Everything You (Never Knew You) Wanted to Know About Obstructive Sleep Apnea (OSA)

[McCamy Taylor]

Long post, huge health problem. Practically an epidemic, but you do not see any ribbons for this one. No rock stars doing benefit concerts—though I have no doubt that some of them have OSA. And if they have it, chances are they do not know it.


Intro. OSA, the Great Imitator

Once upon a time, in the pre penicillin days, syphilis was referred to as “the great imitator”. Syphilis did not merely make people break out in spots. It could lead to progressive neurological dysfunction (sort of like MS). It could make you crazy. At one point in the 19th century, the most common reason for hospitalization in mental facilities was syphilis. It could destroy your arteries and heart…

Now that the infection is easy to diagnose and treat, we seldom see these complications in this country. So, I would like to suggest that another common---and commonly unrecognized—disease be awarded the title “the great imitator.”

I. Obstructive Sleep Apnea 101

What is OSA? Put very simply, it is a condition in which the airway---nose, throat---close during sleep, cutting off the necessary flow of air. Almost anything that interferes with the diameter of the airway can worsen OSA. Allergies that make it impossible to breathe through the nose. A receding chin that falls back during sleep.An enlarged thyroid of other neck mass that pushes on the airway. Smoking, which causes swelling of the airway. Severe heart burn or gastroesophageal reflux disease, which allows acid from the stomach to back up into the throat, causing irritation. In addition, some things make the work of breathing more difficult. Certain neuromuscular disorders that weaken the diaphragm, the muscle that we use to breathe. Severe obesity, which puts a weight on the chest that makes the breathing muscles work harder. Conditions that cause swelling of the abdomen or stomach, such as certain tumors or cirrhosis of the liver, since the diaphragm has to push down against the abdomen when we take a breath. Medications and some recreational substances can interfere with breathing, by making the airway “floppier”. These include alcohol and sleeping pills such as benzodiazepines. Paradoxically, benzos like Ambien, Xanax and Valium are often prescribed to folks with OSA, who complain to their doctors that they are sleeping restlessly at night. Or folks may use alcohol at bedtime to smooth out their sleep. In both cases, if the underlying problem is OSA, they are actually making things worse.

Any list of causes of OSA must include genetics. The condition runs in families. One of the best ways to predict which snorers have OSA and which do not is to find out if Mom, Dad or the siblings have the disease. If so, then it is likely to be sleep apnea. I can not tell you why. It seems that some families lack the ability to keep their airways
open when they sleep.

How does this problem affect sleep? A couple of things happen. First, when the flow of air is cut off, the level of oxygen in the blood falls and the level of CO2 rises. At some point, the sleeping brain says “This is dangerous!” It triggers the adrenals to send out a surge of epinephrine, which makes it easier to breathe in conditions like asthma. Since epinephrine or adrenalin is a stimulant, it wakes the OSA sufferer up. Sometimes, it wakes him all the way up---and he complains of insomnia in the middle of the night, wakening up feeling anxious or restless. More often it does what is called a micro arousal. For a few seconds, the sufferer moves from deep sleep to very light sleep just verging on wakefulness. In the process, he is able to move his chin, reposition his head and neck and open the airway to get a few good breathes. Then, he drifts back to deep sleep. One or two of these micro arousals a night would be no big deal. However, people with severe sleep apnea may wake themselves up (without being aware of it) hundreds of times an hour. This means, they are getting very little refreshing restorative sleep in an eight hour night and they wake up feeling tired and sleepy. During REM or dream sleep, the bodies muscles (except for the diaphragm and the eye muscles) are paralyzed, which can make the problem worse during dreams----and the low oxygen and high adrenalin which results can affect the content of dreams, causing nightmares as the body senses that it is in danger and struggles to wake up. Since REM sleep is necessary for healthy mental functioning, anything that disturbs it on a regular basis can make it harder to learn and remember and even affect the emotions.

In addition to causing sleep deprivation, OSA also affects the body in a couple of other ways. First, if the condition is severe and if a lot of time is spent each night with dangerously low oxygen levels, this can damage the lungs and heart. More commonly, the oxygen level does not get that low that often, because the adrenalin kicks in a wake you up so that you can breathe again. There is a price to pay for all those hundreds or thousands of adrenalin surges. They raise the blood pressure. They contribute to something called insulin resistance, a factor in diabetes and heart disease. They act like chronic stress on the body, impairing the immune system, making folks feel anxious or nervous even during the daytime, for no apparent reason---

Because, keep in mind, all of this occurs when you are asleep. You will rarely catch yourself not breathing. By the time low oxygen forces your sleep deprived brain to a state of complete wakefulness, you have already cleared your airway reflexively and you are breathing alright again. That is why so few people go to the doctor and say “Doc, I think I need to be checked for sleep apnea”---unless a partner or family member has observed him choke, gasp and stop breathing at night. And very often, friends and family do not want to tell you about your noisy snoring/breathing since they do not want to sound critical and they do not understand that it can be a sign of disease.

II. OSA, the Statistics

For many years, if you took a sample of the population and performed a sleep study (a complicated overnight test in which breathing, oxygen and brain waves are recorded),
2% of women over the age of 40 and 4% of men over the age of 40 would have OSA. At least 80% of these people---4 out of 5—would not know that they had OSA. In recent years, those numbers have doubled. Now 8% of men and 4% of women over 40 have OSA---and 4 out of 5 of them still do not know it, despite all the recent developments in OSA diagnosis and treatment.

If you tack on a variety of risk factors---male gender, family history, obesity, smoker, alcohol or sedative use at bedtime, allergies---your personal risk goes up. African-Americans have a double risk of OSA. That does not mean that a lean nonsmoking European-American woman can not have OSA. But she is less likely to have it than her more obese, smoking African-American husband. Advancing age is a risk factor---but there is a subgroup of children with severe obesity or massively enlarged tonsils who are also at increased risk.

Now, a little math. There are an estimated 18 million people in the United States with OSA. Four fifths of these, or around 15 million do not know that they have sleep apnea To put this in perspective, there are around 23 million Americans with diabetes, only 6 million of whom do not know they have the condition. In 2003 the CDC estimated that 1 million were living with HIV. The number may be closer to 2 million now. There about 200,000 new breast cancer cases each year with about 40,000 deaths----

Maybe that is the problem. Maybe that is why there is so little public attention towards sleep disorders. No one ever died of not getting a good night’s sleep. Right? Wrong

III. OSA the Even More Alarming Statistics

Sleep apnea sufferers die on the road. They die from car crashes. A person with untreated moderately severe OSA drives with the about the same lack of care and attention as someone who is legally drunk.

