Sleep Apnea

[baileymb 0]

Can someone please explain some signs of sleep apnea?

Also, I am a picky sleeper (ex: I use a fan, well actually 2) Do they accomodate at the sleep test?

I am not sure yet if I will have to take this, but Iwas just curious.

Thanks!

Baileym

[GeezerSue 7]

Careful what you ask for...

National Institutes of Health

National Heart, Lung, and Blood Institute

Facts About sleep Apnea

WHAT IS sleep APNEA?

Sleep apnea is a serious, potentially life-threatening

condition that is far more common than generally understood.

First described in 1965, sleep apnea is a breathing disorder

characterized by brief interruptions of breathing during

sleep. It owes its name to a Greek word, apnea, meaning

"want of breath." There are two types of sleep apnea:

central and obstructive. Central sleep apnea, which is less

common, occurs when the brain fails to send the appropriate

signals to the breathing muscles to initiate respirations.

Obstructive sleep apnea is far more common and occurs when

air cannot flow into or out of the person's nose or mouth

although efforts to breathe continue.

In a given night, the number of involuntary breathing pauses

or "apneic events" may be as high as 20 to 30 or more per

hour. These breathing pauses are almost always accompanied

by snoring between apnea episodes, although not everyone who

snores has this condition. Sleep apnea can also be

characterized by choking sensations. The frequent

interruptions of deep, restorative sleep often lead to early

morning headaches and excessive daytime sleepiness.

Early recognition and treatment of sleep apnea is important

because it may be associated with irregular heartbeat, high

blood pressure, heart attack, and stroke.

WHO GETS SLEEP APNEA?

Sleep apnea occurs in all age groups and both sexes but is

more common in men (it may be underdiagnosed in women) and

possibly young African Americans. It has been estimated

that as many as 18 million Americans have sleep apnea. Four

percent of middle-aged men and 2 percent of middle-aged

women have sleep apnea along with excessive daytime

sleepiness. People most likely to have or develop sleep

apnea include those who snore loudly and also are

overweight, or have high blood pressure, or have some

physical abnormality in the nose, throat, or other parts of

the upper airway. Sleep apnea seems to run in some

families, suggesting a possible genetic basis.

WHAT CAUSES SLEEP APNEA?

Certain mechanical and structural problems in the airway

cause the interruptions in breathing during sleep. In some

people, apnea occurs when the throat muscles and tongue

relax during sleep and partially block the opening of the

airway. When the muscles of the soft palate at the base of

the tongue and the uvula (the small fleshy tissue hanging

from the center of the back of the throat) relax and sag,

the airway becomes blocked, making breathing labored and

noisy and even stopping it altogether. Sleep apnea also can

occur in obese people when an excess amount of tissue in the

airway causes it to be narrowed. With a narrowed airway,

the person continues his or her efforts to breathe, but air

cannot easily flow into or out of the nose or mouth.

Unknown to the person, this results in heavy snoring,

periods of no breathing, and frequent arousals (causing

abrupt changes from deep sleep to light sleep). Ingestion

of alcohol and sleeping pills increases the frequency and

duration of breathing pauses in people with sleep apnea.

HOW IS NORMAL BREATHING RESTORED DURING SLEEP?

During the apneic event, the person is unable to breathe in

oxygen and to exhale carbon dioxide, resulting in low levels

of oxygen and increased levels of carbon dioxide in the

blood. The reduction in oxygen and increase in carbon

dioxide alert the brain to resume breathing and cause an

arousal. With each arousal, a signal is sent from the brain

to the upper airway muscles to open the airway; breathing is

resumed, often with a loud snort or gasp. Frequent

arousals, although necessary for breathing to restart,

prevent the patient from getting enough restorative, deep

sleep.

WHAT ARE THE EFFECTS OF SLEEP APNEA?

Because of the serious disturbances in their normal sleep

patterns, people with sleep apnea often feel very sleepy

during the day and their concentration and daytime

performance suffer. The consequences of sleep apnea range

from annoying to life-threatening. They include depression,

irritability, sexual dysfunction, learning and memory

difficulties, and falling asleep while at work, on the

phone, or driving. It has been estimated that up to 50

percent of sleep apnea patients have high blood pressure.

