OSA and CPAP questions

I thought you all might have some advice concerning the CPAP machine after surgery.  I haven't slept without my CPAP since I got it almost 10 years ago.  The doctor says I can't use it for at least a week or two after surgery since they don't want to inflate the dead-end limb of my RNY.  I bought some wedge pillows but don't know if that will be of much use.  Of all the aspects of surgery, this one has me the most worried. So did anyone with a CPAP have problems sleeping without it after the surgery?  Were you able to get it back and if so, how long did you wait?  Did you find you didn't need it after a while? Thanks for any thoughts and experiences! -- T.Rob P.S. - Shopping for wedge pillows on the Internet was an interesting experience.  I didn't even know there was such a thing as "sex furniture"!  Hell, I thought *all* furniture was sex furniture.

TRob - I too had to go without my CPAP for two weeks after surgery. At first I was kinda trippin about it, but my experience was that I was so worn out from recovering that I didn't have any trouble sleeping those first couple of weeks. Once my surgeon released me to use it again, I found that it was really a lot of pressure even with ramping.  Now, (12 weeks out) I don't even use it.  Now before all the preachers and soap boxers jump all over me.....I did speak to my pulmo guy and he advised that if the machine was preventing me from sleeping, then indeed I needed another study but if I slept well without it I could quit using it.  And since I do.....I did. Don't fret it.  Talk to your doctor.  Good luck.  And oh by the way..........the wedges are great for sleeping on.  Also, along with the wedges as "furniture".......I also recommend the small "yoga ball" as an adjunct for pre-sleep bedroom activities.

Hi T I am 8 days post-op from lap RNY and my Doc never said anything about NOT using cpap. I have been using mine since the day after surgery. I'll be interested to see the others comment. Havent heard this question before. I hope I havent inflated anything. Picturing those long, floppy, arm waving thingies at car lots. Wonder if those are considered sex furniture. Elliott

Hey T-Rob, I'm 6 months out now and had my surgery with a surgeon at a Center for Excellence.  He never said not to use the CPAP.  In fact he recommended I use it in the hospital and said they might even use it in recovery (they didn't).  The worry of inflating the dead end limb really doesn't make sense to me.  We breath through one tube, we eat through another.  If what he is saying is really a risk, then even breathing is a risk to the RNY.  Certainly, we've all swallowed a drink or food down the wrong pipe.  But air getting into the food pipe and liquids getting into the air pipe both occur during the times when we eat, not when we are sleeping.   On this one I would follow your inner gut here.  The risks of sleep apnea far outweigh the risk of inflating the dead end limb of RNY in my opinion. As a follow-up, I am now about 6 months out as I mentioned.  About 3 weeks ago I went on a trip to my parents for Easter and forgot to bring my CPAP machine.  I was sort of freaking out because in the past that resulted in very little sleep and utter exhaustion.  At the time I was down about 98lbs.  What I found is that after the first night (sleeping about 4 hours) that I actually didn't need it any more.  I used it just once when I came back and find I am actually sleeping better now than with the CPAP (because the mask leaking was waking me up as much as apnea).  So the day is coming in the future when you won't need the CPAP, but in my opinion it probably is not right after surgery.   if you find yourself somehow belching multiple times a night while using the CPAP before surgery, then maybe this argument holds water.  But I would think the risks of not using the CPAP (heart stress and all the reasons you needed it in the first place)  far outweigh the risk of the inflating the dead limb of the RNY that sits down a pipe that you don't use when you sleep.  But good news is on the way, my friend.  Soon you will not need the elephant mask anymore. Hope this helps. Greg

TRob, There must be a big difference in procedures. When I had my RNY I was told to bring my CPAP and I used it the night of surgery. I used it for about a month after and decided to try it without and haven't used it since. I just passed the 1 1/2 year mark since surgery and feel GREAT!!! Stay well Woody

