Study: CPAP Treatment Linked to Lower Mortality in Stroke Patients with OSA

An interesting article about Obstructive Sleep Apnea and strokes just came out. The article says that CPAP treatment reduces mortality risks for people with OSA who have had a stroke.

A researcher quoted in the article also points out that mortality rate increases for OSA patients who have had a stroke but who don't use a CPAP machine. Yet another reason to seek treatment for sleep apnea!

One of the challenges of the future is finding ways to ensure CPAP usage compliance amongst stroke patients with Obstructive Sleep Apnea. It can be a complicated situation.

Read the article for the specifics of the study results. The article has a link to the original scientific research study results.

Traveling with Sleep Apnea Tip #2 - Packing your CPAP like your life depends on it

Traveling somewhere by plane? If you have sleep apnea and use a CPAP for treatment like I do, then I recommend the following tip for airplane travel with a CPAP machine.

"Pack your CPAP machine like your life depends on it."

Going without treatment puts a damper in a vacation and can also have risks. Getting a replacement CPAP quickly will be a challenge while traveling.

I always carry my CPAP and mask in my backpack which I carry the airplane. It gives me comfort. Putting valuables in check-in luggage leaves me with a fear of loss or theft, so carrying it on with me means it never leaves my sight.

Also, realize that CPAP machines are delicate. Protect it in a way as to prevent damage from impact or being crushed. Take care as to avoid letting the buttons or display get damaged.

Put some sort of padding around it. If your CPAP didn't come with a padded travel case, take a look at padded camera bags as an alternative.

Bonus tip: When going through security gates at airports, take your CPAP out of your backpack and put it in a separate bin for scanning (like others do with laptops). Oftentimes, the security team needs to do a quick cotton swab test on CPAPs for some reason. Make it easy for security and they'll be quick.

I'm Too Sexy for My CPAP

Dr Michael J Breus covers a topic that will make most people blush.

The article has a witty title "CPAP: Cannot Possibly Act Passionate" and discusses ways to address the potential impacts of a CPAP machine on romantic life.

He writes "Let's get real, I don't think it takes a CPAP machine to kill the moment" and points out that the benefits of CPAP treatment far outweigh not getting treatment. Without treatment, those with sleep apnea are much more likely to be tired and tiredness will put an even greater damper on romance.

Read the full article here on the Huffington Post website. The article is Dr Breus' response to a commentary on MSNBC here about the impact of a CPAP machine on romance. Both are interesting reads.

Types of CPAP Masks for Sleep Apnea Treatment

People with sleep apnea should be aware of the treatment options. Did you know there are several types of CPAP masks?

Here's a brief article on the different types of CPAP masks used with CPAP machines for the treatment of obstructive sleep apnea. The article discusses common triangular CPAP masks and the less common oral masks, nasal pillows and hybrid masks.

I've used triangular CPAP masks of both the nose only and nose and mouth variety. The nose mask is the most common type of mask.

I used a nose mask for a few years. It was very easy to wear and get used to. The downside for me, with a high pressure setting on my CPAP, is that the nose mask caused dryness in my nasal passages and required me to either use a humidifier or use saline solution a few times a day.

A second sleep study revealed that the nose mask left me with the problem of breathing through the mouth.

I tried using a chin strap to keep my mouth closed, but that didn't help much, though I only tried one type of strap. There are potentially better chin straps on the market that I have yet to try.

I switched to a nose and mouth full face mask. Full face CPAP masks require more adaption time because the masks must be on tighter to prevent air from escaping from the seams. The first several nights for me were interrupted by the bzzzzz sound of air escaping from the seams. Making the straps tighter then became uncomfortable. Getting to the right balance took time. Oh, the joys of severe sleep apnea!

After the right balance is achieved, the nose/mouth full face mask worked better in my situation. Each situation is different. This article discusses types of CPAP masks and how the masks are used.

View the article here about the different types of CPAP masks.

How to Reduce Out-of-Pocket Sleep Study Costs

Not insured? Have to pay out-of-pocket?

The best way to reduce out-of-pocket sleep study costs is to pretend it is like buying a car. Shop around. Do your homework before choosing a sleep center.

