Patients with Sleep Apnea - Surgeon Approval?

Hello,

I would like to know a bit about how the surgeon approves a person with sleep apnea? My bariatric physician advised me that I will not be approved by the surgeon if I am not using my CPAP every night. I will be meeting the surgeon at TOH, and would love to know how he checks it?

I have had two sleep studies earlier this year and it was found that I have severe sleep apnea. It was 118/hour and went to 1.4 with the CPAP. I hated sleeping with it though, and had rented the "grey cube", the Dream Station, now I own the ResMed. I purchased my CPAP two weeks ago and it shows I've been using it 10/15 nights, and only 2/15 for 4h+. I have started using it full nights the past few nights, b efore I was taking it off after 3 hours.

I don't want to be delayed for surgery.

I can't say what your surgeon does or will do, but mine didn't check or investigate in any way. I was asked if I had apnea and if I used a machine, that was the extent of the conversation on the matter.

They will require you to bring it with you to the hospital for the surgery and to use during your stay. You should really keep using it consistently between now and then to get used to it because they won't let you take it off there.

Thank you! I'm making it a point to keep it on at least half the night now. if it wasn't so hard to actually fall alseep with it, I wouldn't even mind it. Hopefully when I'm asked, and I'm honest that I'm using it as much as possible, it won't be a problem.

Well here is my experience. I was able to have this surgery with a BMI between 35-40 based on the fact that I have sleep apnea. Like you I struggled with wearing the headgear. I was fine until I turned over on my side and then it fell off my face. Most nights I would just take it off. I didn't notice a difference sleeping with it on or off. I just keep thinking, "I can't wait until I get the weight off, then I won't need to worry about whether I should be wearing this or not" - the guilt was real. I went through a period last year, that regardless of how I felt I was going to wear it because I was afraid that surgery would be denied. After some road blocks in the early spring, I just gave up and stopped wearing it. During my sessions with the nurse/doc/surgeon I was asked if I have a CPAP machine and I always said, "yes", but I was never asked if I wear it - until the day of surgery. One of the doctors who was filling out my information just before surgery asked me if I wear it and I said, "No". He just said, 'Okay' and continued filling out the paperwork. I had brought my CPAP machine to the hospital expecting to wear it but it never came out of the case. Nobody asked me about it or touched it. I picked it up as I was leaving the hospital and put it in my closet at home. I guess I was very lucky. I had my surgery this past Tuesday, I am down 8 pounds and don't plan on using it again.

Barb

Oh wow, thank you so much for your reply. Exactly like you, I feel fine and refreshed when I don't wear it. I've had a couple of doctors tell me that I may still have sleep apnea after surgery, but the weight loss will still help immensely. Although everyone's experience differs a bit I'm sure, I hope that I won't have any difficulties when that time comes for me.

Apnea is very serious. Your brain is being starved of oxygen for hours and hours every night. Do you really want to mess with that?

That said, I empathize. It's a real pain to get used to and most people take a few months to work up to 100% compliance. To me, it sounds like you're doing quite well!

But, I'm not your surgeon. Mine didn't check my CPAP but I've had it for a few years now.

The CPAP machine/mask takes time to get used to but once you get used to it things get easier. 2 weeks isn't enough to get used to it you need more time before giving up on it. The whole point is to ensure that you get enough oxygen while you sleep and keep your airway open - if you have sleep apnea it means you can't keep your airway open and don't get enough oxygen to supply to your vital organs. When you are in recovery from surgery not only are you going to have to deal with your inability to breathe properly due to sleep apnea the breathing issue is also exacerbated by the anesthesia and drugs they give you. I would advise getting used to your CPAP machine and take it to the hospital with you as they will put it on you in recovery. They will measure your blood oxygen constantly with a pulse oximeter that they put on your finger and it has to be above a certain % - the CPAP pushes air into you to keep the % high. I have sleep apnea and when I woke up from surgery they had it on me to keep my oxygen levels up. It's a pain but its not worth messing around with.

Your CPAP or BiPAP has an sd card which records data on your use, i.e. how many hours you used it or what your ahi was, etc. He should ask you to bring your sd card in and it will be read or you can have your medical supply folks that issued the CPAP print a copy and take it to the surgeon. The surgeon just wants to make sure that your health is as good as possible and if you aren't using your CPAP as prescribed, you are injuring your health. Sleep apnea contributes to high blood pressure, heart problems, etc. If you are having trouble wearing the mask, you may need a different mask. I started with a nasal mask and after 3 weeks of sleeping less than I ever had before and being so tired I couldn't keep my eyes open, I ended up throwing the mask against the wall in a fit of frustration. My heart would pound and I'd be so anxious, I couldn't stand it. Went to my supplier and she said, I know exactly how to fix the problem. She gave me the pre-version of the swift fx which just has nasal prongs that fit in my nose and it worked great. I was experiencing

If you are having trouble wearing the mask, you may need a different mask. I started with a nasal mask and after 3 weeks of sleeping less than I ever had before and being so tired I couldn't keep my eyes open, I ended up throwing the mask against the wall in a fit of frustration. My heart would pound and I'd be so anxious, I couldn't stand it. Went to my supplier and she said, I know exactly how to fix the problem. She gave me the pre-version of the swift fx which just has nasal prongs that fit in my nose and it worked great. I was experiencing claustrophobic episodes and so couldn't sleep. I now have the swift fx and sleep like a baby. Hopefully, after my surgery, I won't need the CPAP anymore but until then, I use it faithfully.

Thank you! Ironically, I have high blood pressure which has temporarily stalled me for surgery until it's cleared up. This is how the topic originally came up because I was asked about using my CPAP.

I really wanted a nasal mask, but it was a no-go for me because I have bad sinuses. I'm getting used to it now, but I still do wake up a lot during the night. Hopefully things smooth out soon.

good luck with your surgery and sleep apnea. Hopefully neither of us will have to deal with a CPAP again.

That is my hope. No more apnea, no more high blood pressure, no more joint pain.