Wow, lots of responses.  Thanks!  I will answer them all at once...not sure if notifications are generated by thread or only if I reply individually but I guess I'll find out... @Danny - You and I seem to be in the minority here as far as procedures so I'm glad you responded.  Makes sense that between the physical trauma and the pain meds one would be able to sleep.  I know if I take a meperidine, lortab or vicodin in the evening I sleep like the dead.  And I'll have a pulse-ox monitor the first night or two so if it's a big problem the doc may change his mind.  12 weeks is a real short time for that much improvement, which is very encouraging.  @Eliott - I'm actually encouraged that so many folks responded like you and were told to use their CPAP.  Makes me think the dangers the doctor outlined may be over-inflated. @Greg - I know some of the OSA problems can be caused by too much weight.  In this case, all that weight bearing down on the throat collapses it.  But my brother who is average weight also has OSA and in his case it is due as much or more to muscle relaxation as weight.  So if the muscle that switches from eating mode to breathing mode is subject to that kind of relaxation, I can see the basis for this.  That said, it still seems somewhat extreme, especially as you and others said compared to the risk of not using it until some weight is lost. My Dr. is Roc Bauman and the facility is also a Center of Excellence.  The Dr. has a zero mortality rate so I kinda want to follow his procedures.  I don't want to be the guy who ruins his perfect record!  Still, based on the advice I see here I'm planning to grill him on this point in the pre-surgery meeting and to bring my CPAP to the hospital just in case. @Woody - I'm surprised by the differences in procedures regarding CPAP.  I just assumed when I heard I was not to use it that this was standard procedure so I'm really glad I asked here.  I hope like you to be able to give it up entirely so I'll be spending the occasional Friday night without the mask once I get a few months out and a few pounds down. ---------------------------------- Thanks everyone for the advice and comments.  I'm not nearly as worried now as I was and I'll run all this by my Dr. at the pre-op appointment. -- T.Rob (Who is sleeping soundly again thanks to you all!)

 T-Rob....before my surgery my doctor told me to turn my CPAP machine down to 10 psi and after a month turn it back to 13 psi. I still use mine. The problem I had before surgery was I stoped breathing 119 times an hour. I'm not going to take a chance on not using mine. I've come along way now with the surgery and all to start cutting corners.....hope all goes well with you either way you go. Dave

Hey T Rob, they provided me one at the hospital. Stopped useing mine when I had lost about a hundred pounds. I was fighting with the mask again and just decided to try it with out it. Not advice just what I did. pan head

Wow.  I'm just 13 days out and NEVER was without the CPAP.  I asked about the temporary suspension after surgery and was given an firm NO. The reson was, "The same risks of sleep apthnia are present right after surgery as before. Nothing has changed".    The hospital even wanted the CPAP to be brought in and tested prior to surgery, to make sure it was fully functional.  I was on the CPAP within 7 hours of surgery and I can say it made the hospital stay much more pleasant, as I tried to be without it for a while, as I dozed in the room. 

I have been a "heroic" snorer for my whole life. (And yes, "heroic" was the doctor's term.) When I was 16, I was 5-10, about 175. I was a shot putter and cross country runner. I rattled the windows as I slept. Thouhgout my time in the military I gained weight and the snoring got worse. In the course of serveral medical exams for various things, I was refered to an ENT. He tried all the things that lead up to CPAP... sleep studies, tennis balls in t-shirts(WT2?!), etc. He only detected OSA once and it was minor. That same study states that my snoring was bad. After a UPPP, tonsil and adnoidectomy, rhinoplasty and some kind of reshaping of my wind pipe, my snoring virtually disappeared... for a month. Armed with one study indicating OSA and my heroic snoring, the ENT prescribed a CPAP. It works great. But, I dont think that my losing weight will get rid of the snoring. My fear is that weight loss will make the OSA go away but the snoring will remain and the CPAP won't be justified. IMHO, my snoring is just as bad as OSA. Plus, it has the added problem of sleeping alone. My wife cannot sleep in the same room with me unless I use the CPAP.  Witha lean mass of 211lbs, I'll never get down to 175 to see if the snoring AND OSA goes away. I'm kinda worried about that part of my future.