People with undiagnosed OSA do not know that they are sleep deprived, and that is part of the problem. If you are driving home after working a 24 hour shift, you know to be extra careful and pay extra attention on the road. People with sleep apnea think they just got 8 hours of sleep. They do not realize that they are chronically sleep deprived. They drive the same way they did when they were 20---talking on cell phones, applying make up, eating breakfast. They go too fast and they hug the bumper of the car in front of them—just like the rest of us. But when something unexpected happens, say, for instance, another car tries to enter their lane or the car in front of them slows suddenly, their reaction time is poor. Accidents happen---not always the fault of the sleep apnea sufferer, but their poor attention contributes. People with OSA have been estimated to have a seven fold increased risk of motor vehicle accidents. And you do not have to be a sleep apnea sufferer to die on the road because of the disease. If a truck driver falls asleep behind the wheel, it may be you that suffers.

Untreated sleep apnea also jacks up the nation’s medical bills. If you review the medical histories of folks diagnosed with OSA, turns out that they have increased utilization of medical services---including hospitalization---for the previous five years . A study from 1999 found that these people spend an average of $1500 a year more than others without sleep disorder, and the nation may spend $3.4 billion extra a year on care that is not really necessary----since many of the secondary problems would resolve if the OSA was diagnosed and treated. That was 10 ten years ago. With the increased prevalence of the disease and rising cost of medical care in this country, the amount has probably increased.

http://www.ncbi.nlm.nih.gov/pubmed/10505820

Before you say “But people with obesity and other problems are just plain sicker in general” keep in mind that the medical costs incurred by people with OSA decline once they are diagnosed and treated.

http://www.ncbi.nlm.nih.gov/pubmed/15233955?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed

Before their OSA diagnosis, people are also more likely to report poor quality of life and problems with their work---which means that U.S. productivity is compromised, with more days off work, more people on disability and more mistakes on the job. If the OSA sufferer works with heavy machinery, drives a truck, runs a train or is in charge of a dangerous facility such as a nuclear power plant, their errors can be catastrophic—and costly.

Obstructive sleep apnea has been associated with a high risk for motor vehicle accidents, probably the highest of all risks due to medical conditions. Treatment of sleep apnea with nasal continuous positive airway pressure appears to reduce the risk of traffic accidents to the one of the general population. The risk for accidents may also be increased in untreated patients in the home and work environment. The increased risk seems unrelated to the symptom of daytime excessive sleepiness, and in many studies lacks a clear dose-response relationship with respect to the severity of apneas and hypopneas. The association of sleep apnea, chronic sleep deprivation and consumption of hypnotics or alcohol has not been thoroughly studied, although alcohol has been considered as a confounding variable in some studies. The cost of traffic accidents due to sleep apnea has been estimated to be so high that diagnosing and treating all drivers with sleep apnea in the USA would be cost saving and result in a decrease in society costs related to the disease.

http://www.ncbi.nlm.nih.gov/pubmed/19494476?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=5&log$=relatedreviews&logdbfrom=pubmed

Scared yet?

IV. Who Has Obstructive Sleep Apnea?

This is the $64,000 question. If there was a blood test that friends and family (who happen to own a glucometer) could administer to check for OSA, that 4 to 5 ratio would probably be much lower.

In order to confirm the diagnosis of OSA, you undergo an overnight sleep study in a lab. In the process, you are hooked up to so many machines, you look like the woman trying to give birth in Monty Python’s The Meaning of Life . All that equipment costs. Until very recently, many insurers including Medicaid, did not cover the test and/or treatment. Some plans still do not cover sleep studies. Rural communities do not have sleep labs, which means driving to the city for the test. Even if you live in the city, the waiting time to get an appointment can be months. And if you are one of the 40 million Americans who does not have health insurance you will be asked to fork over $1000 up front.

With so many barriers to diagnosis, it is no wonder that patients and doctors only think about OSA in the most extreme situation---the morbidly obese male who falls asleep on the couch and who keeps the family awake at night with his snoring. Your average family doctor and internist can spot these guys a mile away. They know that their sleep studies will be abnormal. That takes care of the one in five. Unfortunately, they miss the rest of us, even when we have conditions that should raise a red flag about possible sleep disorder.

V. Have You Considered the Possibility that Your ____ May Be Caused by Sleep Apnea?

Here are some people whose sleep apnea would usually be overlooked.

Tyrone, a slightly overweight African-American male in his 40s with severe hypertension. Though he no other significant health problems---he does not drink or smoke, he does not have diabetes, he exercises---his doctor has him on four or five different blood pressure medicines, all at their maximum dose, and he still had readings of 170/110 when he comes to the office for a check up. Tyrone needs to be asked about his sleep. Does he snore? Has be ever been told that he chokes or stops breathing in his sleep? When he checks his blood pressure first thing in the morning is it higher than it is later in the day? Note that people who get normal sleep have their lowest readings when they first wake up. Folks with OSA spend their nights riding a roller coaster of adrenalin, so they wake up with high readings.

Sally is a 12 year old child with migraine headaches. In a recent study, half of all children with doctor diagnosed migraine headaches also had sleep apnea. Sally’s mother, Sara, who also has really bad migraine’s along with fibromyalgia needs to be screened, too. Migraine’s run in families the same way that OSA runs in families. Often, the two occur in the same families.

Sally’s brother Jason, who has ADD and whose tonsils are the size of tennis balls needs to be screened, too, even if he is not overweight. Removing those tonsils may provide a cure for his behavior and learning problems. You would have a hard time paying attention in school, if you only got a few hours sleep at night. And a stimulant, such as Adderal, would mask your symptoms of sleep deprivation the same way that coffee keeps adults with OSA awake.

The same goes for fifty year old Bob, who wakes up to use the bathroom two or three times a night even though he is not on a diuretic (fluid pill) and even though his prostate is not enlarged and he does not have diabetes. Those adrenalin surges from low oxygen stimulate his body to produce more urine, in an effort to clear the lungs of imaginary fluid overload and raise the blood oxygen. Nocturia---having to get up one or more times a night with a full bladder---can be one of the most reliable markers of OSA, since it is less subjective than feeling tired or sleepy. Every doctor who suspects a sleep disorder should ask about the symptom. Older children who still wet the bed should raise a red flag, too. And speaking of genito-urinary problems, did you know that erectile dysfunction without an obvious cause can be the result of sleep apnea?

I mentioned fibromyalgia. Anyone with chronic muscle pain so severe that he or she is on narcotics should be screened for a sleep disorder. Especially if there is no obvious cause for the muscle spasms and pain. Add in tiredness and the other symptoms of chronic fatigue syndrome and OSA becomes even more likely.

