posted
My wife, after listening to me sleep and gasp for air the other night, suspects that I might have sleep apnia. What do I do to get myself checked out? Do I make an appointment with my doctor? Do I contact a special sleep center?
posted
Your doctor has to order it. It usually takes several weeks to schedule, sleep centers are usually very busy. At least here in the Midwest they are. If your wife observed you having typical symptoms sthen insurance usually pays for it. What exactly did she observe?
Posts: 1990 | Registered: Feb 2001
| IP: Logged |
posted
I have OSA (obstructive sleep apnea), so yeah, I'm a bit of an expert on it.
Get thee to a sleep specialist as quickly as possible. NOW, MAN! RUN!
Primary care physicians generally know almost nothing about apnea or other sleep disorders and are not in much of a position to properly diagnose or treat. The severity of the apnea, as well as to judge the best course of treatment, usually a CPAP machine, has to be done by a sleep specialist.
CPAP machine - basically, it's an air pump that pumps air through a hose attached to a mask that you wear on your face at night. The blowing air acts like a split to keep your throat from collapsing, assuming that that's the cause of the apnea.
If you have central sleep apnea, however, then drugs will fix it. Central sleep apnea is when the brain fails to send the correct signal to your lungs to breathe.
Now. Seriousness of apnea. Depending on the severity of apnea and how long you've had it, you could have severe sleep deprivation. If that's the case, then you could also be experiencing narcolepsy (falling asleep involuntarily) or other secondary sleep disorders. If your apnea is severe in terms of frequency and duration, then it can be putting excess strain on your heart. That can be very bad. If left for too long, it can cause permanent damage.
My apnea, for example, isn't that bad because I stop breathing only 45 times an hour and my heart rate climbs from 40 to 120. My uncle, however, stops breathing 120 times an hour and his heart rate climbs to 160-180. He caught his in time to prevent permanent heart damage. If it had gone on for another ten years, it would be another story entirely. In his family (he married into the family, not my biological uncle), the men tend to die of heart attacks in their sleep in their forties and fifties. Likely due to apnea. Sara, er, CT, will be along sometime to tell you whether I'm right or wrong.
The other thing they'll do at the sleep lab is find out if apnea is your only sleep disorder, or if you have more. Anecdotal - it seems to me that a lot of people with sleep disorders have more than one. That's certainly the case with more than half of those I'm related to. I also have periodic limb movement. Anyway, they'll find out, and if that's the case, get you treated for that, too.
If you're overweight, your doc will advise you to lose weight as being overweight tends to make apnea worse and, in some people, can cause apnea.
posted
Well, I've been meaning to get a checkup for, oh, a copule of years, so I guess it's time to do that anyway.
My wife observed yesterday morning (when I was in an unusually light sleep) that I wouldn't breathe for a long time, then I'd take three gasping breaths, then again I wouldn't breathe for a long time until I took three more gasps.
Posts: 16551 | Registered: Feb 2003
| IP: Logged |
posted
The best way to get TO a sleep specialist is to have a sleep study. Which, in America, is usually ordered by the primary care physician. The study is then read and interpreted by a specialist at the sleep lab.
Posts: 1990 | Registered: Feb 2001
| IP: Logged |
posted
Keep in mind that sleep apnea is much more involved that just stopping breathing every once in a while. There are a lot of criteria. During the study they look at how many times an hour it occurs, what stages of sleep, etc etc. And most people with significant sleep apnea have symptoms of daytime fatigue. It can't be diagnosed over the internet or even in the doctor's office. However, if you have NO symptoms and this was just a one-time thing, your doctor may not be concerned yet. You should have your wife continue to observe you and, if you go to the doctor, be able to describe to him the patterns Bev sees. Or take her with you. (Or have her tape you sleeping and snoring and not breathing, that can be impressive.)
Posts: 1990 | Registered: Feb 2001
| IP: Logged |
quote:CPAP machine - basically, it's an air pump that pumps air through a hose attached to a mask that you wear on your face at night. The blowing air acts like a split to keep your throat from collapsing, assuming that that's the cause of the apnea.
Just to warn Bev -- I found that sleeping next to someone running a CPAP machine much harder to get accustomed to than sleeping next to a snorer. But it is worth it to keep them alive, of course. Just be aware that it can really change your sleep habits, and....uh...sometimes the spontaniety of "other" bedroom activities.