Although it is not known with certainty if there is a cause

and effect relationship, it appears that sleep apnea

contributes to high blood pressure. Risk for heart attack

and stroke may also increase in those with sleep apnea. In

addition, sleep apnea is sometimes implicated in sudden

infant death syndrome.

WHEN SHOULD SLEEP APNEA BE SUSPECTED?

For many sleep apnea patients, their spouses are the first

ones to suspect that something is wrong, usually from their

heavy snoring and apparent struggle to breathe. Coworkers

or friends of the sleep apnea victim may notice that the

individual falls asleep during the day at inappropriate

times (such as while driving a car, working, or talking).

The patient often does not know he or she has a problem and

may not believe it when told. It is important that the

person see a doctor for evaluation of the sleep problem.

HOW IS SLEEP APNEA DIAGNOSED?

In addition to the primary care physician, pulmonologists,

neurologists, or other physicians with specialty training in

sleep disorders may be involved in making a definitive

diagnosis and initiating treatment. Diagnosis of sleep

apnea is not simple because there can be many different

reasons for disturbed sleep. Several tests are available

for evaluating a person for sleep apnea.

Polysomnography is a test that records a variety of body

functions during sleep, such as the electrical activity of

the brain, eye movement, muscle activity, heart rate,

respiratory effort, air flow, and blood oxygen levels.

These tests are used both to diagnose sleep apnea and to

determine its severity.

The Multiple Sleep Latency Test (MSLT) measures the speed of

falling asleep. In this test, patients are given several

opportunities to fall asleep during the course of a day when

they would normally be awake. For each opportunity, time to

fall asleep is measured. People without sleep problems

usually take an average of 10 to 20 minutes to fall asleep.

Individuals who fall asleep in less than 5 minutes are

likely to require some treatment for sleep disorders. The

MSLT may be useful to measure the degree of excessive

daytime sleepiness and to rule out other types of sleep

disorders.

Diagnostic tests usually are performed in a sleep center,

but new technology may allow some sleep studies to be

conducted in the patient's home.

HOW IS SLEEP APNEA TREATED?

The specific therapy for sleep apnea is tailored to the

individual patient based on medical history, physical

examination, and the results of polysomnography.

Medications are generally not effective in the treatment of

sleep apnea. Oxygen administration may safely benefit

certain patients but does not eliminate sleep apnea or

prevent daytime sleepiness. Thus, the role of oxygen in the

treatment of sleep apnea is controversial, and it is

difficult to predict which patients will respond well. It

is important that the effectiveness of the selected

treatment be verified; this is usually accomplished by

polysomnography.

Behavioral Therapy

Behavioral changes are an important part of the treatment

program, and in mild cases behavioral therapy may be all

that is needed. The individual should avoid the use of

alcohol, tobacco, and sleeping pills, which make the airway

more likely to collapse during sleep and prolong the apneic

periods. Overweight persons can benefit from losing weight.

Even a 10 percent weight loss can reduce the number of

apneic events for most patients. In some patients with mild

sleep apnea, breathing pauses occur only when they sleep on

their backs. In such cases, using pillows and other devices

that help them sleep in a side position is often helpful.

Physical or Mechanical Therapy

Nasal continuous positive airway pressure (CPAP) is the most

common effective treatment for sleep apnea. In this

procedure, the patient wears a mask over the nose during

sleep, and pressure from an air blower forces air through

the nasal passages. The air pressure is adjusted so that it

is just enough to prevent the throat from collapsing during

sleep. The pressure is constant and continuous. Nasal CPAP

prevents airway closure while in use, but apnea episodes

return when CPAP is stopped or used improperly.

Variations of the CPAP device attempt to minimize side

effects that sometimes occur, such as nasal irritation and

drying, facial skin irritation, abdominal bloating, mask

leaks, sore eyes, and headaches. Some versions of CPAP vary

the pressure to coincide with the person's breathing

pattern, and others start with low pressure, slowly

increasing it to allow the person to fall asleep before the

full prescribed pressure is applied.

