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01 August 2008 @ 10:52 am
Symptoms of sleep apnea  
(Since I posted the link to an article about sleep apnea and the increased risk of death, I thought I would re-post from my forum about symptoms and treatment.)

The public is just beginning in the last few years to hear about sleep apnea. Normally you hear that it is something that interrupts your sleep and makes you tired and prone to have car accidents. Maybe you've heard that it is a cardiac risk factor but have no idea why. You hear also that people who are over weight and snore loudly are at risk, and since you are thin and don't snore or snore "gently" you think you are probably safe.

Think again. Respiratory therapists who treat it think it is one of the most underdiagnosed diseases out there.

You can be young, thin, snore loudly, barely snore, be athletic, not think you are tired during the day, and still be suffering from sleep apnea. The only way you can know for sure is to be tested. Testing is easy now and can be done in your home in most cases. A respiratory therapist can hook you up to painless heart monitors, and a tube that measures your breath will be taped so that it is at the entrance of your nostrils, recording the oxygen level and breaths. You sleep through the night and the data collected in a small device is then taken back to the therapist for evaluation.

Some of the indicators of sleep apnea may be:

daytime drowsiness or feeling groggy upon awakening, even with 8 or more hours of sleep, needing lots of coffee

tossing and turning at night rather than sleeping in one position

remembering only a few dreams rather than several or more

snoring is classic, and it needn't be loud

excess weight is a risk factor but in some cases may be caused by the fatigue of apnea (in a sort of feedback loop)

heart disease diagnosis or high blood pressure may indicate sleep apnea as a silent cause

risk increases with age, or apnea itself worsens with age

physiology--a respiratory therapist can often tell from facial and neck structure that you are likely to have apnea

memory problems, attention deficit, getting worse over time, more than seems age-appropriate

lethargy, sense of laziness that has worsened over time

parent or grandparent has apnea


Sleep apnea has two causes that may also appear together in the same patient. The first is an obstruction of the soft tissues in the throat or other respiratory passages. The partial or total blockage occurs throughout the night as you relax in sleep. This is the cause of snoring, hence the connection between the two. You rouse as the brain senses the lack of needed oxygen, and the heart is affected by pumping harder. This constant rousing throughout the night causes the drowsiness, the interruption of the dream state, and also may cause you to be restless and toss and turn.

The other may be observed by someone awake in the same room: the brain doesn't send the signal for the next breath. There is the out-breath, then silence. After a moment or two, the brain reacts to the lack of oxygen and sends the signal, belatedly. A huge gasp for air occurs and breathing has resumed, only to be interrupted later.

You can have either or both of these types and not know it for many years, until the symptoms increase and become more acute, sending you to your doctor for answers. Doctors are slow to even think of sleep apnea as the cause of memory or fatigue problems.

Treatment is easy and not even that expensive, once the diagnosis is made. The most common treatment is the CPAP machine (Continuous Positive Airway Pressure). There are a variety of mask styles to fit any facial configuration or sleep style. Once you have the proper mask for you, adapting to its use is fairly easy if you have the type of CPAP that adjusts to your oxygen level and varies its pressure accordingly.

I diagnosed my husband's apnea years ago, but could not get him to talk to the doctor about it. Ironically, I also had sleep apnea and never suspected, even after he finally got treated. My diagnosis came as an afterthought by my doctor, after he looked into several other possible reasons for my fatigue and memory problems. (He finally thought to ask, do you snore?) I snored, but only mildly (my husband could shake the house). I never guessed, and neither did my friend Randa who had also diagnosed a mutual friend. Yet I had slept over at Randa's house many times and shared a futon with her, and she never guessed I had it. But tests showed I had a severe level of sleep apnea. My heart rate was dipping down to the low 30s (beats per minute) at night and I stopped breathing many times. My heart had to work hard to deal with the apnea, and I am sure it hastened the onset of my heart disease. In fact, I got the heart disease diagnosis and surgery before finding out I had sleep apnea.

I had to try a second type of mask before I was happy with my CPAP. The first type didn't work with my side-sleeping style or my face. As my face relaxed it lost its seal by the bridge of my nose, sending air hissing into my eye and waking me up again. I settled on the "nasal pillow" which is ideal for me as a side-sleeper although a back sleeper might not like it. I hardly know I have it on when I'm asleep, in fact sometimes when I wake up it feels so natural I don't even think I still have it on until I touch it.

Now that I have my machine and mask, I find myself sleeping most of the night in one position, whereas I had always, from childhood, tossed and turned all night. I remember so many years of not wanting to wake up for school or work. Now it is not a problem. I thought I couldn't have sleep apnea because I dreamed. Now I dream ten times as much, at least! I am amazed at the difference. Who knows how much time I've wasted over the years being tired when I could have been sleeping well and waking up rested and full of energy?

I know not everyone has sleep apnea, but if I could diagnose my own husband and yet be so clueless about my own apnea, I have to believe that there are a lot of other undiagnosed people out there.

You can learn more at http://www.sleepapnea.org.

There are other treatments but the machine has worked so well for me that I don't want to bother with any others. I am so happy with my machine I won't sleep without it. I even took it on my trip to Chicago with me. (It's quite portable.)

It has the added advantage of being a white noise machine, so I hardly ever wake up with noises from outside anymore.

So please don't be afraid to get it checked out if you think it is a possibility. Lots of people have heard horror stories about CPAPs, but that's because the early versions didn't adjust to your breathing level but just blasted you all night at high pressure. Mine is gentle to start, and by the time it needs to speed up I am already falling asleep and not really aware of it.

A good night's sleep is priceless.

Please feel free to ask questions. I just want to spread the word--as well as the great sleep!

More info on Wikipedia.
 
 
 
Mari Adkinsmariadkins on August 1st, 2008 06:58 pm (UTC)
daytime drowsiness or feeling groggy upon awakening, even with 8 or more hours of sleep, needing lots of coffee

It was paying attention to this pattern that made me realize it was the coffee putting me to sleep - not that I was sleeping poorly. :snort: Go figure, right?
Tapatitapati on August 1st, 2008 09:10 pm (UTC)
Yes, I think the main point is that none of us should take tiredness and sleepiness for granted--it is not normal, it is not about age, it is something that we should investigate. I'm glad you figured out the cause of your problem!
Mari Adkinsmariadkins on August 1st, 2008 09:11 pm (UTC)
You're right - it's not normal and should be investigated. And I'm glad I'm not tired all the time.

Now, about my weight...LOLOL