Sleep apnea

[saucywench]

Reading about another poster falling asleep at work prompted me to start this thread (not saying that's why she fell asleep, it just reminded me of it.)

Several years back (2000, I think) I was diagnosed with sleep apnea, after undergoing a sleep study. Having slept alone for a while, I was unaware of my problem until, well, I slept with someone else. A concerned FA (thanks, Artie) told me the next morning that I snored loudly and seemed to stop breathing in my sleep, and that I should have it checked out. When I got back home, I saw my PCP, who referred me to the sleep study center.

Prior to all of this, I was aware that I snored, as I sometimes awakened myself by the noise, or awakened myself gasping for breath. As this usually occurred during deep REM stages, I generally just fell back asleep, but I was still conscious of the fact that these things occurred. Other symptoms I was aware of but, due to ignorance of sleep apnea, did not associate with the condition, were falling asleep at odd times of normal waking hours (at my desk at work, usually mid-afternoon, or while watching television or reading during early evening hours.) I was often irritable or had trouble focusing or concentrating (almost Adult Attention Deficit Disorder-like symptoms.) I felt sluggish or mildly disoriented (the feeling that I just wasn't 100% "in the moment.")

A couple of years prior to this, I had been diagnosed with fibromyalgia. I personally feel that these two disorders may be closely related, especially in fat people, but I have not researched this to know whether my feelings are backed up by scientific research. I did talk with a rheumatology expert about whether their might be a correlation between the two in some cases, and he agreed that that might well be possible. Fibromyalgia is a syndrome where deep REM stages of sleep are disrupted, for some as yet unknown reason. The REM stage of sleep is when serotonin, a naturally-occurring chemical/hormone in the body, is transmitted to muscle tissue, giving one that refreshed/rejuvenated feeling upon awakening. If REM-stage sleep is constantly being disrupted, this prohibits serotonin from performing its restorative task to muscle tissue, leading to muscle achiness and feeling that sleep has been of little or no benefit.

I will relate what I underwent during my sleep study. I'm sure a similar routine is how most of them work. I was scheduled to arrive early in the evening. I brought an overnight bag and work clothes for the next day. I first viewed an informative video with the others who were undergoing a sleep study that night, which at the time happened to be another woman and two men. After that we were each assigned a room, where we changed into sleeping clothes. One by one we were led into the lab where we were hooked up with the electrodes that would monitor our sleep patterns. We then went back to our rooms to await being hooked up to the monitor. (Side note: While waiting in my room to be hooked up, I actually fell asleep on the bed before they got to me.) The technicians then come and hook you up to the monitor. They will then monitor you for four hours, at which time they will wake you up. You are monitored for four hours without a CPAP machine and four hours with one. It is during the monitoring that they determine at what level (and degree) you suffer (if indeed that is your case) from sleep apnea. After eight hours you are awakened and have the electrodes removed, then you are free to shower and dress and leave for work. A couple of weeks or so, after the pulmonary/sleep doctor has had time to evaluate your results, you will return to the doctor (I forgot to mention that you must see the pulmonary/sleep doctor before the study) where he/she will prescribe (if it was determined that you have sleep apnea) a CPAP machine (generally the case, unless for some reason they determine that you need surgery or some alternate treatment.)

I can’t tell you what a difference the CPAP makes. Just that one night of the sleep study made a tremendous difference in my functioning the next day. Once I got my machine, the results were immediate. About two weeks into treatment (use of the CPAP machine) I felt like a new person. I was my old self again. Another thing that amazed me is how many people use a CPAP machine. Because I was so excited to finally have a good night’s rest, I often talked about it to others—even on the work shuttle bus. I found that many people I know, and even strangers, used a CPAP. The bus driver told me that his study documented that he awoke about 600 times during a night’s sleep. That is an incredible number of times to stop breathing, so you can imagine the burden that places upon the heart. After that, any time I heard of people complaining with symptoms similar to mine, I would educate them about sleep apnea. I felt particularly good that I was able to persuade a few people in chat to get tested, and they are now using a CPAP machine. I hope that by talking about sleep apnea in this forum, I and others can persuade a few more to consider having a sleep study performed if they experience similar symptoms. I will attach to this post some of the symptoms. Anyone who feels they may have sleep apnea can review the symptoms and perhaps be prompted to contact their PCP, who will then refer them to a pulmonologist/sleep specialist for an evaluation/sleep study.