Dental appliances that reposition the lower jaw and the

tongue have been helpful to some patients with mild sleep

apnea or who snore but do not have apnea. Possible side

effects include damage to teeth, soft tissues, and the jaw

joint. A dentist or orthodontist is often the one to fit

the patient with such a device.

Surgery

Some patients with sleep apnea may need surgery. Although

several surgical procedures are used to increase the size of

the airway, none of them is completely successful or without

risks. More than one procedure may need to be tried before

the patient realizes any benefits.

Some of the more common procedures include removal of

adenoids and tonsils (especially in children), nasal polyps

or other growths, or other tissue in the airway and

correction of structural deformities. Younger patients seem

to benefit from these surgical procedures more than older

patients.

Uvulopalatopharyngoplasty (UPPP) is a procedure used to

remove excess tissue at the back of the throat (tonsils,

uvula, and part of the soft palate). The success of this

technique may range from 30 to 50 percent. The long-term

side effects and benefits are not known, and it is difficult

to predict which patients will do well with this procedure.

Laser-assisted uvulopalatoplasty (LAUP) is done to eliminate

snoring but has not been shown to be effective in treating

sleep apnea. This procedure involves using a laser device

to eliminate tissue in the back of the throat. Like UPPP,

LAUP may decrease or eliminate snoring but not sleep apnea

itself. Elimination of snoring, the primary symptom of

sleep apnea, without influencing the condition may carry the

risk of delaying the diagnosis and possible treatment of

sleep apnea in patients who elect LAUP. To identify

possible underlying sleep apnea, sleep studies are usually

required before LAUP is performed.

Tracheostomy is used in persons with severe, life-

threatening sleep apnea. In this procedure, a small hole is

made in the windpipe and a tube is inserted into the

opening. This tube stays closed during waking hours, and

the person breathes and speaks normally. It is opened for

sleep so that air flows directly into the lungs, bypassing

any upper airway obstruction. Although this procedure is

highly effective, it is an extreme measure that is poorly

tolerated by patients and rarely used.

Other procedures. Patients in whom sleep apnea is due to

deformities of the lower jaw may benefit from surgical

reconstruction. Finally, surgical procedures to treat

obesity are sometimes recommended for sleep apnea patients

who are morbidly obese.

NATIONAL CENTER ON SLEEP DISORDERS RESEARCH (NCSDR)

The mission of the NCSDR is to support research, training,

and education about sleep disorders. The center is located

within the National Heart, Lung, and Blood Institute (NHLBI)

of the National Institutes of Health. The NHLBI supports a

variety of research and training programs focusing on

cardiopulmonary disorders in sleep, designed to fill

critical gaps in the understanding of the causes, diagnosis,

treatment, and prevention of sleep-disordered breathing.

FOR MORE INFORMATION

Information about sleep disorders research can be obtained

from the NCSDR. In addition, the NHLBI Information Center

can provide you with sleep education materials as well as

other publications relating to heart, lung, and blood

diseases.

National Center on Sleep Disorders Research

Two Rockledge Centre Suite 7024

6701 Rockledge Drive MSC 7920

Bethesda, MD 20892-7920

(301) 435-0199

(301) 480-3451 (fax)

NHLBI Information Center

P.O. Box 30105

Bethesda, MD 20824-0105

(301) 592-8573

(301) 592-8563 (fax)

U.S. Department of Health and Human Services

Public Health Service

National Institutes of Health

National Heart, Lung, and Blood Institute

NIH Publication No. 95-3798

September 1995

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[baileymb 0]

..Thanks for all the info... I appreciate the time to look into it!

Has anyone had any one this or went thru the testing?

Just curious as to what it is like!

Thanks again!

Baileym

[GeezerSue 7]

I did. Didn't take fans. Took husband. Impossible-to-remove-from-hair-goop. Forty thousand electrodes hooked to your body.

My experience was that I learned that I had really bad sleep apnea when I was sure I didn't ahve it at all. Go through the testing. You need to know.

