October 6, 2010

Identifying Sleep Apnea – Part 1

Do you know what a sleep apnea episode is? Unless you have a recorder and record yourself, you are probably like the rest of us, you could describe in words, but not what it sounds like. Since I have not really discussed this in previous blogs, I am taking this blog and the next blog to write about the areas not covered previously.

A sleep episode is basically when the air flow stops and the oxygen level in your blood drops. This drop causes your brain to jump start your breathing and briefly disturb your sleep. This often causes a gasp or choking sound as you body restarts the breathing. If you have obstructive sleep apnea (OSA), chances are you may not remember these brief awakenings as you will stir just enough to tighten your throat muscles and open your windpipe. In central sleep apnea, you may be conscious of your awakenings.

In sleep apnea that is untreated, breathing is briefly interrupted or becomes shallow during sleep. These breathing interruptions normally last ten to twenty seconds and can happen hundreds of times each night thus preventing you from getting a restful night's sleep.

When breathing is paused, you can be jolted out of your normal sleep, and I can remember this happening, sometimes completely waking me up. It did not happen all the time, but still I was not getting the restful, restorative sleep I needed. This meant that I was sleepy during the day, I had poor concentration, and I was extra careful to avoid accidents.

Sleep apnea can also bring on other serious health problems including diabetes, high blood pressure, heart disease, stroke, and weight gain. Once I was on a CPAP machine, I felt more refreshed and alert and not sleepy during the day, but I still got diabetes.

My wife was smart enough to have me get an appointment with a doctor that was a sleep specialist. She said I was snoring loudly and most of the night, and I was choking or gasping for air during my sleep. I was waking up with a dry mouth, but not a sore throat. I did not have morning headaches, but was still tired the entire day. I don't remember going to the bathroom more frequently or being moody and irritable and at least my wife agreed with me.

My sleep specialist asked lots of questions of both me and my wife. He did feel from that answers that I had sleep apnea. He did tell me that not all people that snore have sleep apnea, but based on the answers to his questions, he was scheduling me for a sleep study.

One thing you may do for yourself is keep a sleep diary. Record the hours in bed, any nighttime awakenings, and whether you feel rested and refreshed after waking. If you are married or have a significant other sleeping with you, get them to add what they witnessed and have them make a note about any gasping, choking, or other sounds.

If you live alone and have video or audio equipment, set them up to record you while sleeping. Hopefully you can set the equipment up to be sound activated or have a connection to your computer to do the actual recording.

The sleep study did show that I had very severe obstructive sleep apnea and though I was not the worse he has seen, I was near the top. Not what I wanted to hear, but at least with the CPAP, I started to get the restful and restorative sleep that I desperately needed.

October 4, 2010

Sleep Apnea Surgery Options

So you have sleep apnea and want to have surgery. Before you settle on something like surgery, do your homework. Many surgeries do not accomplish what was wanted and once done, you will have to live with it.

After I was diagnosed, I was made aware of this, but discouraged by my sleep doctor until after I had tried other options and learned more about the different surgeries. I am happy that he had that attitude. After doing a lot of reading and research, I will put up with a nasal mask before I will do something that can't be reversed.

In my second year shortly after I was diagnosed with diabetes, a surgeon specializing in obstructive sleep apnea (OSA) surgery was brought in to examine about a dozen of us. There was only one person that fit the criteria he was willing to do surgery for. I don't know what happened, but I am very thankful he felt I did not qualify for surgery.

From my knowledge now, I would try different CPAP equipment and if necessary all of the oral dental appliances until I had exhausted every other facet before I would consider surgery.

Now that I have said that, for those that cannot accept the continuous positive pressure (CPAP) for OSA or oral dental appliances, the following surgery options are available.

1. Uvulopalatopharyngoplasty (UPPP)
2. Tracheostomy
3. Other Surgical Options

I will not summarize these, but urge you to read about them here. It does discuss the complications involved especially UPPP.

More sites that will give you a better understanding of the successes and failures of surgeries for sleep apnea.

Site 1 This site does have information about surgeries for adults and children.
Site 2 Excellent coverage about treatments and drugs.
Site 3 Conversations with two individuals who regret having the surgery.
Site 4 From Sleep Apnea Organization.
Site 5 The U of Maryland an excellent discussion about the success rates and types of complications to expect.

I urge you to do your homework and research diligently before accepting surgical solutions.