[saucywench]

From The National Institute of Neurological Disorders and Stroke (http://What is Sleep Apnea?)
What is Sleep Apnea?
Sleep apnea is a common sleep disorder characterized by brief interruptions of breathing during sleep. These episodes usually last 10 seconds or more and occur repeatedly throughout the night. People with sleep apnea will partially awaken as they struggle to breathe, but in the morning they will not be aware of the disturbances in their sleep. The most common type of sleep apnea is obstructive sleep apnea (OSA), caused by relaxation of soft tissue in the back of the throat that blocks the passage of air. Central sleep apnea (CSA) is caused by irregularities in the brain’s normal signals to breathe. Most people with sleep apnea will have a combination of both types. The hallmark symptom of the disorder is excessive daytime sleepiness. Additional symptoms of sleep apnea include restless sleep, loud snoring (with periods of silence followed by gasps), falling asleep during the day, morning headaches, trouble concentrating, irritability, forgetfulness, mood or behavior changes, anxiety, and depression. Not everyone who has these symptoms will have sleep apnea, but it is recommended that people who are experiencing even a few of these symptoms visit their doctor for evaluation. Sleep apnea is more likely to occur in men than women, and in people who are overweight or obese.

Is there any treatment?
There are a variety of treatments for sleep apnea, depending on an individual’s medical history and the severity of the disorder. Most treatment regimens begin with lifestyle changes, such as avoiding alcohol and medications that relax the central nervous system (for example, sedatives and muscle relaxants), losing weight, and quitting smoking. Some people are helped by special pillows or devices that keep them from sleeping on their backs, or oral appliances to keep the airway open during sleep. If these conservative methods are inadequate, doctors often recommend continuous positive airway pressure (CPAP), in which a face mask is attached to a tube and a machine that blows pressurized air into the mask and through the airway to keep it open. There are also surgical procedures that can be used to remove tissue and widen the airway. Some individuals may need a combination of therapies to successfully treat their sleep apnea.


What is the prognosis?
Untreated, sleep apnea can be life threatening. Excessive daytime sleepiness can cause people to fall asleep at inappropriate times, such as while driving. Sleep apnea also appears to put individuals at risk for stroke and transient ischemic attacks (TIAs, also known as “mini-strokes”), and is associated with coronary heart disease, heart failure, irregular heartbeat, heart attack, and high blood pressure. Although there is no cure for sleep apnea, recent studies show that successful treatment can reduce the risk of heart and blood pressure problems.


What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research related to sleep apnea in laboratories at the NIH, and also support additional research through grants to major medical institutions across the country. Much of this research focuses on finding better ways to prevent, treat, and ultimately cure sleep disorders, such as sleep apnea.

[swamptoad]

Both my Mom and my Step-Dad have had to use the CPAP machine. Now, it may be possible that my wife might possibly need to use one, as she has said so herself. :( But I know that it is very beneficial. I believe it does make a difference and can improve how you feel after you've slept.

Good post, saucywench.

[FEast]

Thanks, Saucy! My b/f suffers from very bad sleep apnea. He was prescribed a BiPAP machine, but no longer uses it. The one or two times he did, it worked wonders, but he says that, if he wakes in the middle of the night, he feels very claustrophobic and rips the mask off his face. This makes for getting very little sleep, and he has to sleep sitting up. He's always falling asleep at the worst moments, and his normally sweet personality has become very cranky. He's also had two strokes, and I believe this has contributed to them.

I told him he needs to stick with it, as he'll get used to it eventually, but he makes every excuse and rationale not to use it. His snoring would wake a hibernating bear (although for some reason it doesn't bother me), and it's really scary when he stops breathing (which is easy to determine, 'cause when he stops snoring, you need only look at his chest to realize he's also stopped breathing), and I'm not with him enough for my nudges to start breathing again to be of much help.

I was at the dentist's office the other day, and the doc told me there are many kinds of masks, as well as dental procedures that can help, so we're going to look into those. Many fat people are afflicted with sleep apnea, and I'm not sure just how many people have it, but I suspect it's a much bigger problem in the fat community.