Posts: 9538 | Registered: Aug 2003
| IP: Logged |
My diagnosis was simple. The doctor had a recorder that is attached to a mask. You wear the mask for a couple nights, then bring the machine back to the doctor. He sends the data back to the sleep lab, and they record your breathing pattern, then diagnose apnea. It's not as thorough as a sleep study, but if insurance doesn;t cover it (mine didn't), they waive the cost of the study.
Your life will be many many many times better after you get a CPAP. Trust me. I was stopping breathing 90 times an hour. I used to sleep from Friday evening to Sunday morning every single week, and I was never well-rested. Now I need about 6-7 hours every night and I'm fine.
It does tend to put a damper on any "romantic agenda," if you're single, but you don't have that trouble. It has been weird for me, though, at first with new significant others. "Ooooh, that was fantastic, baby. I'm so glad you're here with me. Now, let me just put on this Johnny Space Commander mask and turn on the medical equipment..." *hhhmmmmmmmmshhhhhhhhhhhhhhhhhhhhhhhhh* "Gnight."
It's worth it to avoid dying in my sleep which almost happened to a friend of mine with apnea.
Posts: 720 | Registered: Oct 2004
| IP: Logged |
posted
Thanks for all the info on this guys. I think my younger brother is suffering from this and I'm going to do what I can to get him checked out.
Posts: 6415 | Registered: Jul 2000
| IP: Logged |
posted
Yeah, I'm in this boat. Only problem is I haven't been able to sleep with the mask on for like...4 months
But yeah, I had to go through a series of tests, mostly because I have other sleep problems. But anyway, good luck!
Posts: 3003 | Registered: Oct 2004
| IP: Logged |
posted
When I did my sleep study, they pretty much confirmed I had it (even though the techs aen't allowed to diagnose) so they woke me up and let me spend one hour on a CPAP machine.
I awoke feeling a decade younger. It's amazing the difference it can make. Definitely get checked ASAP.
Posts: 3846 | Registered: Apr 2004
| IP: Logged |
quote: Mary won't let me snore. [Grumble] She keeps waking me up and forces me to sleep on my side.
Yeah, that usually works. But one night a few weeks ago I came to bed after he fell asleep. He was on his side snoring away. There wasn't anything I could *politely* do to get him to stop. I slept on the couch that night. Posts: 7050 | Registered: Feb 2004
| IP: Logged |
posted
My father almost certainly has sleep apnea, but he won't heed my mother's and my advice on it. Maybe I'll go to him armed with the info from this thread and tell him to get an appointment.
Posts: 4816 | Registered: Apr 2003
| IP: Logged |
posted
With untreated obstructive sleep apnea, you have an significantly increased chance of stroke and heart attack. You also probably wouldn't have had a good night's sleep in over a decade. Sometimes treating sleep apnea naturally leads to a decrease in weight, as you have more energy during the day. It also may help depression.
Oh, and the mask? I think it looks tres chic, a'la Star Trek. And the soothing woosh-woosh makes for an excellent white noise. I have a hard time not sleeping next to a CPAP machine, now.
As was so eloquently explained above, the thing to do is start with your primary care doctor who can refer you to a sleep clinic. Sometimes you can self-refer, but you'd have to check your insurance first, and sounds like you really should get a check-up anyway.
If you want to streamline the process, make a tape of your sleeping with the pauses and gasps. Since you are a tall slim man, you -- like my husband -- don't fit the stereotype for obstructive sleep apnea, so the tape can help convince a screener. They will also be looking for reports of your chest heaving and/or legs kicking with the pauses, and daytime sleepiness. However, you might not even know that you are sleepy during the day, if you haven't slept well for a long long time. It's like depression -- you don't realize how bad it has gotten until you get it fixed.
When my sweetie had a sleep study, they put the CPAP on halfway through the night. When he woke that morning, he said he felt like a five-year-old. He'd forgotten what it was like to have energy again.
Derrell knows all about this stuff, so he might be a good one to answer questions.
posted
Well, I've got an appointment. It's been many, many years since I've had one, so it's a good idea all around.
Posts: 16551 | Registered: Feb 2003
| IP: Logged |
quote: And the soothing woosh-woosh makes for an excellent white noise. I have a hard time not sleeping next to a CPAP machine, now.
