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Qustions To Ask Dr. re: sleep apnea
Old 08-22-2008, 06:57 PM   #1
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Qustions To Ask Dr. re: sleep apnea

On Wed. night I had an overnight test for sleep apnea. My doctor ordered the test because I have been complaining of fatigue, morning headaches and waking tired after 8 or more hours of sleep. I snore enough that DW has been wearing ear plugs to bed for 25 years.

The Dr's office called today and said that they had received the test report and I have an appointment on Tues. to discuss the results with the Dr.

What questions should I ask? Anybody here use a CPAP device? What other options are there to treat sleep apnea, if it turns out I have it?

Grumpy
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Old 08-22-2008, 07:53 PM   #2
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You may have already read this but this is a good article on sleep apnea.
http://www.medicinenet.com/sleep_apnea/article.htm
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Old 08-22-2008, 10:43 PM   #3
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DH uses one... it's kind of a pain to think that you'll probably be using it forever, but it has improved his quality of life so much that he doesn't mind. He did one overnight trip without it, but said "never again"!

I don't think his doctor explored other non-surgical options; he said it was the worse case he had seen and that he couldn't believe DH was walking around and lucid. DH has the Bi-PAP, with just a nasal mask; the newer "gel" kind is more comfortable.

Another friend of ours had surgery to his palate, but it didn't resolve the issue and was very painful, to boot.

Just follow the doctor's advice (esp. if it is non-surgical) and, if you get the CPAP you will likely be amazed at how much better you feel, especially at first.
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Old 08-23-2008, 12:19 AM   #4
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I think my wife suffers from this. She has told her doc that she has trouble sleeping and the doc just gave her some ambien. The ambien works okay but she doesn't want to become dependent on it.

How should she go about getting tested for sleep apnea? She is definitely tired a lot, even with plenty of sleep. She also gets terrible migraines constantly.
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Old 08-23-2008, 01:10 AM   #5
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I have a CPAP machine since last Xmas. I use it every night. (No problem for me, I am used to masks from 40 years ago in the Army and since then, air supply masks in chemical plants and refineries.) I do prefer a 'nose pillow' (a soft, dinky little thing that pokes into your nostrils), but I find the masks relatively comfortable. I carry it on airplanes. I have never had a problem with it (but I commute--the same rouite every time).

I love it! I wake up rested, even with only 6 hrs of sleep (same as before). I am much less grumpy, less hostile (maybe I am just becoming Canadianized?) in a high-pressure work environment.

DW is happy with it, too. It is very quiet. It does produce a small jet of air, but she says it doesn't bother her at all.

I have always known that I snore. My wife has complained for many years that I stop breathing many times a night.

At her prodding, I got my doc to refer me to a sleep clinic. (Bring earplugs! My sleep clinic had noisy HVAC. It was like trying to sleep in a laundromat.) The sleep doc interpreted the results to me. I stopped breathing 58 times an hour. He told me to go across the street and get a CPAP machine NOW! (Sleep apnea can can kill you, it seems. DW knew this, thus her prodding.) The paperwork would follow later.

It has a little water box in it to humidify the air. This is great for me. I work in Calgary, where the air is low humidity--sometimes VERY low--all year. I used to wake up because my air passages were all dried out.

Now that I have one, I am surprised to learn that many people I know use them--and are as pleased as I am with them. I work with a young chap who has similar sleep problems and at my recommendation is going to be tested. This is the most satisfying thing I have achieved up here (today working on a $2+ billion project). I have helped somebody.

Strongly recommended.
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Old 08-23-2008, 07:32 AM   #6
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Mom has the CPAP...if you have apnea and get a CPAP, you may have to change your avatar and handle!

Seriously though, sleep apnea can kill you, as Ed said. It will raise your BP, cause heart problems, etc, in addition to being sleepy and/or grumpy alot.

Honestly I fear I may develop apnea since my mom and a couple of her brothers both have it...and 3 nights or more out of the week DW seems to migrate to another room during the night due to my snoring...

One thing I have heard is that weight loss (if you are heavy) can reduce or eliminate symtoms, but I have heard otherwise as well. I would be interested if there are any perspectives here about that. Mom had some surgery for it, didn't do anything but give her pain for a couple of weeks. Then she got the CPAP, and has felt much better ever since. She cannot exercise for other reasons and has not been able to lose weight.

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Old 08-23-2008, 10:48 AM   #7
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Originally Posted by CybrMike View Post
I think my wife suffers from this. She has told her doc that she has trouble sleeping and the doc just gave her some ambien. The ambien works okay but she doesn't want to become dependent on it.

How should she go about getting tested for sleep apnea? She is definitely tired a lot, even with plenty of sleep. She also gets terrible migraines constantly.
CybrMike,

I first went to my internist, and complained of fatigue, muscle weakness, headaches, etc. He did some blood tests and listened to my heart. I suggested to him that maybe I should be tested for sleep apnea. He agreed and sent me to an ear, nose and throat doctor. As soon as I described my symptoms he wrote me the order for the sleep test.

Grumpy
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Old 08-23-2008, 11:11 AM   #8
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Grumpy.. maybe you will need to change your handle! Now that you and your doctor are on track to deal with the situation you should have smooth sailing ahead.
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Old 08-23-2008, 11:53 AM   #9
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Weight loss can bring dramatic improvement to some people with OSA (obstructive sleep apnea). For others, it is more related to the individual anatomy of the upper airway. Only way to know is to do it.

What some people don't realize is that if your disease is enough to cause low blood oxygen over night if not treated, it can lead to heart failure, permanent damage to the vessels of the lung, and other permanent or even fatal outcomes.
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Old 08-23-2008, 12:12 PM   #10
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Weight loss can bring dramatic improvement to some people with OSA (obstructive sleep apnea). For others, it is more related to the individual anatomy of the upper airway. Only way to know is to do it.

