[T-5Yrs] Auto-CPAP

Jan 2004, more insurance changes later and another doctor later brought me to trying Auto-CPAP. My compliance with CPAP with different kinds of masks was pretty poor. My compliance with the dental app was also very poor.

The doctor Dr. VA sent me to an overnight sleep study in Cupertino. Confirmed OSA with 31 events per hour, supine AHI of 61, lowest Oxygen saturation was 83% thought less than 1% of the time was spent in saturation below 90%. Apparently at this time I had also started to snore which was never present before.

The doc sent me for a yet titrating overnight sleep study at Cupertino sleep lab. Nasal-CPAP with a humidifier came up with an optimal air-flow pressure of 7cm was found to be adequate for me.

At about July that year (2004), a Stanford study ad doing a research study looking for volunteers caught my eye. They were looking at blind drug study (more later). As a part of this study, I saw two doctors that year who were responsible for pre-screening patients. The first one was Dr. Mujahid Mahmood. He diagnosed me as soft palate with significant redundant tissue, long uvula, 2+ tonsils, Malampati grade II, high-arched palate, small jaw and some retrognathia. I was still having sleepiness during driving, taking afternoon naps 2 times/week. This inspite of sleeping for 9 to 10 hours every night. His recommendation was to simply continue with CPAP.

My sleep specialist asked me to give another try at CPAP. This time around the CPAP machines had improved. There was now a builtin tank to provide warm humid air. I had also discovered the Stanford Hospital Sleep specialists. I started participated in some sleep studies. As a part of the protocol, the doctors check your background, do your EKG and run a baseline sleep study. Great way to interact with numerous doctors. One doctor in particular, Jed Black recommended an excellent mask. This one didn't leak and was reasonably comfortable. My compliance to CPAP improved. I did not see a great improvement on my overall symptoms. Jed and his band of doctors asked me to stick to it. CPAP is supposed to be the gold standard for sleep apnea.

Thanks to my great insurance, I even got myself an adaptive meter which varies the amount of pressure through the night based on the required pressure. It  even monitored the number of events and even the pressure over the night. I hated it but desperately wanted it to work. I always ended up removing it after a few hours early in the morning. Zed and his gang of Stanford specialists told me to stick to it, they even suggested specialized CPAP psychiatric counseling. An year later I was off CPAP.

Recently I ran across this wonderful paper from Powell/Riley which talks about the poor compliance to CPAP and why surgery is the way to go.

http://www.sleepsurgery.com/pdf/Tail-End-Of-Dog.PDF

The road was pointing to surgery. I was losing the long fight against having surgery!