Saucy, I, too, suffer from fibromyalgia. It was a lot worse in my younger years, and I had a really bad sleep disorder because of it, although I was never diagnosed with sleep apnea, despite being tested for it. I consider myself fortunate that I get only the occasional "flare" nowadays, although I think I've also gotten more accustomed to just living "with" it and am in a position to "pamper" myself most of the time to minimize the pain, so it's not quite as debilitating as it used to be. I believe it's a hormonal or chemical imbalance, and now that my hormones are no longer at their peak, I sleep pretty well, and, as I said, my symptoms have calmed down some, even the irritable bowel and depression, especially during the last year or so (see, gettin' old actually does have benefits, LOL!). I also use ice packs liberally (so much better than heating pads), and have a freezer full of them, although I use it mainly on my ever-present sciatica.

I suffered from fibromyalgia for most of my life, especially during my most productive years, and getting even a diagnosis took years. This is certainly another thread that could be started, as when it was at its worst, I was glad to have the support of a fibromyalgia group. Although millions of people cope with it, there's very little financial support for research into finding the cause(s) or even a definitive test to show that you have it. The only way they can diagnose it is from your symptoms and ruling out other things that can be tested.

As a side note, I think this thread is another example of the need for a Health Board. Conrad, it could be called something like Fat and Fit or Health-ee...although I'm sure someone can come up with a name that's far more clever.~Bountifully, Fuchsia

[curvluver]

Surgery....

According to my wife who is a Registered Polysomnographic Technician (the sleep tech who interprets the results from the sleep study and reports the finding to the doctor), do not ever get the surgery (even the new laser surgery) as a cure for sleep apnea. The results are only temporary (the longest durationshe has seen in clinical practise is 1.25 years), and afterwords the CPAP treatment is not as effective. The surgery does stop snoring, and open up air flow, but due to scarring sleep apnea does return between 6 months - 1 years time. She recommends the use of CPAP machine for sleep apnea...

[Webmaster]

Great post. See, this is in part hat I have in mind for the section or perhaps entire website that deals with serious fat-related issues. There is so little real information out there that many fat people just don't know what their options are, and what they entail.

[ChickletsBBW]

haha.. (not laughing at the posts.. just that it's me she was referring to falling asleep at work)
sadly.. i haven't been able to sleep much lately because I'm still sick AND.. i managed to pull a muscle in my low back which is connected to the muscle in my bum and its terribly painful and i havent been sleeping well.
On the subject of S.A. I do not have it.. however my mother and brother both do and they both use the cpap and say that couldn't survive w/o it :P

[Zandoz]

Thanks, Saucy! My b/f suffers from very bad sleep apnea. He was prescribed a BiPAP machine, but no longer uses it. The one or two times he did, it worked wonders, but he says that, if he wakes in the middle of the night, he feels very claustrophobic and rips the mask off his face.

I have been using a CPAP and now a BiPAP for going on 9 years. From my experience, and that of a number of friends, the support after diagnosis and being given the "Machine", is near universally lacking if not non-existent. As is the case for many, and I'm guessing him to, they are given one mask/headgear setup, and given instructions that go little beyond a glorified "put it on your face and turn it on". People having problems like your b/f generally do not even know that there is a large number of different styles of masks/headgear, some are more invasive than others...and even for any given style of mask & headgear, adjusting it properly to work with an individual's sleep habits and physical layout, is very important.

I can not use what they frequently call the "full face" masks...the ones usually given out to new machine users. I use what is called nasal pillows...they are much less invasive than the typical full face masks.

Two years ago, a friend who is SERIOUSLY claustrophobic was diagnosed with severe sleep apnea. Fortunately she is a fighter, and refused to settle for the mask given her. It took some "nagging hissy fits" but she finally got the attention of her sleep clinic, and got them to work with her on finding a solution. For her that ended up being a unit they had to build from scratch from medical tubing and fittings. What she ended up with looks similar to the setup used in hospitals to give patients oxygen...tubing that loops over the ears, crosses the face between the nose and upper lip, and has two prongs that fit in the nose for delivery of the air. In effect, very little actually covering her face, and none of it in her line of sight.

What it boils down to is that he needs to get on the case(s) of his sleep clinic and/or equipment supplier, and goad them into working with him to find the equipment and setup that works for him. To be blunt, this CAN kill him if he ignores the problem...This comes from personal experience. I put it off for a long time...then had my sleep study put off for months by insurance hassles. By the time I actually got into the clinic for what was supposed to be a 2 night study before diagnosis, I was so bad that the LONGEST I would actually sleep was 113 seconds. Four hours into the the first night of the study, they woke me up and immediately put me on a CPAP, because my oxygen levels had dropped dangerously low.