I don't have that problem. I have slept with a fan on for a couple decades now, the noise and the breeze help me sleep. It's more the big plastic mask over my face. I sleep fine with it, I just think it looks really bizarre.
posted
My father was diagnosed with sleep apnea a few years back and sleeps with the CPAP machine. He is affectionately known to some as "Grandpa Snuffleupagus".
Posts: 7050 | Registered: Feb 2004
| IP: Logged |
posted
mph, think of your wife. If you haven't gotten a decent nights sleep in a decade, neither has she! You wake her up every night. I mean, think about it, iverytime she makes you roll over, it's because you've awakened her.
I never slept well to begin with, but between my insomnia and my husband's snoring, I nearly went crazy. Well, okay, I did go crazy, but that was for an entirely different reason.
Once you get the CPAP, (if it's winter and you don't have a humidifier in the house, get one. Don't use the one built into the machine) you'll not only sleep better, but you and your wife will be healthier. Not just in warding off heart attacks and such, but simple colds! My husband, who got sick every year, hasn't been sick since he got his CPAP (4 or 5 years ago!)
Posts: 9871 | Registered: Aug 2001
| IP: Logged |
posted
It runs in my family. My maternal grandfather died from either a heart attack or falling asleep at the wheel, both attributable to sleep apnea. My father wrecked a rental car in Mexico. He had no idea he was falling asleep briefly multiple times during the day. He just felt exhausted all the time. All of my maternal uncles and one aunt have been diagnosed.
Now we all have our CPAPs and are much less crabby and tired. I also get sick less often. (The vibration of the throat while snoring causes friction abrasions, which allows germs to get in.) I love my nose hose.
Oh, and I don't have that bulky contraption in the picture. I have a Simplicity mask that just covers the nose, and a modified headgear that is only one strap...much less confining. I had one like the one in the picture at first, because the medical equipment store was out of the one my doc prescribed. It left two little rectangular weepy sore dents in my forehead every morning.
Posts: 1379 | Registered: Feb 2002
| IP: Logged |
posted
Yeah, if any of you have tried using a CPAP and are having problems adjusting to it, then you're probably not using a mask that suits you very well. There are hundreds of different styles, but most respiratory care companies only carry a half dozen. Ask to try on different masks. Also, they may have fitted you with the wrong size, so you may be experiencing leakage. For example, I have a very small nose, so I have to use an extra petite mask, or the equivalent of what they'd fit onto a child. There are masks that fit around the nose only, ones that cover mouth and nose, ones that go in the nostrils, some that have gel for a better fit (but I can't use because I'm allergic to the gel), and so on and so forth.
My allergies improved drastically after I started on a CPAP machine. Heck, my entire immune system improved after CPAP.
Also, something like half of those who are eventually diagnosed with apnea were originally diagnosed with depression. The systems can be so similar, and primary care physicians so unfamiliar with sleep disorders, that it's that common. If you're on any medication, don't be surprised if you have to change dosages after you start on CPAP. But do it with your doctor's advice.
There can be some rather pleasant side effects of getting enough sleep. For me, I went from having the periods from hell that lasted 2-7 weeks long to having normal 3 day ones. If you used to get up several times in the night to pee, get used to not having to do that anymore.
Life is seriously much better on CPAP than off. Posts: 8355 | Registered: Apr 2003
| IP: Logged |
So if sleep disorders can go together, is there a chance that poor sleep rhythms could be making this worse? Like staying up late? I thought that the narcolepsy was just the body trying to make up for interrupted sleep.
My mother in law couldn't adjust to the CPAP, but she has some kind of machine that concentrates oxygen and she just wears an oxygen tube at night. I guess the theory there is that the breaths she does get will be more oxygen rich.
My husband has it, but he is not tall and slim. Sometimes obstructive sleep apnea can be a complicating factor in keeping someone overweight, since sleep deprivation correlates with some elements of metabolic syndrome (too much cortisol, insulin resistance.)
Posts: 2010 | Registered: Apr 2003
| IP: Logged |
posted
Well, there's some controversy as to what came first, the obesity or the apnea. Sometimes, obesity can cause apnea, and sometimes, apnea can cause obesity.