Prices can vary from $2500 to $4000 out-of-pocket for a sleep study, according to Express CPAP Supply. That really is like buying a used car.

A Google search for "cost of sleep study" reveals many more discussions of the costs for out-of-pocket sleep studies with some people paying more than $5000 (see here and here).

Why the variation? Not all sleep studies are created equal. According to St. Joseph Memorial Hospital (see here): "Because of the variety of sleep disorders, the required sleep monitoring and evaluation studies may vary and consequently the total cost of the sleep study may also vary."

So it pays to talk to your doctor about the options to minimize out-of-pocket sleep study expenses. Maybe you don't need to fancy sleep study. Or maybe your doctor can recommend lower cost sleep centers.

Another emerging option is special deals that CPAP supply companies offer. For instance, Express CPAP Supply of San Jacinto, California, recently partnered with a sleep lab to offer lower rates for sleep studies. They offer a $999 sleep study and CPAP system combo. More info on Express CPAP Supply's website here.

A Sleep Apnea Sleep Study Success

Wow. Here's a women whose doctor discovered she had irregular heartbeats. After being monitored in a hospital for several days and not having a solution found, she was sent to do a sleep study.

At the sleep study, she was recorded with 150 apnea episodes per hour. That is a lot of not breathing!

The diagnosis was sleep apnea. She was given a CPAP to use and says this of the results of using a CPAP:

"It is a life saving machine, in my case. The nights are quiet now, no snoring. I wake up, refreshed and ready to tackle the day. If I’m tired, its because I have stayed up way past my bedtime, which I tend to do, just because I have filled my days with so many activities and things to do these days — because I can."

Read her complete story here.

Is there a way to prevent CPAP headgear strap marks?

Sometimes during the continuous quest to prevent mask leaks, I strap on the mask too tight and wind up with red marks from the straps. The strap irritates my neck and ears. Appearantly, this is common enough to have a solution.

There's at least one product that helps prevent strap marks. I haven't tried it, so I cannot say if it is any good or not, but the name is "StrapGuard". It looks like it is just a soft cloth that wraps around pretty much any CPAP mask headgear strap. One place I saw this online charged $15. If you know how to sew, you could probably make your own.

I'd prefer that my insurance company paid for these types of things. I'm not even going to try asking, because I know they won't. It would be nice if headgear manufacturers actually build this cushioning into their products.

Lazy Smurf diagnosed with Obstructive Sleep Apnea

I was looking through some old toys and stumbled upon a few plastic Smurf figurines from that popular cartoon television show of the 80s. Playing with the toys as I had in my youth, I pondered how the Smurfs dealt with Lazy Smurf’s snoring. Would complaints of snoring lead him to seek remedies? Was his snoring a sign of sleep apnea?

Obstructive Sleep Apnea (OSA) prevents people and Smurfs from breathing freely while sleeping, resulting in a lack of oxygen and a very bad night’s sleep – every night. Some frequently occurring symptoms include loss of energy, trouble concentrating, anxiety, depression and failure to contribute fully to the Smurf Village. Left untreated, sleep apnea can lead to hypertension, coronary heart disease, heart attack, stroke, psychiatric problems, impotence, cognitive dysfunction and memory loss. For a Smurf, this increases the risk of capture by Gargamel.

Besides snoring, remember that Lazy Smurf always appears quite tired. Cartoon zzz’s frequently escaped from his head. He even fell off my toy box a few times. These are among the classic indicators of sleep apnea.

In the Smurf Village, Lazy Smurf’s behavior was considered disruptive. Lazy Smurf snoozes on the job. His sleepiness became a real problem to himself and those of the Smurf commune.

Many Smurfs complain to Papa Smurf about trouble sleeping due to Lazy Smurf’s loud snoring and strange gasping sounds made while sleeping. Vanity Smurf emphasizes the importance of beauty sleep.

Brainy Smurf points out the likeliness that Lazy Smurf suffered from sleep apnea. “In fact, the word ‘apnea’ means ‘not breathing’. Lazy Smurf’s gasping sounds originate from a lack of oxygen and a reflexive attempt to start breathing again.”

Papa Smurf refers Lazy Smurf to Doctor Smurf. Doctor Smurf has Lazy Smurf do a sleep study, known as polysmurfography (a polysomnography for Smurfs), conducted by Sleep Technician Smurf.

