleep apnea might be hereditary and not due to obesity. I am pretty upset not going to lie. People important lesson don't discontinue your Cpap therapy unless your rechecked just because you had wls I know it sucks!!!!!

 

I imagine you are bummed! Sorry to hear this!

My husband is going back for a sleep study soon. At the practice he uses, they retest with a sleep study once 50 lbs is lost, but we did not know that, so he is 134 lbs lighter and was not retested. I would ask to have a new sleep study and see what your new settings should be.

I do agree though--never stop the machine until you are cleared!!

I am a nurse in a pulmonology and sleep medicine clinic. There is obstructive apnea which is caused by physical obstruction like what can be caused by the extra weight or big tonsils or soft palate stuff etc. There is also central apnea which is neurological in origin. You may have more central apnea.

I was told today my incidents of OSA are much higher than my central apnea episodes she said i have a few here and there but they are normal. My pressure is a min of 6 and a max of 10 and she showed me a copy of my report which showed 95% of the time i stay at a 9.5 pressure and my AHI is 0.2 right now. My pressure hasn't even changed with the weight loss.... i haven't maxed out to 10 like i did before but i am still getting pretty close. 

I'm sorry you're not off the CPAP. That has to suck. However, if it is hereditary or a neurological issue then please don't DC it!

As the previous posted noted, you may have a physical obstruction not related to weight that is causing it.  My brother, who was only about 25 pounds overweight at the time, went for a sleep study because he was loudly snoring and then started having the issue with stopping breathing and suddenly startling and breathing again.  My SIL started sleeping in the guest bedroom because it was so bad.  They diagnosed sleep apnea but also sent him to an ENT because the snoring was so loud.  A couple of weeks later he had surgery to remove part of his soft palate, his uvula (which was hanging almost  onto his tongue), his tonsils (which were enlarged because of the constant snoring), and his adenoids. A month later he was no longer snoring and the sleep apnea was gone.

I had sleep apnea (and snored) when I was MO and SMO, but I refused to use a CPAP because of PTSD (the mask would be highly triggering).  I would fully wake myself up a couple of times a night when I would startle and begin breathing again.  I am not sure exactly when the snoring and sleep apnea stopped, but both were completely gone by the time I was 6 months out (and down a bit over 100 pounds (to 230-ish). 

How much weight someone needs to lose to eliminate the apnea probably depends on how heavy someone was to begin with.  Some who was 350 pounds to begin with might need to lose 150 pounds whereas someone who started at 250 might only need to lose 50. I can understand your frustration, but don't lose hope!

Lora

Thank you Lora! 
I actually made the appointment myself because i was SOOOO SURE my sleep apnea was gone. In fact the last week i have used it maybe twice because i was THAT SURE. I had my tonsils out when i was like 10 years old so about 19 years ago. There was a question of whether i would need my adenoids out as well but they chose not to do it. The pulmonary lady said my neck isn't very big and my chin is small which could be causing it. I had WLS for MANY REASONS.. but honestly a huge one was in the hopes that i would be in the what is it like 80% that got rid of the OSA. I do have centrals here and there but not near enough to require bi-pap the PT said that a few centrals a night is completely normal. My AHI is 0.2 while on cpap and they aim for under 5 so she said i am doing great for where i am. She said another 40 lbs i should wait a month after losing that amount and make another appt. Like i said though she seems convinced it's genetic. My mom has sleep apnea but she is also obese she had gastric bypass surgery open in 2001 she gained all her weight back but 60lbs. My brother also claims he snores but he is also overweight right now at 260ish and hasn't been tested. So i really don't know. I just hate it so much and hoped so badly to be rid of it!!! I am only 29! I know RNY doesn't guarantee sleep apnea going away but the percentage is high. I am trying to remain positive that maybe i just haven't lost enough weight yet for it to fully go away and it's not a physical defect. I actually started at 401 at my highest weight in 2011 so i am down 156 lbs and only 4.5 months post-op so i still have plenty of weight to lose *crossing fingers*

Hang in there. I too am hoping my CPAP can go away after surgery and weight loss. Unfortunately I think my tonsils and palate will keep that from happening no matter how much I lose. If your sleep Dr. Thinks that you oral area contributes there is a surgery called UP3 or UPPP. But there's no guarantee it fixes your apnea. There are also dental orthotics that may or may not work.
That being said, you may just need the annoying machine, but it's worth it vs. The long term effects on your heart. CPAP stinks.

I've had sleep apnea for years.  Before I ever considered surgery, my Dr. told me I would always need to use CPAP.  the anatomy of my throat or something that no matter how small I can get, I will still have OSA.  this may be your issue as well.  We might just have been born this way!

Good luck!