The old criteria for apnea used to be middle-aged overweight male. I say old because they're starting to see that that's just who was being diagnosed, not who actually had it. Like me, for example. Female, slim, and young - at least, I was when I first started experiencing it. I just didn't get diagnosed until at least a decade after the sleep deprivation became a huge problem, and by that time, I'd gained a lot of weight, at least partially due to the apnea.
The thing about sleep disorders is that one can always make another one worse. I've been through several sleep labs. Once we got the PLMD (period limb movement disorder) treated with medication, I was much easier to diagnose for apnea, but until then, I was waking up from the PLMD 2-4 times a minute that they couldn't really tell how bad my apnea was. I also had narcolepsy, but that went away as soon as I started treatment for the primary sleep disorders. Same as my nightmares, sleep walking, sleep terrors, and all the rest of it. It all went away as soon as I got treatment for the apnea and the PLMD.
If your mother in law can adjust to being on oxygen, she can probably adjust to being on CPAP. But the biggest problem that I've seen is that so many respiratory therapists (in Canada, at any rate, they're the ones who sell and fit the CPAP machine and equipment) don't care to take the time to explain how everything works, explain about adjustment periods, get masks and such to fit properly, and all the rest. They tend to sell the equipment, and as soon as they have their money, they're gone. But a good respiratory therapist will make sure you have a good fit and will follow through to make sure you're adjusting and will help you along the way.
My first month on CPAP was difficult. I ended up tearing the mask off after an hour or two initially - couldn't stand it. Eventually, I made it up to wearing it a full night. It took me six months to get used to the noise from the CPAP machine - I'm a really light sleeper. It can be a hassle adjusting. However. The benefits outweight the inconvenience by a long shot. I stuck with it because I can be stubborn and obstinate and I was sick and tired of feeling sick and tired. It paid off. But if the therapist doesn't explain that everyone goes through an adjustment period and that it does get better, many patients just give up. They don't see the point.
If you or someone you know is having trouble adjusting to being on CPAP, find a support group if you can. There are some online. Talking to others with the same medical problem and the same treatment can hugely help.
Posts: 8355 | Registered: Apr 2003
| IP: Logged |
posted
I have wondered if I have mild narcolepsy. I certainly have inherited my father's ability to fall asleep anywhere instantly. (Keep in mind, my father has been diagnosed with sleep apnea, and supposedly this stuff can run in families.)
When I was in my early twenties and commuting to work in the mornings through Dallas rush-hour traffic, I would struggle almost every day with falling asleep repeatedly at the wheel. It was *really* scary sometimes. I can't trust myself to drive very long because of it.
All growing up I couldn't read much and sometimes couldn't do my homework because it put me to sleep. Reading still has that effect on me. And whatever my morning class was at school, I spent much of it in and out of sleep.
I have also occasionally experienced that feeling of all my muscles suddenly threatening to go slack, but I jolt back into control before it totally takes hold. This can happen while I am walking about even. This hasn't happened to me in awhile though.
All I have to do is get bored and still enough, and I start to fall asleep. It is really annoying. But it isn't near as debilitating as I know it *could* be, so I have never bothered to do anything about it.
posted
Um, beverley, I would strongly urge you to see a sleep specialist about this. Now.
What you're describing could be narcolepsy, or it could be severel sleep deprivation. Either way, it's better to get it checked out. What you're describing is not healthy.
As for apnea - yes, it can run in families. Not the same way heart attacks and diabetes run in families, but still.
With obstructive sleep apnea, for example, it's most commonly caused by the throat collapsing during sleep. The throat collapses easier when the person has a larger neck because the weight of the tissue surrounding the esophagus makes it easier to collapse. For me, it's because my throat is oval, so the flat sides collapse. But we have larger necks in our family anyway.
You know how pregnant women sometimes have problems sleeping in their last months of pregnancy, but find that sleeping in a recliner can make it much easier to sleep? That same short-term solution is also good for those with apnea - the elevation makes it so that gravity isn't working on the neck tissue in the same way, so it can help.
And I have read that apnea can affect women in late stages of pregnancy because of the weight gain. I'll see if I can find a link.
Anyway. Both of my brothers have apnea, as does my mother, and so do various aunts and uncles and cousins. On both sides of my family. (But then, given how I'm related to myself in 49 different ways that I know of, my father's side of the family IS my mother's side. And vice versa. Ew!)
