My Journey with Sleep Apnea
Symptoms of my Health Enigma
"JP, I felt beyond exhausted, irritable, disoriented, not being able to see the forest through the trees, depressed, anxious, hypervigilent, disassociated, lack of normal cognition, could not track or even send a clear concise email at work." This is how I explained the sleep apnea to my supervisor at work once the team of doctors and I got it diagnosed. What an enigma it was for me since even as tired as I was, I did not know it. Now that I am treating the sleep apnea, I realized how sleep deprived I was. I feel more alive now than I have in four years.
The Mayo clinic defines sleep apnea as: A potentially serious sleep disorder where breathing is disrupted and stops and starts up again. There are two types of Sleep Apnea
- Obstructive Sleep Apnea which I will cover in this article- This is the most common form of sleep apnea and it occurs when the throat muscles relax.
- Central Apnea occurs when the brain does not send the proper signals to the muscles that control breathing.
Symptoms can overlap for both of these types of sleep apnea but for my purposes I will discuss Obstructive Sleep Apnea Symptoms since that is the type I was diagnosed with.
- Excessive need for sleep or daytime sleepiness also called hypersomnia.
- Loud snoring which is more prominent in obstructive sleep apnea.
- Episodes of breathing cessation during sleep witnessed by another person
- Abrupt awakenings at night accompanied by shortness of breath
- Waking up with sore throat and or a dry mouth
- Headaches upon wakening in the morning
- Difficult time staying asleep (insomnia)
- Frequent urination at night
- Attention and tracking problems
- Concentration and cognitive impairment
- Feeling no rest after a night of sleep or nap
Sleep Study Room
Physical Cause of Sleep Apnea
Obstructive Sleep Apnea occurs when the muscles in the back of the throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils and the side walls of the throat and tongue.
When these muscles relax, the airway narrows or close as one breathes in and you can't get an adequate breath. This lowers the oxygen level in your blood. This triggers the brain to say, Hey, no ability to breath so lets rouse her awake so her airway opens up. This reawakening can be so brief that you don't remember it. That's why I had no idea what was happening. I did wonder however; why I was up so often at night to use the bathroom.
Risk Factors for Sleep Apnea
My doctor explained to me that sleep apnea can happen to anyone, including children.
- Excess Weight can cause sleep apnea. Fat deposits around the upper airway can affect your breathing. The doctor measured my neck and stated that those that have a circumference of 18 inches or more are at higher risk for sleep apnea. I did not fit this category but told my doctor I felt it still had to do with being overweight. However, not everyone who has sleep apnea is overweight. Thin people develop this disorder as well. In fact, a friend of mine has sleep apnea and is fit and trim.
- Narrow Airway can be an inherited genetic disposition or your tonsils or adenoids may become enlarged which blocks the airway. As my sleep doctor said "Laura, you can't just look at someone and say yep, they have sleep apnea."
- Being male is a risk factor since they are twice as likely to develop sleep apnea. However, women are more prone to this disorder during menopause since weight gain is common.
- Sleep Apnea occurs more often in adults over 60
- If you have a family member with sleep apnea, you may have an increased chance of developing it (family history).
- Smokers are 3x more likely to have obstructive sleep apnea than people who never smoked because of inflammation and fluid retention in the upper airway. The risk drops once the person quits smoking.
- Nasal congestion- If you have difficulty breathing because of nasal congestion; whether from anatomical problems or allergies, you are more likely to develop sleep apnea. I am one of those people who developed allergies in my late forties.
My Sleep Lab Room
Sleep Apnea is considered a severe medical condition if left untreated.
Some complications include:
High Blood Pressure (Hypertension)- This can happen when oxygen levels drop during sleep. This puts an extreme strain on the heart and cardiovascular system. The more severe the sleep apnea, the greater risk there is of stroke or heart attack. Studies from the Mayo Clinic, American Sleep Apnea Association and Academy of Sleep Medicine show that sleep apnea is associated with increased atrial fibrillation, congestive heart failure, and other vascular diseases.