Brenda, a 35 year old with a long history of intractable depression has tried every antidepressant on the market, she still lacks energy, feels moody, has a hard time getting her job and other daily tasks done and just does not feel like “herself”. Brenda is just as likely to have OSA as she is to have bipolar disorder without the manic component. I am amazed at how many psychiatrists think “bipolar” in folks who have never shown any symptoms of mania----reduced need for sleep, foolish spending and other irrational behaviors, pressured speech---and do not consider “sleep disorder”. I am appalled at how many of their patients end up on Abilify or some other atypical antipsychotic. Since the main side effects of these drugs is weight gain, they are only going to make an undetected sleep apnea condition worse.

Jill, who has been told for years that she suffers from chronic anxiety, even though she has nothing in particular to feel anxious about, also needs to be screened for OSA. All those adrenalin surges act on the body the same way that being in combat does. If you test the sympathetic nerves of someone with sleep apnea (sympathetic referring to the “flight or fight” nervous system that makes us take off running if we see a tiger) you will find that the nerves are revved up compared to a normal person. It takes only a minor fright---say a car pulling in front of you on the freeway---to activate a full blown panic attack. That is because nature wants people who live lives of danger to be ready to respond at a moment’s notice. But what if your life is not dangerous at all and the only thing you have to fear is your own exaggerated response to everyday situations? You need to consider the possibility of a sleep disorder. And also consider the possibility that the Valium your doctor has you taking at bedtime, so that you can sleep may be making your OSA worse. And the coffee you drink by the gallon during the day to stay awake is not helping your anxiety.

Bill, a young man who has been to the ER a number of times for SVT---a particular type of rapid heart beat or tachycardia could have underlying heart disease and needs to be tested. He also needs to have his thyroid checked and if there is any doubt, a drug screen. These things are routinely done. But how often is Bill asked about the signs and symptoms of sleep apnea? Grandma, who keeps going into atrial fibrillation, a different more serious type of arrhythmia that can lead to strokes, should also be checked for a sleep disorder.

Patrice, who was just involved in a single car motor vehicle accident and who ended up in the hospital , will be checked for drug and alcohol abuse, diabetes, seizures, stroke, heart disease. Too bad that no one will think to check her for sleep apnea.

Tony, a youngish 40 year old who has always had perfect health comes in complaining that he is developing early Alzheimer’s. His memory is not what it used to be. If he does not write everything down, he forgets. And it is harder for him to concentrate on tasks, especially those that are boring. He makes a lot more mistakes on the job than he used to and he is afraid that he is going to get fired. Tony could have a rare, progressive disorder that is destroying his brain. But he is more likely to be chronically sleep deprived and not know it.

Latonya, a 29 year old from Texas with severe allergic rhinitis, who gets tired, depressed and anxious every year during September and then January through March but who is fine the rest of the time and who feels much better if she can leave Dallas and go down to a Mexican beach during these spells is not suffering from seasonal affective disorder. That does not happen in September. What does happen in September is rag weed bloom. And in Texas, the winter months are notorious for mountain cedar. The severe obstruction of her airway during high pollen seasons may be enough to tip her over the edge of sleep apnea.

Chin is worried because all the men in his family develop premature coronary artery disease, despite a good diet and healthy lifestyle. In addition to checking Chin’s cholesterol, his doctor should ask about his sleep, especially since Asians have an increased incidence of sleep disorders.

Rachelle, in her mid 20s, who suffered pre-eclampsia with her first pregnancy and premature delivery with her second should pay attention when told that she snores during her third pregnancy, especially if her mom has OSA. Because of the effects of pregnancy on the body, sleep apnea may be unmasked at an early age and then disappear after delivery only to pop up again later in life. And all those episodes of low oxygen and high adrenalin are not good for the baby.

Sylvia has hypothyroidism, She still feels tired even though her doctor says that she is on the perfect dose of thyroid supplement. Hypothyroidism, especially with a goiter is a risk factor for OSA.

Juan woke up in the middle of the night with stroke symptoms. It was a “passing” stroke. He regained full use of his left arm. But he does not want the same thing to happen again. Guess what can cause strokes, especially at night.

We then performed laboratory studies and were able to show that OSA could elicit excessive sympathetic and parasympathetic activation that would lead to respective surges in blood pressure (up to 230/130 mm Hg) and bradyarrhythmias with a complete heart block. It seemed rational to hypothesize that vacillating blood pressures with hypoperfusion and hypoxia may predispose OSA patients to cardiovascular and cerebrovascular catastrophe.

http://www.uihealthcare.com/topics/medicaldepartments/neurology/apneaandstroke/index.html

That’s some pretty severe blood pressure elevation. Maybe Henry, who keeps getting chest pain at three in the morning should ask his wife whether or not he snores, since blood pressure elevations are one of the causes of angina and heart attack.

Manuela, 22, is being treated for polycystic ovary disease. This is a condition which is associated with infertility, weight gain, abnormal hair growth and insulin resistance. Her doctor has her on medication that has made her cycles regular again and which has stopped her facial hair growth. She has been told that she made need “fertility pills” in order to get pregnant. She probably has not been told that she has a 5 fold increased risk of having OSA. Oh, and her severe cramps with her periods---they are associated with OSA, too.

If you have been told that you have a life threatening condition called pulmonary hypertension then I assume that you have also been screened for OSA, since pulmonary specialists are very aware of the effects of OSA.

VI. Doctors Are Blind to Sleep Disorders So You Have To Be Extra Vigilant

If you think your situation resembles one of the above, do not wait for your primary care doctor to ask about your sleep and diagnose a sleep disorder. Physicians are very bad about overlooking OSA. In part, this is because they are not trained to ask about sleep in medical school. One study found that almost no residents included a sleep history when they admitted someone to the hospital. Also, many residents train at facilities where diagnosis and treatment of OSA are not high priorities. If you are up to your neck in people with gun shot wounds and if your population includes a lot of homeless or extremely poor folks who would not be able to get OSA treatment even if the condition was diagnosed, you will not be encouraged to look for the disorder. If your public clinic does not have the money to pay for sleep studies and your patients are too poor to pay for themselves, you will definitely think about any disease other than OSA.

Physicians develop their practice patterns early on. They look for diseases which they have experience diagnosing and treating. If they have witnessed cardiology success stories---people with incipient heart attacks averted with stints---they will be very good at detecting folks who need interventional cardiology. If they have never actually diagnosed anyone with OSA or witnessed people getting better with treatment, OSA is not going to cross their minds most of the time. Oh, they will pick up the 300 pound man who falls asleep during the medical examination. But for the other 4 out of 5, sleep apnea will never even cross their minds.

Worse yet, if the doctors does happen to think about OSA and if he asks a question about it---“Do you snore or stop breathing at night?”---the patient may not know that he snores or chokes. Especially if he lives alone, and no one has witnessed these events. He tells his doctor “no” and the doctor dismisses the possibility of a sleep disorder. In a perfect world the doctor would then go on to ask “Does anyone in your family have sleep apnea? Does anyone in your family snore or choke? Do you get up at night to use the restroom? How many times? Do you feel tired when you wake up in the morning? Do you have a morning headache? Do you fall asleep easily when sitting on the couch? Do you feel sleepy even after a good night’s sleep? Do you wake up a lot at night or toss and turn? Is there a family member you could ask about snoring or choking?”