What some people don't realize is that if your disease is enough to cause low blood oxygen over night if not treated, it can lead to heart failure, permanent damage to the vessels of the lung, and other permanent or even fatal outcomes.
Rich,

The only info the sleep test technician was willing to give me was that my oxygen saturation dropped as low as 84% during the test. Is that considered a serious drop? I will, of course, discuss this with the ENT Doc on Tues.
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Old 08-23-2008, 12:35 PM   #11
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Rich,

The only info the sleep test technician was willing to give me was that my oxygen saturation dropped as low as 84% during the test. Is that considered a serious drop? I will, of course, discuss this with the ENT Doc on Tues.
Yes, that's low. Glad you found it in plenty of time.

As an aside, in most communities sleep disorders are managed by a pulmonary doctor with boards in sleep disorders, unless ENT surgery is anticipated. However, I am sure there are some ENT docs who have the proper training and perspective to do an excellent job.
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Old 08-25-2008, 11:31 AM   #12
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I have a sleep test coming up next Monday (Labor Day night). The last time I had a sleep test, 10 years ago, it came back inconclusive. The inconclusive probably was because I had such a hard time going to sleep. They told me to sew a tennis ball into my night clothes (in the back) so that I wouldn't sleep on my back. I really would like to try a C-Pap machine, but, they have to diagnose you with apnea first...we will see. The C-Pap with the humidity thingy sounds like something I would really like.

I know I snore and I have caught myself not breathing sometimes when I wake up. I also sometimes wake up with a headache and get really sleepy during the day. I have a mouth guard for my teeth, since I have found myself really gritting my teeth sometimes.... What next.
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Old 08-25-2008, 11:42 AM   #13
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For milder cases of sleep apnea, you may have some luck with inclining your bed slightly or adding a little 'wedge' under the top end of the mattress to give you a few inches. I occasionally woke up with a little trouble breathing once I went past 46. Taking the two wheels off the bottom of the bed frame to drop it down a couple of inches pretty much did the trick.

I've also seen a mouthguard for the lower jaw that pushes the lower jaw forward slightly and can help alleviate some cases of the problem. I'd probably want to talk to my dentist about how that would affect my bite first.

For cases where the problem is loss of muscle tone in the throat muscles, I wonder if some exercises for that are might help (make your own joke). I remember Jack LaLane used to do some sort of throat/neck exercise where he separated his jaws by about an inch and then stiffened up all his neck and jaw muscles and then tried to move his jaw, sort of a resistance thing. I've tried it and it seems to work all the appropriate muscles.

So there are some cheap/free, easy things to try. Considering the condition might kill you, get the doctor involved regardless.

http://www.webmd.com/sleep-disorders...or-sleep-apnea
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Old 08-26-2008, 02:37 PM   #14
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I just had my follow-up visit with the ENT to go over the results of the sleep study. The tests show that I have severe sleep apnea, with an index of 64 apnea events an hour during REM sleep. Anything over 30 is considered severe. No wonder I have been feeling so lousy for so long! I have an appointment next week for CPAP Titration, where they will determine the proper pressure settings for the CPAP device. Then the doctor will order the device and I will finally start getting a restful night's sleep.

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Old 08-26-2008, 02:49 PM   #15
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I hope it works for you grumpy! I could never adapt to it being a "mouth breather". I would wake up and it would sound like a wind tunnel with the air shooting through my mouth! Should have made a video I guess...might have got on TV!

Next was the dental device. Bite/jaw issues resulted. And of course they gave me ambien......

Tough issues. I'm glad I only "woke up" every four minutes. I am near good compared to you!
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Old 08-26-2008, 02:51 PM   #16
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Grumpy, sorry to hear about the diagnosis but glad you have some relief in sight.

It seems a shame you have to wait until next week for the needed information to get the device ordered. If I were you I'd want some help right now!
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Old 08-26-2008, 03:15 PM   #17
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Grumpy, you dodged a bullet. Had the diagnosis gone undetected for a long time it could be a lot worse.

Now that you know what's going on and are taking care of it, you'll do just fine.
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Old 08-26-2008, 04:11 PM   #18
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Grumpy, you dodged a bullet. Had the diagnosis gone undetected for a long time it could be a lot worse.

Now that you know what's going on and are taking care of it, you'll do just fine.
Rich,


Thanks for the advice. Actually, I think the diagnosis did go undetected for quite a while. I have struggled with sleepiness, weakness, dizziness and alot of other vague symptoms for many years. About two years ago I was found to have high blood pressure and put on medication for it. Could that have been caused by the apnea? Once I am stabilized on the CPAP, is my BP likely to go down enough to remove the need for that medication? Do I need to be checked for cardiac complications? Any further advice greatly appreciated.

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Old 08-26-2008, 07:15 PM   #19
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I just had my follow-up visit with the ENT to go over the results of the sleep study. The tests show that I have severe sleep apnea, with an index of 64 apnea events an hour during REM sleep. Anything over 30 is considered severe. No wonder I have been feeling so lousy for so long! I have an appointment next week for CPAP Titration, where they will determine the proper pressure settings for the CPAP device. Then the doctor will order the device and I will finally start getting a restful night's sleep.

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Old 08-26-2008, 08:39 PM   #20
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Rich,
About two years ago I was found to have high blood pressure and put on medication for it. Could that have been caused by the apnea? Once I am stabilized on the CPAP, is my BP likely to go down enough to remove the need for that medication?
Definite association between OSA and hypertension, and it may well resolve with treatment. But remember that hypertension is common all by itself, so you'll just have to see.
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