(My cardiologist gently mentioned that if I didn't have sleep apnea, I'd be the first person with a BMI of about 45+ he'd met who didn't have it.)

[Chris S. - L.I. 0]

I have (or had) sleep apnea for about 3 years now. Because of the surgery I have lost about 40 pounds and because of that I don't use my CPAP machine anymore. When I reach a 50 pound loss, I will go for another sleep study to make sure I am OK without the CPAP. So the good news is....if you do have it, when you lose weight you should be able to get rid of it.

[maudeispam 2]

Oh wow thanks. I have sleep apnea and use a Cpap machine at night! It will be nice to not have to use it in the future. The surgeon told me this, but I had to hear it from someone who has been there, done that! Thanks again!

[Maurice 0]

I was waking 72 times per hour according to my sleep study. I'm now down 85 lbs., and have gotten off of the CPAP

[Bobalooey 0]

The sleep Studies (Testing) that I had were both nightmares. They glue a s***load of electrodes to you, hand you the wiring harness and march you into the room you're supposed to sleep in. Then they tell you to get into the bed (bed.....more like a cot) and they proceed to hook up the wiring harness to the patch panel on the wall just behind the bed. If you are are used to sleeping in the buff or maybe just underwear, abandon all hope. Bring loose fitting PJ's. They'll even measure how many (voluntary/involuntary) erections you have through the night so you can expect there will be wires coming out of every sleeve and pant leg. Once you are in the bed and comfortable (yeah...right) they tell you to go to sleep. So now you are "rigged" up like a phone closet, in a strange room, with the lights out, oh yeah and a little camera over your head watching your every movement, and you'll keep telling yourself you've got to go to sleep. Longest night of my life, I don't recall even dozing off for a moment, but they said they got adequate readings. The second time I had to go back with the CPAP pump test where they determined the proper amount of pressure to set it at and whether or not I could sleep with it on. I could really write a book about the second night. I'm looking forward to getting my weight down to where I can discard the pump, which I'm become so accustomed to now, I'm actually afraid to even take a nap without it. Sleep Apnea is a serious serious condition and never to be taken lightly. I even had the Uvulo Pharyngeal Palato Plasty operation (UPPP) where they surgically removed my uvula and most of my soft palate to counteract the apnea. The fact that I needed the CPAP in addition will tell you how well the UPPP worked.

Lastly, just wait until the sleep study people show you the EKG style readout that shows you how many times you actually stop breathing throughout the night. Freaked me out so bad that for fear of having a heart attack, I slept upright in a chair for weeks until I was able to get the damn CPAP. My CPAP experiences would yield yet another book. You've got to go through this though or you won't get the Rx for the pump. Don't be afraid of the testing, but don't expect it to be a walk in the park. If I had to do it all over again, I'd have shown up so snockered on tequila that I could have slept through a nuke. Unfortunately, this would have skewed the test results really bad. Maybe try to stay up 3 nights in a row leading up to it and you'll sleep through it. Nuff said. I'd really like to hear back about your experiences with the testing to see how it varies from mine.

[Parvathi 2]

I had the sleep test too. Was a pain in the arse and took about a week to get all the gook out of my head afterwards - washing 2 and 3 times a day.

In the end, I found out I was stopping breathing about 90 times an hour, on average. I didn't think I had sleep apnea at all LOL. My doctor said since I was so close to having the surgery (the test was done 2 weeks prior), that I didnt need to be on a CPAP and that as soon as I lost even 10 lbs, I'd see a difference. I've now lost 40 lbs and my hubby says I sleep heaps better now (I don't wake him with my snoring either).

Go have the test. While you won't get a good night's sleep because of being hooked up to so many wires (and honestly, the bed's aren't comfortable at all lol), atleast you'll know all the gory details and can take necessary steps to fix the problem.

Good luck with it all

[maudeispam 2]

My sleep test wasnt too bad. They had an over sized twin bed and it wasnt too bad. I brought my own night clothes and own pillows...they even said I could bring my own blanket if I wanted to. I actually was able to tell them what time I wanted to try to sleep...so I wasnt forced to try to sleep to early. The nurses got a good read out and hooked me up to a CPAP machine halfway through the night. I was able to leave the hospital when I woke up the next morning around 5:30. I looked like a real site riding the city transit with my morning hair, two pillows and over night bag. The bus driver had a good laugh!