If the patient answers “no” to all these questions, he could still have a sleep disorder, but it is very unlikely. If he answers “yes” to most of them, then he probably needs a test. What kind of test? It depends. If he has obvious OSA, then a trip to the sleep lab to get him fitted for CPAP---the special breathing system that helps most but not all OSA sufferers. If the diagnosis is unclear, a simpler test is an overnight pulse oxymeter. The patient wears an oxygen monitor overnight while he sleeps at home. That test will pick up the more severe forms of OSA, though it can not rule out a mild sleep disorder, and if the patient fails that test they need to go on to get a formal sleep study. For those who do not want to spend a night away from home or for whom money is an issue, there are now home sleep studies which can be performed at a reduced cost.

VII. Ok, So Now I Know. What Should I Do Next?

I am not going to spend a lot of time on treatment. Most of the battle, in our current health care climate, is getting a correct diagnosis. Once you know that your have OSA, you will be able to see doctors who will know how to treat you----

Assuming you have insurance or money. Here are a few things that will help, if you are forced to wait for treatment.

1. Sleep on your side! Use pillows to prop yourself up. If you think about your airway, when you are on your back the tongue and jaw have a tendency to fall back, making it more difficult to breathe. On your side, they fall forward.
2. Control your allergies. Use antihistamines and decongestants at bedtime. Try one of those nasal strips. Keep your bedroom dust and pet free. Consider a HEPA filter.
3. Avoid certain sedatives such as valium and others of that class at bedtime. They will relax your throat and make it easier for you to choke. Avoid alcohol at bedtime for the same reason.
4. Lose weight. If you are overweight and you can lose some of those extra pounds, there will be less fat around your neck and airway.
5. Stop smoking.
6. Dental guards---a special kind of retainer that pulls the lower jaw forward while you sleep are relatively inexpensive and many dentists make them. In some studies they work as well as CPAP.
7. CPAP does not really cost all that much for what you get. And if you absolutely can not afford it, there may be a local charity that will help.
8. If you have insurance, there may be some surgical procedures, including some that can be performed in the office, that will help. Tonsillectomy can cure some kids.
9. Most important of all Be careful when you drive! Make sure you are rested. Do not let anything distract you. Stay many car lengths away for the car in front of you. If you are not rested, take public transportation or get someone else to drive. No one wants to become a road safety statistic because they could not get a good night’s sleep.

Good night and sweet dreams

[HeresyLives]

1. Everybody snores.

if you lie on your back, you snore.

Another fake disease of this era and this culture.

[McCamy Taylor]

5. Actually ,lots of people can sleep on their backs without snoring or having apnea.

If you know someone who can not sleep on their back, that person could well have OSA. Some cases are mild and side sleeping is all that is required to correct the problem. But that person needs to know that when she goes to the hospital for emergency gall bladder surgery, they will position her on her back post op. And with her incision and bandages, her pain medicines and the lingering effects of anesthesia, she may develop low oxygen, rapid heart rate--and the nurses and doctors may not even consider that she is not getting air. I have seen it happen. IV Ativan given to control "anxiety" that was really the body struggling with low oxygen.

Moral, everyone needs to be aware of their own body and be proactive. Tell the nurses "Please put me on my side post op. I do not breathe well on my back."

[pnwmom]

8. Good advice, McCamy Taylor. n/t

[HeresyLives]

15. Sure they can.

Depends on what level of sleep they are in. Total relaxation in the deepest sleep means your jaw relaxes and drops open.

[Hekate]

41. For any kind of surgery now, including dental, I make sure they understand I have apnea...

[happygoluckytoyou]

53. i forgot to tell them when i had a colonoscopy..... BOY WERE THEY PISSED WHEN I QUIT BREATHING!!!!

OOPS!!!!

[Hekate]

55. LOL I'll bet they were! For the colonoscopy and dental surgery both I made sure they knew...

... and I offered to bring in my own CPAP just in case. I was afraid of exactly that -- I could just see the nurse -anesthesiologist freaking when my blood-oxygen levels dropped through the floor.

Hekate

[goclark]

59. Better yet, get evaluated for Sleep Apnea nt

[pnwmom]

6. "Another fake disease" -- another ignorant post.

When my 3 year old was diagnosed, the doctor said she only had a 1/2 inch wide airway because her tonsils were so enlarged. If she had gotten a cold before her operation, her airways might have been completely occluded.

When my husband was diagnosed, he was stopping breathing at least 60 times an hour.

But you keep telling yourself sleep apnea is a "fake disease."

[HeresyLives]

10. If any of this were true,

we'd have huge numbers of people with a history of snoring, dying in their sleep. We don't.

In fact we'd have a huge number of people with no history of snoring dying in their sleep. We don't.

And never did.

Chin straps were popular in the Victorian era, especially for women, because it was 'indelicate' for women to snore.

My guess is the chin-strap makers wanted another round of making money.

Your 3 year old had a tonsil problem, not a snoring one.

Your husband didn't 'stop breathing', he just snored. He could have just rolled over.

[pnwmom]

16. We DO have huge numbers of people dying of heart disease,

many of whom have had sleep apnea that has combined with their other risk factors to worsen their heart problems.

What you don't understand is that snoring -- while benign for many -- can also be a symptom of a serious condition. My daughter's SNORE was the only symptom that alerted us to her tonsils -- she had only had a couple colds in her life and her tonsils had been fine at her last check-up. My 3 yr. old daughter started coming into our bed in the middle of the night when she woke up. Fortunately, we didn't kick her out. She'd be lying there, snoring very loudly. She'd get louder and louder and then get completely silent. And completely still. I would count the seconds -- one, two, three, four, five, six, seven, eight, nine, ten, eleven, twelve . . . Then, finally, she'd throw her arms and legs out as she jerked herself awake and started breathing again. Then she would gradually start snoring again, getting louder and louder again, until she fell silent. AGAIN. And stayed still for long seconds until she jerked herself awake again. And this would go on for hours.

We wouldn't have known if she hadn't come into bed with us, because sleep apnea is more likely to occur in the second half of the night -- when the throat muscles are the most relaxed -- than in the first. When we would look in on her at our bedtime, she would be fine. It wasn't until 2 or later that she'd start to have her problems.