The diagnosis is severe obstructive sleep apnea, just as Brainy Smurf had known. From now on, Lazy Smurf was to use a continuous positive airway pressure (CPAP) machine while sleeping.

The results are phenomenal. After being on the CPAP for just a few days, Lazy Smurf is no longer sleepy and appears energetic.

The other Smurfs look at him strangely. “What have you done with Lazy Smurf?” asked Papa Smurf, thinking that an imposter has entered the village. Lazy Smurf stomps away angrily.

Early the next morning, with the other Smurfs still sleeping soundly, Lazy packs his bags and heads into the forest. “They don’t like me ‘lazy’ and they don’t like me energetic either,” Lazy Smurf says to himself.

When the other Smurfs awaken, they cannot find Lazy Smurf. Papa Smurf thinks he knows why and recalls what he said to Lazy Smurf. Brainy Smurf explains to Papa Smurf the positive effects many sleep apnea patients have when using a CPAP machine. Papa Smurf tells the Smurfs to go looking for Lazy Smurf.

But it is too late. The sinister wizard Gargamel captures Lazy Smurf and locks him in a cage.

Gargamel holds Lazy Smurf for ransom. A ransom note decrees, “Either tell me the location of the Smurf Village or Lazy Smurf will be made into Smurf soup.”

Papa Smurf gathers the Smurfs together to go over the rescue plan.

The Smurfs gather in the woods near the cage with Lazy Smurf inside. Smurfette shouts loudly to get Gargamel’s attention. As Gargamel walks towards Smurfette, Vanity Smurf uses his mirror to shine the sunlight in Gargamel’s eyes. Gargamel stumbles onto the ground. Meanwhile, Handy Smurf grabs the key and unlocks the cage to rescue Lazy Smurf.

We cut to a scene where Papa Smurf explains sleep apnea to the other Smurfs. During a big Smurf ceremony, Lazy Smurf’s name is changed to “Sleep Apnea Smurf.” Everyone smurfs happily ever after and I put my toys away for another day.

Mattel's New Sleep Apnea Barbie?

Ok, this Barbie is not from Mattel, but by a doll costume maker who's husband has sleep apnea. The creator says of the custom Barbie, "I do not mean to make light of it, but rather to amuse those who have to live with it." Take a look at the pictures, I think you will agree.

More pictures

The challenge of keeping the mouth closed while using a CPAP

Keeping my mouth closed when sleeping has always been a challenge. I used my chin strap for the first month I had the CPAP. It was irritating and had to go. I tried putting a sock in my mouth and that didn't work either.

Years later, I only sometimes use the chin strap, because it slips off and is still uncomfortable.

The chin strap I have is the black, 1 inch wide strap that has a hole for the chin. For some reason I have been breathing with my mouth open a lot lately, so I need to try something new.

I've seen some alternative ideas around that I may try. Some home-brewed ideas include using a 2" waterproof adhesive tape or any kind of easy to remove medical or sports adhesive tape and taping the lips with it, being sure to have an easy way to remove it. Others have tried duct tape and found it just a little too adhesive. Go figure.

There is even an anti-snoring tape product out that is similar, except that it tapes around the mouth without sealing the lips. Ya, that'll work.

There seems to be a lot of chin strap products out there. The problem is that each is a little different and everyone has a different head. One version may work for you but not for me. I have enough problems with my nasal mask headgear rubbing against my ear. I don't want a chin strap to rub my ear too.

To get an idea of what is out there, this vendor has a lot of large pictures of different chin strap products. View.

Another vendor provides this 2 minute video that shows some chin strap product options in use. Video

Note that among these samples, nobody is sleeping with cats. Cats and headgear don't play well. 8 cats and headgear play worse.

Another thing I've read is that chin straps are not always needed for long term use. If one has regularly breathed with an open mouth while sleeping, changing to closed mouth breathing is a change of habit. Habit changing does not come easily, but once the habit has been changed, it should stay for a while until a new habit is formed.

Alternatively, one could pursue using a full face mask (FFM) instead of using a nasal mask. Though slightly less attractive when trying to be romantic, the FFM may have the potential for good results if I can find one that fits.