I've read statistics that indicate that something like 5-10% of the population is thought to have OSA (obstructive sleep apnea), but only 5% of those who have it have ever been diagnosed.
Posts: 8355 | Registered: Apr 2003
| IP: Logged |
posted
Yes, it takes time to adjust to the CPAP mask. I loved the Capt Space Commander imagery. Plus you get to wake up and sound like Darth Vader. One drawback, you tend to swallow a good bit of air, so it finds its way out again. Posts: 2 | Registered: Jan 2005
| IP: Logged |
quote:There are times that I snore so loud that I wake myself up.
Awww... poor Porter. *pat*pat*
My Mom has it REALLY bad. I think I might have it too...but I have no way to check and no money to see a doctor at this point. Hmmm... I need to find a sleep-mate to watch me!
Posts: 4953 | Registered: Jan 2004
| IP: Logged |
quote: One drawback, you tend to swallow a good bit of air, so it finds its way out again.
I don't have that problem. Is it possible it's an adjustment problem? I have no idea how long you've been on it, so I don't know. Or perhaps you need a chin strap to remind you to keep your mouth closed while you sleep? I was a mouth breather before CPAP, but not since, and I seem to recall what you describe as from mouth breathing.
Posts: 8355 | Registered: Apr 2003
| IP: Logged |
posted
I don't snore, but I am an extremely restless sleeper. And I always am tired. I only feel rested after about 10 hours of sleep. Maybe I should get a sleep study but I hate to spend the money.
posted
It depends on how much of a bite that is taking out of your lifestyle. But I think it's within the range of normal. Of course, I'm not a doctor, the following is a book report of a book written by a Canadian psychologist:
I read a book called Sleep Thieves by Stanly Coren, and he talks about how the circadian rhythms of the body seem to work with sleep. That's why I talk so much about having good sleep patterns. The body is most prone to sleep in a healthy person between 1-4, both A.M. and P.M. There were studies showing higher rates of traffic accidents at those times. There is also a spike in traffic accidents right after daylight savings and a dip in them right after the return to standard time, showing that many people are operating in a slim margin.
And the sleep hormones/food hormones is a cyclic thing. Insulin and Cortisol interact quite a bit and adrenaline and stuff like that. Insulin helps make seratonin, some of which is made into melatonin. Melatonin is the hormone produced when it is dark that essentially makes you sleep (again, if you're normal).
Caffeine, chocolate and exercise will interfere with sleep if used too close to bed time. The body has flexibility built into the biorhythms due to the changing length of days, and part of this system is a 12 hour echo. If you skip breakfast, you get the munchies at night. If you take coffee mid afternoon, you make wake at 3 in the morning.
When I was trying to get some rest before work, I woke up feeling unable to breathe and then I couldn't sleep because my heart was beating too fast... I don't think these are good signs.
Posts: 4816 | Registered: Apr 2003
| IP: Logged |
posted
Now I'm worried. Sometimes I snore so loudly that people call me "chainsaw". Plus, I wake up once or twice per night, sometimes gasping for air. Hmmm...
Posts: 1785 | Registered: Oct 2003
| IP: Logged |
posted
Let me see if I can give this some context for you . . .
Before I went on CPAP, I had 45 apneic events an hour. I never woke up gasping for air. Not once in all the years I've been having apneic events.
If you are waking up gasping for air, it's likely either apnea or stomach acid on your esophagus. You'll know if it's the esophagus if you still can't breath properly after a few minutes. If it only takes a few seconds to recover your breath, then the esophagus bit is out.
In other words, get thee to a sleep specialist immediately!
Posts: 8355 | Registered: Apr 2003
| IP: Logged |
posted
Ha, it's probably that second one. I don't usually have problems with acid or heartburn, but I'm sure having it today.
Posts: 4816 | Registered: Apr 2003
| IP: Logged |
Printer-friendly view of this topic
![[Smile]](smile.gif)
![[Grumble]](graemlins/grumble.gif)
She keeps waking me up and forces me to sleep on my side.
![[Frown]](frown.gif)
![[Wink]](wink.gif)
![[Wave]](graemlins/wave.gif)
]![[Blushing]](graemlins/blushing.gif)
![[Big Grin]](biggrin.gif)
![[Kiss]](graemlins/kiss.gif)
![[ROFL]](graemlins/rofl.gif)