Decades later, I recognized when my husband started to have the same problems -- though he always slept on his side -- but it took several years before a doctor decided to follow up on it. My husband had a sleep study in a hospital where he was connected to an EEG -- and that proved how many times an hour he completely stopped breathing for 20 seconds or longer. My husband was a skeptic -- HE hadn't been the one bothered by his snoring -- but after a week on the machine, he admitted that he felt much more rested in the morning.

As to your other ignorant comment, I do know a 40 year old, slim, healthy woman who died in her sleep. Just stopped breathing. It does happen.

[HeresyLives]

19. But not snoring.

And again, we have no numbers.

I'm sure you're happy your husband is quieter, but 20 seconds is not life-threatening.

[pnwmom]

25. Twenty seconds, 60 times an hour results in low oxygen levels for hours through the night --

which IS bad for the heart and can be life-threatening.

I could live with the sound. What I couldn't live with was lying next to him, waiting for him to start breathing again.

[HeresyLives]

28. He was fine.

YOu were the one with the problem.

You stop breathing many times thruout the day, you just don't notice it.

[pnwmom]

30. He doesn't think he was fine -- not since he knows what it feels like

to wake up rested. He is very motivated to use the machine.

I think you must be a monster snorer, in major denial. I pity any spouse/partner.

[HeresyLives]

31. LOL well now you've scared him to bits, probably not.

And no, I sleep on my side, and don't snore. And yes, I'd be told if I did.

[pnwmom]

32. Nope, I can hear you snore all the way from here.

And all that oxygen-loss is clearly starting to affect your brain.

[freeplessinseattle]

36. oh, snap!:)

something odd is definitely affecting this joker's capacities.

[roguevalley]

45. mom stopped breathing 200 times an hour all night. But I doubt that

matters to dr. Heresy.

[JuniperLea]

81. Plus some people never get enough REM sleep...

Not enough time to get the real restful, rejuvenating sleep. It causes MS like symptoms in some people, like my dad... and it mimics several other diseases too... my dad has had years of sleep studies and has tried different drugs... now working with Scripps in San Diego with some success. He's sleeping up to four hours at a time now, which is huge. This know it all you're arguing with is going on my ignore list... sad to see denial like this with no knowledge.

[MiniMe]

63. Sleep Apnea and snoring are 2 separate things

If you have OSA, it is likely that you snore. But just because you snore doesn't mean that you have OSA. OSA is because you aren't breathing because your airway is blocked. I used to way up trying to take a breath in, and I couldn't. I thought it was part of a dream, but it wasn't. And the numbers are in the sleep study, when you find out what your O2 levels are and how many times your breathing is obstructed. You also find out how much time you spend in each stage of sleep. For people with OSA, we spend little if any time in deep sleep. For me, anytime I started to go into a deep sleep, my throat would relax and I couldn't breathe. I would then wake myself up enough to start breathing again, but not enough to remember it.

[Kali]

27. they aren't dying in their sleep

they are dying due to lack of sleep - from heart and kidney disease, to car accidents - I suggest you investigate the medical consequences of OSA, they are real, measurable, and serious.

[HeresyLives]

29. People don't die from lack of sleep either.

[Kali]

33. you appear to be either willfully ignorant or just

rudely obnoxious. You are making untrue assertions with no evidence whatsoever. There is plenty of evidence for OSA and its effects. A very basic understanding of physiology should be all you need to grasp the concepts. Start there. I won't be replying to anything else you have to say unless you can link to some credible medical or scientific evidence of skepticism of this condition.

I sincerly hope you or anybody you care about that manifests OSA gets fast diagnosis and treatment. CPAP, while a bit ungainly and definitely unromantic, is relatively simple and VERY effective.

Here is a link to the study I participated in: https://apples.stanford.edu/index.html

[Hekate]

42. I used to doze off while driving. Could have killed me AND my kids. Used to fall asleep at work...

... I could have been fired for that.

My snoring didn't bother me, but it used to wake my husband up, and then my stopping breathing used to scare him half to death. HE's the one who told me to talk to our doctor about it.

The sleep test involved many electrodes on my head and a thing that measured the oxygen levels in my blood. The doctor who evaluated the results was a NEUROLOGIST, not a chin-strap salesman.

Good lord'n'butter, as Opus used to say. What's wrong with YOU?

Hekate

[roguevalley]

46. data, dr. heresy, and not the stuff you're pulling from your butt. you

are positing your opinions as fact.

[HCE SuiGeneris]

93. Your rudeness is surpassed only by your egotistical and ignorant proclamations.

Fools like you I cannot suffer. *PLONK*

[goclark]

61. K and R again and again and again

[freeplessinseattle]

35. "dying in their sleep"? dude, actually read at least some

of the article before making ignorant remarks

[noamnety]

40. Why are you giving bad medical advice on DU?

Are you channeling Dr. Frist?

[roguevalley]

44. where's the data to back up your opinions. opinions are not facts.

[Chemisse]

75. Perhaps it's possible to die in your sleep

But what happens to me is I just keep waking up, every time my throat closes up. It matters not what position I get in, as soon as my muscles relax, the airway closes up.

Before I was diagnosed, I only occasionally woke up gasping for breath. I just slept through it, albeit lightly. Now that I have the CPAP, if I try to go without it (power outage, airplane flight), I wake up each time I stop breathing.

[McCamy Taylor]

11. My grades went from barely passing to all As after my tonsils came out.

And they did not even know there was such a thing as OSA back in the mid 1960s. It was like waking up all of a sudden at the age of 7.

[HeresyLives]

13. Infected tonsils have nothing to do with it.

Antibiotics could have solved it.

[pnwmom]

18. Yes, antibiotics are good for infected tonsils. But the tonsils often remain

enlarged after the infection is cured. And they can be large enough to interfere with breathing and that, combined with floppy throat muscles in the night, can result in sleep apea.

[HeresyLives]

21. So have a tonsillectomy.

But don't blame it on snoring.

[pnwmom]

22. The snoring is a SYMPTOM. You don't have the tonsillectomy or use a CPAP

machine because of the symptom, but because of the underlying problem that the snore is demonstrating -- an occluded air passage, whether by an obstruction or floppy muscles -- that is interfering with adequate sleep and adequate oxygen in the bloodstream.

[HeresyLives]

23. Snoring just means you're relaxed

and your mouth has come open.

There is no such thing as a 'floppy muscle'.

[pnwmom]

20. And you were old enough to remember how great it felt.

Glad they figured out your problem. I was always so grateful we figured out our daughter's problem before it had turned into a crisis.

[goclark]

60. + 100 and K for your wisdom

I have sleep apnea and as I read the Original Message, I wanted to reach out and give the thoughtful Poster a hug from my computer.

What I can't believe ~ would be any poster that would take this post lightly or make a joke of it.

This post should be a Banner Headline and saved and bookmarked and sent to everyone we hold dear in our life.

