One Sleep Quality Measuring Stick
Many pathways lead people to PAP therapy for OSA/UARS. Some only seek treatment to please a bedpartner who has witnessed an actual apnea or must suffer through the loud snoring. Others are greatly impaired with daytime fatigue and sleepiness and would try anything to overcome these major obstacles to a better quality of life.
Depending upon the entry pathway, some are much more interested in measuring their progress in alleviating symptoms, while others could care less. In between, we often find a large group of PAP users who are very uncertain about their response and would like to know more about why they should keep using the device. Though unclear about any benefits, they faithfully use PAP for assorted reasons, like cardiovascular health, blood pressure control, or less trips to the bathroom at night. Even so, these individuals are not raving about incredible PAP results.
In these circumstances, one “trick” I’ve often suggested that usually leads to reliable clarification is the instruction to stop PAP for a period of time and then start it again to see what differences are noted. The timetable for cessation could be as short as one day off and the next on as well periods of a week or two, even a month. In rare situations, taking a 3 or 6 month break is indicated when the individual is on the verge of quitting anyway because they don’t like the experience and don’t see the reward.
This on-off method proves reliable in two different ways. In the best case scenario, the absence of the machine makes the individual more aware of how poorly they are sleeping or how worse they feel the next day or ideally both. Now, this individual has not only gained renewed motivation to get back on the device, but also, they openly raise questions about whether more steps will lead to further improvements.
In the other scenario, the individual notices no difference either off or on PAP. While this response doesn’t immediately sound like a success, it actually clarifies two things that prove useful going forward. First, it may mean the patient is not getting a good treatment and needs a more thorough reassessment and possibly new therapeutic steps. If so, the patient is likely to consider making such attempts now that it’s clear the response is not yielding much if any obvious benefit.
Or, second, it could be the patient will never achieve benefit beyond something more or less “intangible,” like better blood pressure control in someone who never noticed his blood pressure was poorly controlled. For this individual’s doctors, they can now regularly communicate to the patient the importance of continuing to use PAP, otherwise, he might need to start or up the dose of blood pressure meds. Thus, a connection has been established to motivate the individual despite the absence of more tangible benefits.
Under the supervision of your sleep doctor or other healthcare professional, the on-off strategy is worth pursuing if the forecast remains cloudy regarding how you are benefiting from PAP.
Happy Thanksgiving