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Blue Cross Blue Shield of Massachusetts



Question: Do I really need a CPAP machine for sleep apnea?

I recently participated in a sleep study, at my wife’s instance. The results were that I have 28 sleep interruptions per hour and my oxygen saturation dropped as low as 81%. Do I really need a CPAP machine or is it just being recommended because that gets the sleep center paid for a second sleep study? My understanding is that I may have a “moderate” level, but doesn’t everyone. How can this diagnosis be accurate with just one visit…. This “machine” will be attached to my face for the next 40+ years (assuming I live to 80), is it really necessary.

Dr. Joshua Rassen responds:

While you are clearly skeptical about the results of your study, the numbers you mention are pretty impressive. While you had only one visit, there are numerous examples during this visit that confirm a diagnosis of sleep apnea. The 81% oxygen saturation may not seem too bad but the normal value is at least 95% or so. To a physician, 81% represents a very significant, and potentially dangerous, drop in oxygen levels as you sleep.

Sleep apnea is very common. The American Sleep Apnea Association notes on its web site that, ” Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty…. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.

Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues."

I would guess that your wife had a reason for “volunteering” you for the study. If she has noticed interruptions in your breathing, that would strongly support that your sleep study reached a valid conclusion. Perhaps you also have loud snoring. Patients with sleep apnea sometimes have what is called “heroic snoring” that can be heard in the next room!

It is not unreasonable to get a second opinion both as to the diagnosis and treatment alternatives. I can certainly understand that a C-PAP machine is less than appealing. However it seems virtually certain that you have a real problem that needs to be addressed in some way. As mentioned above, sleep apnea can lead to very serious heart rhythm disturbances, high blood pressure and other complications. You may find that with the C-PAP treatment you feel distinctly better including being more rested and energetic.

Thank you for your question.

Dr. Joshua Rassen

-- Joshua Rassen, MD, is a board-certified internist and geriatrician in northern California. He has a private practice in geriatrics and internal medicine and is the Chief of the Division of General Internal Medicine at California Pacific Medical Center.


Our reviewers are members of Consumer Health Interactive's medical advisory board.
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First published March 29, 2005
Copyright © 2005 Consumer Health Interactive