[Mithreal]

67. Agreed

[pnwmom]

72. We were lucky with our little girl because at the time

very few people including our pediatrician were familiar with sleep apnea, especially with children. But I'd been reading a book about how to get your child to sleep at night and in the very back, almost like a postscript, was a chapter talking about apnea and how this was the cause of night-wakings for a few children. So when I described all this to the pediatrician, he was willing to refer us to the ENT specialist, who didn't even need a sleep study to diagnose her (those tonsils had to go, one way or another). The difference afterwards was immediate -- and amazing.

Later, my nephew needed a tonsillectomy at the same age; he did have a sleep study first though. It suddenly occurs to me that in the days when tonsillectomies were very common, there probably was less of this, at least in children.

[goclark]

91. Thanks for the information and I'm so glad to learn

about the skilled care you received for your children.

It causes me to wonder if it was a bad idea to keep my tonsils.
Is it too late to have them removed? I'm a Senior and the doctors said then to keep them.

What is the belief now?

I get allergy shots every week and never fail to keep my appointment every six weeks with the ENT Dr. ~ he is amazing.

I had to have 2 Sinus surgeries.
The 2nd one was my fault because I didn't do all of my follow up visits as consistently as I should have ~ I'll never make that mistake again.

I have sleep apnea, they rated me as Mild ~ I just made the cut off for the sleep machine. I am so grateful that I found out that I needed help.

[pnwmom]

94. I don't know what the current thinking is about tonsil and adenoid removal

for adults with apnea. It would be worth it to ask your ENT about that.

[goclark]

97. I have a visit to my dr. in a few days ~ I'll ask Txs nt

[truedelphi]

9. This condition involves more than snoring. It involves a

Person who snores and then seemingly holds their breath. For very long periods of time.

And then semi-wakes up, as their body's inner mechanisms start them deep breathing all over again.

The result is that they are very tired and as the article explains, the person is at risk for many serious problems. Especially for being misdiagnosed for depression and then having to take anti depressants. And heart problems.

[HeresyLives]

12. Hokum.

[roguevalley]

47. sad.

[Mithreal]

69. Why do you hate medical science?

[Chemisse]

76. Great. Another poster who makes ridiculous contrary statements to get attention

She knows as well as we do that sleep apnea is a problem. She is just trying to get a rise out of us.

[roguevalley]

43. my mother had sleep apnea and was tested in a lab. she was found

to awaken 200 times a minute, a scale of disruption that the techs had never seen. In reality, she was never asleep and hadn't been for years. Sleep apnea is real. your comment is ridiculous. lying on your back, you snore. Sleep apnea is not snoring. Its the lack of ability to breathe. My mother got to sleep like an ordinary person only after this test and it took a breathing machine to make that happen.

[goclark]

68. Thank you for your wisdom and your ability to address the issue

in a meaningful way.

It is so shocking to read some of the responses.

How anyone could be anything but supportive is beyond me.

[roguevalley]

70. I don't know, honey, but I will never forget my mother's suffering.

because it wasn't detected early enough, it contributed to her death. :(

Hugs,
RV

[pnwmom]

73. Sorry to hear about that, RV. Hopefully the OP will help someone else. n/t

[goclark]

57. I have a sleep machine and I never lied on my back

The poster is to be believed.

This is a serious problem for millions of people.
I prefer to take it seriously.

[Chemisse]

78. Hey, I call mine a 'sleep machine' too

It sounds much less clinical. I don't like feeling like a hospital patient in my own home.

[goclark]

89. I'm still learning to use it but I am so grateful to be able

to have my Insurance pay for all of it.

I will treasure this gift and I promised myelf that I will do everything I can to educate and help people understand the benefits.

[Chemisse]

98. I can't go without mine now

I even bought a battery pack so I can use it when the power goes out, and on plane flights.

[goclark]

99. I was doing pretty good on mine and

now I have to send my Card from the Machine to the Tech for evaluation.

I'm cleaning the filter, using the distilled water, cleaning the hoses etc. and my Hyp? numbers were about 4, then all of a sudden, they were 5.2.

So I sent the card but the rep told me to keep using the machine no matter what.

I am determined to get it right.

I get so sown hearted when it doesn't work smoothly.

But ~ I won't give up!

[lizerdbits]

58. Wow thanks

I'll tell my dad and cousin to throw their CPAPs away so they can go back to dozing off while driving due to not getting enough sleep at night.

[Fluothane]

80. Interesting response Heresy

Usually I am content in just reading the threads on this website, but this comment triggered me to respond. OSA is a real disease in this culture and other cultures around the world. No, not everybody snores, and snoring is not a normal pattern of ventilation.

Snoring indicates that you are having airway obstruction. When you snore your minute ventilation decreases and as a result your arterial content of carbon dioxide increases. High levels of carbon dioxide cause vasoconstriction in the pulmonary vasculature. This vasoconstriction causes the right side of your heart to pump harder and eventually leads to remodeling of the right ventricle. Give it some time and you end up with pulmonary hypertension (bad). Give it some more time and you get cor pulmonale (death sentence). So…yes OSA does kill people, and yes they can be quite challenging patients when anesthetized.

[pnwmom]

96. Welcome to DU, Fluothane, and thank you for a very informative post! +1000.

[Fridays Child]

2. Eye-opening post!

Thank you. :thumbsup:

[medeak]

3. CPAP

immediate relief if fitted properly. Had patients kill others falling asleep driving...real disease and ignore the above..

[Name removed]

4. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[Juche]

7. Sleeping on an incline also is important

http://ajrccm.atsjournals.org/cgi/content/abstract/155/1/199

We used a specially adapted nasal continuous positive airway pressure (nCPAP) mask to measure upper airway closing pressure (UACP) and upper airway opening pressure (UAOP) during non-REM sleep. Statistical comparisons were made between postures using ANOVA for repeated measures. Elevation resulted in a less collapsible airway compared with both the supine and lateral positions (mean UACP: 30 degrees elevation -4.0 +/- 3.2 compared with supine 0.3 +/- 2.4 cm H2O, p < 0.05 and; lateral -1.1 +/- 2.2 cm H2O, p < 0.05). Supine UACP and lateral UACP were not significantly different. Elevation or lateral positioning produced a 50% reduction in mean UAOP (supine 10.4 +/- 3.5 cm H2O compared with 30 degrees elevation 5.3 +/- 2.1, p < 0.05; and lateral 5.5 +/- 2.1 cm H2O, p < 0.05). We conclude that in severely affected OSA patients upper body elevation, and to a lesser extent lateral positioning, significantly improve upper airway stability during sleep, and may allow therapeutic levels of nCPAP to be substantially reduced.



Another thing to try on the cheap is gargling with salt water before bed.

[HeresyLives]

14. Gargling with salt water is an old remedy

for swollen tonsils.