[DeLarla 22]

I would snap straight up like an arrow out of a dead sleep gasping for air. sleep Apnea closes off your airways when you sleep and causes your heart to stop beating. It used to scare the hell out of me. In a nutshell, it sucks.

I went for the sleep studies. They were quite comfy, but they might not let you use a fan since they are trying to get some real readings... they might think you need the fan to help you breathe (does that make sense?) Then again, maybe they'll let you use the fan with no problem. Go get the study - it will give you peace of mind, and if you have Apnea, they'll give you a machine to sleep with. Once you get used to it, you'll sleep like a baby for the first time in years.

[DeLarla 22]

I guess I'm weird cause I just pretended I was part of some scientific experiment that would cure the world. Yep, they stick electrodes anywhere and everywhere, then they cram tubes in your nose or over your face and you're expected to sleep comfortably (think Houdini.) But because I was finally getting air for the first time in a decade, I was actually able to sleep through most of it, which was Heaven.

[HotLikeHer 0]

i just had 2 studies done,,, the first on 7/5 and the 2nd on 7/12 with the cpap. I have sleep apnea, I stop breathing every 3 minutes for up to 25 seconds.

The bed was a full size bed, posture pedic, very comfortable, room was set up almost like a hotel. I could bring whatever I needed to help me sleep, I have a sounds machine and I play the ocean part on it. I could watch tv till I was tired, and it was not so bad... they need to get at least 6 hrs of sleep watching on ya.

The cpap test was more bothersome, had problems with the nasal one, leakage, then switch to a bigger one, mouth still opened with chin strap, so then came the full mask, not bad, but by then I was so paranoid of leakage of air, any sound I was awake or trying to adjust the mask...lol

But they told me today that I did quite well with it and didnt need the force as high as she started me out on. So I will only be at 8.

Dr said I may lose the apnea after weight loss, but also to keep in mind it is also genetic, and my mother, G-ma and Uncle have it, but they are heavy also...So no telling until I can get my TOOL,, I want my lap band...

To me the most embarassing part is going to have to wear the thing to bed with my fiance... how bad is that? 33 and falling apart.. not to sexy for sure..

As far as the glue in the hair, it is thick, but if you turn the shower up as hot as you can stand it and keep running your hands through it, then Shampoo, I got it all out on the first shower...

[txbldhnds 0]

My husband took to sleeping on the sofa, saying I was snoring too loud. I thought he was snoring too loud and waking himself up!

I did wake up congested and with a *terrible* headache every morning. Seriously, every morning and I was exhausted all the time.

I had the sleep study done (it wasn't all that bad for me) and got my CPAP. It helps so much! It hasn't gotten hubby back in the bed for the night because we get tangled up in the tubing, but that's okay for now. After the weight comes off, it should be better.

By the way, sleep apnea is serious business. My husband's uncle died from it last year. He had been wearing his CPAP, but had a bad cold, so took it off. His wife passed by his room and heard him taking it off. He said it was uncomfortable and he wanted to sleep a little while longer. When 2 hours went by, she went in to check on him and he was dead.

I never really understood how serious it could be.

Take care of yourselves!

Colleen

[vinesqueen 2]

I used to be exhauasted for ever and a day. I also *knew* there was no way I has sleep apnea. No possible way. I just had developed insomnia, that was all...

Well, they did the test, and I was waking up 180 times every night, and didn't even know it. It's pretty bad when you impress the sleep study folks... My oxygen level would drop down to the low 80's every night.

I had a real love/hate relationship with my CPAP machine. I don't need to use it any more, and even if I try to sleep with it, I take it off soon after I fall asleep.

If you need it, then man, will it ever change your life! You will have more energy, feel better, increase your sex drive, have less head-aches, and there are some studies that suggest that if you get 8 hours of sleep you will do better with weight loss efforts. (Sounds like snake oil, but these are all the side-effects I experienced)