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Sleep Apnea
I was diagnosed with Sleep Apnea in 1999 although I suspect I have been suffering from it for 10 years or so. I don't fit into the usual profile of a person suffering from Sleep Apnea because I am not excessively over weight, I rarely snore (and usually only quietly), I'm not male, and I'm still in my 20s. I was diagnosed after having a Sleep Study done in order to try and rule out any sleep disorders that could be causing my symptoms of fatigue and brain fog. On average, I have 26 apnea episodes an hour. For my full story, click here.The term Sleep Apnea (sometimes spelt apnoea) is based on the Greek word "apnea" which means "without breath." People who suffer sleep apnea stop breathing repeatedly during sleep. There are three types of sleep apnea, the most common of which is Obstructive Sleep Apnea (OSA). Obstructive Sleep Apnea occurs when the airways become blocked. The others are Central Sleep Apnea, which means the problem is in the brain (the brain "forgetting" to tell the body to breathe) and Mixed Sleep Apnea, which is a combination of both Obstructive and Central Sleep Apnea.
You may well ask, if someone stops breathing while they sleep, how do they start breathing again? Fortunately, our body's reaction to absence of breath when we sleep is to wake us up. With Obstructive Sleep Apnea, while sleeping, the body's muscles relax and this causes excess tissue in the nose or throat to block the airways, when the body wakes up, the muscles are no longer relaxed and the airway blockage is removed enabling the body to begin breathing again. Apnea "events" can occur hundreds of times a night and may even last more than a minute! With this in mind, it becomes obvious why people with Sleep Apnea feel so sleepy during the day. Their sleep is being disturbed possibly hundreds of times a night. People with Sleep Apnea are often not aware that they wake up so frequently during the night.
Symptoms of Sleep Apnea usually include: Snoring, Excessive Daytime Sleepiness (EDS) and often the sufferer will wake up during the night gaging or coughing....this is more often noticed by the partner. If your partner tells you you snore and also stop breathing and wake up gasping for air, you may have Sleep Apnea and you should see your doctor. Remember that even though someone with Sleep Apnea will wake many times during the night, they may not be at all aware of it (I know I wasn't!). The reason for this is that you usually don't wake up fully, just enough to disturb your sleep and for your breathing to return to normal. This disturbed sleep means that you get very little or no REM or Stage 4 sleep. These are the deep sleep stages your body requires to do all it's repair work and get you ready to face the day.
The only way to be sure you have Sleep Apnea is to have a Sleep Study (called a polysomnogram) done in a Sleep Lab. This requires an overnight stay while your brain waves, heart beat, breathing rate and limb movement is monitored. Sleep Apnea is most common in over weight men over 40 but can affect anyone of any age, even children, regardless of their size.
Treatment can take several forms. Surgery, although still used, is known to have a low success rate and in some cases makes the condition worse and even sometimes results in it being untreatable by other methods. There are also mouth pieces available that will help to prevent the blockages in the case of Obstructive Sleep Apnea. THe most common and by far the most successful treatment for Sleep Apnea is the Continuous Positive Airways Pressure (CPAP) machine. This consists of an air pressure device and a mask the sufferer wears over their nose (or in some cases nasal pillows which are worn at the nostrils). The machine's air pressure will be set by a technician during a monitored sleep study to ensure the most beneficial results for each individual. The machine works by forcing ordinary air through the airways at a pressure which keeps the airways from becoming blocked when the muscles relax during sleep. It can be difficult to get used to but most people after using a CPAP for the first time see a very significant difference in how they feel when they wake up. It is not uncommon for a person to not realise how tired they were until they spend their first night with CPAP machine.
My Story - After being diagnosed, I underwent a three week CPAP trial but didn't feel any better. After visiting with my doctor again, I was told "CPAP obviously isn't going to work for you, sorry, there's nothing else we can do". I was so disappointed. I had been suffering from debilitating fatigue for four years and I thought that finally, I'd found out why, and finally, I was going to get treated and feel better!
It wasn't until some time later, after doing some research and finding out more about sleep apnea and treatment that I became aware that three weeks is no where near long enough to know if you are going to get any benefit from CPAP, true, some people undergo an instant "recovery" the first day they use a CPAP machine to treat apnea, but, for numerous others, it takes many weeks, sometimes even several months, before you start to see any benefit. I thought about my situation and my other health problems and it made so much sense to me that my body wasn't going to be instantly better, just because I was finally able to sleep properly, my body had a lot of healing to do and three weeks wasn't long enough to do that. I also discovered that the long term side effects of leaving sleep apnea untreated were serious problems like heart disease and stroke. I didn't want that to happen.
I eventually asked my regular doctor to refer me to another sleep specialist. On visiting wtih the new doc, I was informed that I would have to undergo another sleep study as the results that had been forwarded to him weren't comprehensive enough for him. I was put on a twelve month waiting list. It had already been a year since I had been diagnosed, I didn't want to wait another year so I asked to be put on the cancellation list so I had some hope of getting in earlier. As it turned out, I got a call urging me to take the cancellation...two days before my brother's wedding. It was a three hour trip to the hospital. I had to drive myself there. I was terrified, I hadn't driven outside my own town in years because of my inability to concentrate and increased chance of falling asleep at the wheel. I was exhausted by the time I got to the hospital. I though this would be a good thing. I though this would make me go to sleep, but boy was I wrong, any other night, I can sleep within 15 minutes of going to bed but I barely slept the whole night.... I had a Multiple Sleep Latency Test the next day so I had to spend the whole day in the hospital, trying to sleep on and off I was so dead tired, but I couldn't sleep! Normally, I'd have fallen asleep every time I lay down....I think my body was way over-tired and not responding well to the different surroundings and stress of everything that was going on....it rebelled!
About a month later, I went back to see the doctor for my results. He said "well, you slept 52% of the time and there's nothing at all wrong with your sleep" I wanted to yell at him.... I KNOW I didn't sleep that long, it was impossible. I know that most people don't realise just how much they HAVE slept during a sleep study, but I had undergone a sleep study and a CPAP titration before, and both times, I correctly esitmated the amount of time I had slept. (I didn't sleep well on either of those occassions either). I told the doc....hey, all I want is a chance to use a CPAP machine, all I want is a chance to get my life back....but my pleading for him to prescribe a CPAP machine fell on deaf ears. I told him, how is it possible that on two occassions tests showed I had apnea, and now your test says I don't, I believe in miracles, but I think if I'd been suddenly cured, I'd know about it.
I went home very discouraged. After some time I decided to "bite the bullet" and return to the original sleep doctor I saw to try and get him to approve me for government assistance to purchase a CPAP machine. If i'd had the ability, I would have just gone and bought one in the first place. The visit paid off and the appropriate forms were filled in but it was about another year before I was finally able to get the machine!
It has been six months now, since I got my CPAP. I dont' have any trouble wearing it - I guess I'm so tired I couldn't care less about having wearing it. After the first three months, I had my pressure raised from 6.5cm to 8cm because I hadn't seen any improvments and I "felt" like I was still having apneas although there was no way to confirm or disprove it. Now, after the increase to 8cm, I am still seeing no improvment. It gets so discouraging at times, I just want my life back, I want the energy to be able to do all the things I miss out on now. I'm not about to give up though, even if I'm not feeling any improvment yet, at least I am probably preventing long term damage from leaving things as they were. I'm currently considering another pressure increase.
FOR MORE INFORMATION * Sleep Disorders Australia
* Newcastle Sleep Disorders Center
* Phantom Sleep Resources FAQ
* drkoop.com Information on Sleep Apnea
* The CPAP Store
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