[lazarus]

17. valuable post

I recently had surgery for this. It raised my sleeping O2 sat from 60% to 85%. Once I've lost enough weight, I should be able to drop the CPAP, too.

My daughter has it. My infant son likely died of it.

[pnwmom]

26. Glad you got the help you needed.

So sorry to read about losing your baby, though. How's your daughter doing?

[lazarus]

34. she's got a mild case

It's thankfully not life-threatening.

Of course, because it's not life-threatening, the insurance refused to pay for the sleep study. They will, however, pay for her surgery to correct it. :shrug:

My lingual tonsils were the size of plums. Infected with a very nasty staph infection that antibiotics couldn't treat. There were structural issues as well, that are mostly fixed. I can sleep without the CPAP, although I rarely do, without fear of death. Once I lose the weight, I should be okay.

As for my son, it was technically SIDS. But since SIDS is defined as an infant's death that has no explanation, I find sleep apnea to be the likely culprit. The age most likely to be hit by SIDS, 2-4 months, is also the time when the baby starts gaining voluntary control over breathing. It's also the time when sleep apnea is at its most severe.

[Mithreal]

38. Grandmother, mother and I have it. Diagnosis and treatment saved my life.

I have zero doubt.

[Kali]

24. good post but

"Assuming you have insurance or money." shouldn't do that - too many do not have them - sleep test and cpap are VERY expensive, not many options for those MANY uninsured working poor.

I managed because I was extremely motivated and persistent - got into a nationwide study, had to wait almost a year to get a machine, but there are so many so ill from this with little idea what is wrong or how to fix it.

[Mithreal]

37. McCamy, add Neti pots for sinus problems and to possibly replace antihistamines

I alternated between three antihistamines during the first couple of years I was on my CPAP. Now I have cut them out and haven't used them for over 6 months, not even once, since I started using a neti pot.

[Hekate]

39. Kick, Rec, Bookmark to read later. I have severe apnea and have used a CPAP for 5 years

It has been a godsend, but I have struggled to relearn how to keep a regular sleep schedule. As the neurologist said to me, "When you still feel like crap after a full night's 'sleep', what's the point of getting a full night's sleep?" I found that a helpful observation. And truly, when one stops breathing some 200 times in less than 2 hours, one is not getting actual sleep.

Blue Cross paid for my CPAP over a period of a year -- that's because there is apparently a fairly high rate of failure to adjust to using the thing, so they will take it back if you can't. Believe me, I was motivated to LEARN.

Hekate

edited to add second paragraph

[Dr.Phool]

48. How did you sleep with that friggin' thing on?

I tried for months. Cover the nose masks. Cover the face masks. Just could not sleep with that thing on.

I usually woke up with the mask on the floor.

[Kali]

51. lots of people swear by the nasal pad "masks"

they don't cover, rather sit at the nasal openings - still involve the straps and some sort of structure attached to your head but many say they like them. (I would love to try but experimenting with $100 + items on my uninsured budget is not feasible)

Personally I am highly motivated and I like to snorkel, so wearing a mask while breathing was not any kind of freak out to me, although it involved switching from mouth to nose breathing.

Once you have had a few nights of real sleep you will become more and more motivated! I don't like to lie down with out it for even a few minutes, and the idea of being somewhere overnight without electricity makes me feel a little panicky. I really want to get a nice battery pack but that is a real extravagance for me at this time.

LOTS of good support and info here http://www.apneasupport.org/index.php

[Hekate]

54. One thing was I had to have the warmth on the humidifier adjusted because condensation...

... collected and pooled by my nose; eventually I'd feel it dribble by my nostrils, triggering a reflex to Get That Water Out-- and rip the mask off. Less humidity, and my nasal passages would still not dry out, but I wouldn't get that momentary drowning sensation. It really did take me some time before I stopped doing that.

A new doc (who also treats my fibromyalgia, hooray) tried to switch me to the "nasal pillows" which some people tolerate a lot better. However, I found the airflow into my nostrils intolerable -- the narrowness of the two nosepieces made the air "jet" hard against my nasal passages.
(picture here http://www.cpapxchange.com/cpap-masks-bipap-masks/bravo-nasalpillow-cpap-mask-teleflex.html )

I'm sorry you couldn't adjust -- neither could a friend of mine, so she finally had surgery for what she called "the floppy bits" that made her snore, and that seemed to cure her sleep apnea. I have reason to suspect that mine is from more than my snoring, so I am really glad I was finally able to make it work.

Best of luck.

Hekate

[MiniMe]

62. I have a heated hose, it takes care of the condensation problem

The problem is usually because warm humidified air goes through a cold hose, and it causes the moisture to condensate. A hose cover helps also. :hi:

[Hekate]

65. Oh ho -- thanks for the tip! Our bedroom gets very cold overnight in winter...

This winter I started pulling the hose under the covers with me and enjoyed the warmer air on my nose. Five years ago when I was just starting to use the CPAP it was also winter -- perhaps that was why I had such a problem.

Hekate

[MiniMe]

66. Here is where I got it from

http://www.sleepzone.com.au/showitems.asp?heading1=%27SleepZone%20Heated%20CPAP%20Tube%27

Like I said, it is a bit expensive, but well worth it IMHO. If you sew, you can get a piece of fleece just a little longer than the hose, and make it like a tube sock and run the hose through it. It helps, and the tube feels better on your skin.

[Chemisse]

77. What a great idea! I also have that problem nt

[MiniMe]

88. The heated hose makes a big difference

I don't take it if I travel anywhere, and I really miss it. But I don't want to accidentally leave the power brick or something stupid like that.

[Fiendish Thingy]

49. CPAP saved my life, my career, and my marriage

The first two nights I used it I had technicolor dreams better than any acid trip- that's how long I hadn't had any REM sleep. Sleep study showed I was being awakened/stopped breathing 360+ times in a 6 hour period.
People with untreated apnea are at higher risk for heart attacks and stroke, car crashes and much more. This has been known for a long time, it's only been recently that awareness in the general population has increased.
Many medium to large cities have "sleep centers" with board certified specialists who can test for and treat apnea. Insurance companies are generally willing to pay because of the data showing the more serious disorders treatment can prevent.

[earcandle]

50. Thank you for this report!

[supernova]

52. My SO has OSA

He's had a CPAP for years because of it and wouldn't dare lie down with out his mask. If you saw him you would be forgiven for thinking he has OSA because he is obese. But, he said he's always had it, even as a young skinny kid no bigger than a flagpole.

[global1]

56. What's The Reason For The Numbers Of People With OSA Doubling?.....

Just curious as to what is the cause for the doubling? Is it obesity? etc.