Daytime Fatigue- Repeated awakenings during the night cause daytime drowsiness. The restorative sleep cycle is disrupted which makes normal sleep impossible. Others find they take naps more often thinking this will bring a good nights sleep. To their dismay, nothing can fix this cycle until therapy is administered.
Irritability- The lack of oxygen in the brain and the cessation of breathing creates a vicious cycle. One finds they are irritable and feeling "not their normal self".
Driving is impaired- With Cognition being off base, many that suffer with sleep apnea before the diagnosis report they receive speeding tickets and tickets for distracted driving. I myself had three distracted driving tickets before I was diagnosed. My family often told me I wasn't paying attention to the road which rather annoyed me because I thought I was driving just fine.
Depression- Sleep Apnea can cause depression since lack of sleep is a basic need for the human body. I felt like I wasn't in my body and just a visitor. I felt disassociated from myself if that makes sense.
Children with sleep apnea may do poorly in school because lack of concentration. Adults also fail to track or concentrate. I was unable to concentrate. I literally could not focus and It was hard to track or take in any information into my oxygen deprived brain.
Complications for surgery or medications- People with sleep apnea are more likely to experience complications after surgery because they are prone to breathing problems especially when sedated and lying on their backs.
Liver Problems- Those with sleep apnea are more likely to have abnormal results on liver function tests. Their livers can show signs of scarring.
Relationships suffer- Sleep deprived people with sleep apnea have sleep deprived partners. Many reported partners slept in another room away from their partner because of the loud snoring.
Sleep Apnea Poll
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- Memory problems
- Mood swings
- Feelings of depression
- Frequent urination at night (nocturia)
- Children with untreated sleep apnea may be diagnosed with ADHD
Sleep Apnea Cpap Pillows (Better than Mask)
Sleep Study Lab
Looking back, I can see how I rationalized my symptoms. I didn't want to admit I had sleep apnea; even though my children told me I stopping breathing when I fell asleep in the family room. Trust me, throw the ego aside if your hearing from your family that you quit breathing and snore so loud, the windows rattle. Just take a trip to your primary doctor and discuss your symptoms. If they feel you fit the criteria for sleep apnea, they'll set you up for a sleep study. I was so sick and tired of being sick and tired, I couldn't wait to sleep at the hospital and find out what was going on. It was a Friday night when I went through the study. I told myself I was at a hotel to get me through the awkwardness of sleeping in a hospital room.
The sleep study is called nocturnal polysomnography. During the sleep study you are hooked up to equipment that monitors your breathing, heart, lungs and brain activity. It also monitors arm and leg movements and blood/oxygen levels while you sleep.
Hospital Sleep Study Room
The most common therapy for sleep apnea is the CPAP ( Continuous Positive Airway Pressure) which is the therapy I'm using. It's working well for the most part, but my respiratory therapist keeps tweeking the pressure so that I can sleep on my back without breathing cessation.
The CPAP holds the airway open when it tries to close during the night. It also keeps the oxygen level at a normal range. CPAP is effective 100% of the time if you can become accustomed to it. It feels odd at first, but I have gotten used to it. The positive results far outweigh the negative. I've learned to adjust to the tube that lies next to me in bed, and the nose mask pillows that go in each nostril. If one can not get used to the CPAP there are other options. As someone who is severely claustrophobic, It doesn't bother me at all.
Surgery is an option, but a dangerous choice as recovery becomes harder with age.
Dental Devices- This is like a mouth guard and is quite expensive. This mouth guard keeps the airway open but can cause movement of teeth and jaw.
Upper Airway Stimulation- There is no mask needed. One has a small generator and breathing sensor lead and stimulation lead. This can be used for mild to severe apnea. It stimulates the throat and airway to stay open with a remote.
Hopefully my journey of sleep apnea will help others that are having symptoms but not understanding what's happening. Taking the next step, if you think you fit the symptomology for this sleep disorder, will change your life and possibly save it.