Cpap intolerance is a serious thing. Because, as wonderful as cpap is at treating sleep apnea, some people just can’t stand using it. And while cpap is the gold standard in treating obstructive sleep apnea, and does so quite effectively, there’s a whole range of responses to it. Some people fall in love with it, others hate it. And there’s a wide range of responses in between.
However, the average compliance rate is only 30-60%. But if cpap is so effective, why is cpap intolerance so high? And how can we more effectively treat sleep apnea? Let’s take a look at this subject. We’ll also lightly touch on a couple of technological advances that might eliminate cpap intolerance.
It’s really amazing the number of people who go through all the trouble of having a sleep study. Then have a follow-up appointment. And after that, come in and get set up with an expensive cpap machine. Only to find they have what we shall call cpap intolerance.
That really says more about the cpap machine itself, then it does about the patients. It must be frustrating to go through the test, follow up, and cpap set up, only to not be able to tolerate the darn thing.
And yes, there might be patients who just don’t give themselves long enough time to adapt to cpap. There are also those patients who have tried to the point of ridiculousness and still haven’t adapted. And those patients might never adapt to it. That must be REALLY frustrating!
And while we know that knowledge is power; we also know that it’s a bit more complicated than that. There’s that little issue of trust. But all the knowledge and all the trust in the world can’t overcome plain old cpap intolerance. Then there are those people who not only tolerate cpap, they adapt to it quite well. These people live a more enriched life.
Like the following patient.
You Saved my Life!!
I work for a Sleep Center in Fargo North Dakota called Precision Diagnostic Services. We have contracts with hospitals in several states, so we get to see many patients each week. And though I’ve heard of people who say their lives are better now that they’re on cpap, every now and then we get someone who’s especially thankful.
In fact, just recently, a patient called our main office, thanking us for literally saving their life. For that, they are “forever grateful”. And their spouse is equally grateful.
Even the people at their workplace notice a difference. They drove the 3o miles to their workplace without getting tired once. They said they sat at their desk and were actually able to concentrate and get work done. In fact, they’re so awake, they “almost feel hyper”. And at one point in the conversation, they were so moved by the change in their life they actually got a bit teary-eyed.
Although most responses aren’t this exuberant, it does reflect the gratitude of many people whose lives have been changed by the use of cpap. Which brings us to the question of just why so many people can’t tolerate it.
A Full Range of Responses
When I see someone in the sleep lab, I have them try on a cpap mask or two. I do this before the study even starts because I want to know how they’ll respond to it. And I’ll get responses all the way from “Get this thing off me!!”, to “”Wow, this thing is awesome! Can I keep it on?”
However, the overall compliance rate with cpap is anywhere from 30-60%. Think about that. For every 10 people started on cpap, only 3-6 will continue with treatment.
But why is the overall success rate so low? And how do we improve those odds? Well, the good news is, that for those who can’t tolerate cpap, there are other ways to treat sleep apnea. Although as of this writing, cpap remains the gold standard of treatment.
However, research is ongoing to find other, perhaps, better ways yet. And it’s fun to speculate what things will come out in the future.
The Future of Sleep Medicine
There are many factors to consider when looking into the future of sleep medicine. Things like the economy, insurance, peoples attitudes and belief systems. But the technology itself is quite fascinating. Let’s take a brief look into the future, shall we?
First of all, what kind of technology will we have 25-50 years from now? What new forms of treatment will come out? 2 things come to mind: Artificial intelligence and Nano-technology.
Artificial intelligence or AI is a machines’ ability to learn to reason, and problem solve. As well as the capability to perceive and use language. But while computers can be programmed to do some very complex tasks, they’re far from true artificial intelligence. But what does that mean for sleep medicine? Will the sleep technologist of the future be an android, like Lieutenant Commander Data on Star Trek?
Nanotechnology? , on the other hand, involves making ‘machines’ from individual atoms or molecules. These ‘machines’ can be programmed to perform different tasks. In fact, research is currently studying ways to use nanotechnology in the treatment of heart disease.
But how could these 2 technologies eliminate cpap intolerance? Let’s take a peek 50 years into the future, shall we?
Cpap Intolerance is History!
The year is 2067. Your smart home alerts you to problems with breathing while you sleep, and notifies your Doctor. Their computer reviews the data and recommends a sleep study. Soon after, you receive an alert asking you about this appointment. Do you wish to keep it? Change the date, or cancel it?
You’ve been feeling a bit tired and cranky lately, so you decide to keep the appointment. At your visit, your Doctor injects you with some nanobots that will monitor your brain activity, breathing, and oxygen levels. While your smart bed records your body position. Oh and don’t worry. All those nanobots will disintegrate when their tasks are complete.
During your sleep study, the information is downloaded to your Doctors computer. And by the time they see the data, their computer has already written up a care plan. Their computer recommends treatment for sleep apnea and sets up a follow-up appointment with your Doctor.
During your next Doctor visit, you’re injected with more nanobots that will monitor nerve and muscle activity. They’ll stimulate your nerves and muscles to activate as they should. Thus keeping your airway open, and assuring all muscles work to keep you breathing well. Therefore eliminating even the need for cpap itself.
But, could cpap become a thing of the past? Or is this just fantasy? Advancements being made in technology lead me to believe it’s very possible.
Till next time…Blessings.