[Kali]

64. obesity is part

I suspect the majority is diagnosis - wasn't known before, if I recall this is a fairly new
"discovery" early 70s, I think. people just suffered and/or died before with cause of death being the resultant heart problems or car accidents or whatever

[hedgehog]

86. It can be a vicious cycle, too. Apnea causes a cascade which

leads to insulin resistance which leads to weight gain which aggravates apena...

[hedgehog]

71. May I recommend a good book on the subject?

"Restless nights: Understanding snoring and sleep apnea" by Peretz Lavie.

It covers the history of the research and is pretty funny when it describes the sleep researchers discovery of sleep apnea. ("OMG - get the crash cart - the patient's not breath...never mind, he's OK! 5 minutes later:"OMG! get the crash cart!."...it took them a while to figure out what they were seeing)


I thought that sleep apnea was merely the diagnosis de jour when i was scheduled for a sleep test. I really thought I just needed a lot of sleep and took the sleep study expecting to get a diagnosis that get the insurance to pay for Provigil. It turned out I stopped breathing every two or three minutes and never really went asleep! I wish I'd had my CPAP 20 years ago!

[global1]

79. I Take It You Are Using A CPAP Machine......

please tell me the difference from before you were diagnosed and then after the first time and subsequent times you used the machine. Is it really that noticeable a difference? Did you really feel the difference the first time you used it?

I travel a lot and don't want to lug a CPAP machine around with me. Do you have to use it every night? Can I get by not using it when I travel?

What about those new mouth pieces they are promoting? Are they any good?

I haven't yet been diagnosed with OSA - but am thinking that I might have it. So I'm just trying to find things out before I have to confront them. Any help you can provide me would be appreciated.

[mopinko]

82. machines are pretty portable

mine packs into a small travel bag. weighs about a pound, smaller than my laptop.
not a big deal to drag around, considering.

[hedgehog]

83. Here's what happened for me: First I had a sleep test

that showed I have sleep apnea. then I had to wait a couple of months to get a second test to determine what pressure the CPAP machine should be set at. According to the records, I only got a few hours of real sleep that night , but I went home that day and got things done. It took a week or so to get the machine. I was on Provigil before I got the machine and took my last pill the day before. Provigil is essentially a third or fourth generation amphetamine, so what i am saying is that the CPAP machine is better than the best upper out there. (As an aside - it turns out that at least some kids with a diagnosis of ADHD can eleiminate their symptoms by using a CPAP. What's the go-to drug for ADHD? Ritalin.)

The CPAP is not a very elegant device; the prototype was a vacuum cleaner on reverse! It's about as romantic and becoming as an old rubber boot. Still, it gets the job done. I've only taken one nap in the the last month after being up late the night before. Before I was often desperate for a nap. I lied and told people I slept 10 hours a night, when it was more like 12.

I've had to get a different style face mask and a different chin strap. I also use a glycerin and saline nasal spray because my nose gets dried out even with the humidifier.

I fully intend to use the machine every time I sleep from now on. My husband and I were even discussing whether I'd be better off in the future sleeping on trans-Atlantic flights or staying awake. The choice is between staying awake and breathing or sort of sleeping and choking.

I feel like I'm really awake for the first time in years. I had some bumps getting fitted properly, but it's worth it. The last few years I've exercised regularly but was getting very frustrated because not only couldn't I build stamina, I was losing ground. I'm really anxious to get out and in my garden this spring. Last year I would hit a wall after about an hour.

Most literature about CPAP machines merely repeats the same superficial information. I suggest getting a copy of Restless nights: Understanding snoring and sleep apnea because it starts with a discussion of what all has to happen in sequence whenever you take a breath. Once you understand that, the logic of the CPAP falls into place. The book also details what goes wrong when you have chronic apnea, and that's a real incentive to get treatment!

[Kali]

92. this is kind of an amalgamation of two previous posts on the subject

HUGE difference in my life. I don't like to lie down without it now - might fall asleep and wake up choking with major headache. How did I manage until I got mine? I snored since I was a skinny little kid, knew the second I read the definition of apnea I had it, - falling asleep constantly - like 5 or 6 times a day - having to stop and get out to wake up every 45 minutes when driving - burnt out ALL the time. I waited two years to get into a study (no insurance so I sold myself for scientific experiments - ha), then 9 months to get on real pressure (was in the darn placebo group - I could tell because I just knew when I was finally put on my correct setting it was going to me so much better and it was!)

The first night I went back to have my correct settings was amazing - totally different night than any I think I had ever had up until that time. No tossing and turning (I had sore shoulders from staying in the same place!) Not one single bathroom run - after a normal 3 to 5 trips every single night, didn't even need the full face mask like I thought for SURE I would need because I was such a mouth breather (when I was actually breathing, which wasn't very much apparently) mouth stays shut, no more snoring, no drooling, sleep all night, stay awake all day - it is freaking amazing. Yeah there is the Darth Vader/scuba diver not-exactly-sexy look to it all, but hell, you can have sex anywhere anytime. Bed is for SLEEPING finally!!!! I can share hotel rooms!!!

Anybody want to compare test results?

[pnwmom]

95. global1, my husband only went for the sleep study because I asked him to,

and a doctor finally agreed with me. It showed that he was stopping breathing dozens of times an hour. But he had thought he was fine.

After a week, he ruefully volunteered that he was surprised how much more rested he felt when he had the machine. Something in the machine had to be fixed and he didn't have the machine for a couple nights, and he really missed it. So he always takes it traveling with him, now, without fail. The unfortunate thing is that he hasn't been able to go overnight camping since then.

[PADemD]

100. Thank you for the recommendation.

I just ordered the book.

[pnwmom]

74. Some are children and some of those cases were probably avoided in the days

when tonsillectomies were routine. Yes, many of those tonsillectomies were unnecessary, but others probably helped kids like my daughter and my nephew (whose OSA was treated with T&A's).

(Because young children have relatively small throats, enlarged tonsils may be a more serious obstruction than for adults.)

[hedgehog]

85. Routine tonsillectomies went out about the time the

diagnosis of ADHD became more common. Kind of makes you go hmmm....

[pnwmom]

87. Particularly in view of the fact that over-tired children

are more likely to seem "hyper" than quiet.

[mopinko]

84. the nightmares were the worst part.

dreams of being attacked, hitting as hard as i could, and having it bounce off. or dreams of my husband walking away, crying, screaming, hanging on by me fingernails.
all very weird.
now i just have lots of interesting dreams.

[Hydra]

90. Thanks for posting this

And shame on the troll- I haven't slept well in years and need to do something about it. This may be the impetus I need. While I've learned to compensate for the sleeplessness, it didn't really occur to me how many problems I may have further down the line...but when you're worried about where your next meal is coming from, you usually don't.

[PADemD]

101. Thank you for posting this.

Have you ever attended a sleep apnea support group? I'd like to get one started in our area. There are so many sleep clinics locally and no support groups.