I put one sentence of the quote in bold red because that was an extremely smart doctor who made the possible connection about OSA and GERD:btesterman wrote:I'll have to agree that it seems strange that he never observes me not breathing normally. He has trouble sleeping so he is awake a lot. He says I snore mildly, I'm not obese although I'm somewhat overweight. I was sent for the sleep study because I have GERD. When my doctor suggested it I readily agreed to do it because I have gone through all the drowsy periods almost daily. I am not doubting test results but wonder how I can stop breathing 14.3 times an hour and my husband insist I'm breathing normally.
http://www.sciencedaily.com/releases/20 ... 080008.htm
"These are patients without significant heartburn symptoms, who are experiencing acid reflux during sleep," explained William C. Orr, Ph.D. of Lynn Health Science Institute in Oklahoma City, OK. "'Silent reflux' may be the cause of sleep disturbances in patients with unexplained sleep disorders."
"All patients with sleep apnea should be evaluated for gastroesophageal reflux," said J. Barry O'Connor, M.D., of Duke University Medical Center, one of the investigators.
Chicken or the egg -- can be either way -- if one is found (GERD or Sleep Apnea) the other is more likely to be there, too.
About your husband's statements:
He may be awake "a lot", but I doubt if he stays awake absolutely all night long -- I'm talking about EVERY minute... all night -- observing you.
Snoring mildly is a sign of restricted airway. That restriction (regardless of how "mild" the sound might sound to him) means you're not getting as much air through as you could. Depending on the size of the airway, even a slight restriction could mean a person is having hypopneas. An observing bed partner could be watching hypopneas happen right in front of his eyes and think that was normal breathing since some breathing is still going on. I think of hypopneas as "baby apneas" -- partial closure of the airway, not full closure as with an apnea. Airflow with a hypopnea is not as much as it should be, but some breathing is still happening. CPAP would keep the airway open for good breathing all night.
A person can also have what's called Upper Airway Resistance Syndrome (UARS.) With that, the brain is so hypervigilant to the slightest beginnings of airway closure that the brain "arouses" the person to breathe better BEFORE a hypopnea with drop in O2 can happen, and before a full apnea can happen. Those constant arousals to "breathe better" can play havoc with the sleep stages. Yet your breathing during those arousals could look quite normal to your husband and you would still appear to him to be "asleep."
"Arousals" to breathe better, by the way, are usually so brief that we are not aware of them at all. Without benefit of seeing EEG data (via the patches taped on your head during the sleep study) a person (your husband) observing you sleep wouldn't be able to see the many brain arousals (to open the airway a little better) happening. Arousals that wreck your sleep architecture. Jolting you up out of whatever stage of sleep you were in at the moment. All without you or the bed partner noticing those sleep disruptions at all. UARS is also treated with CPAP to keep the airway well and truly open during sleep.
Regarding this:
The AHI of 14.3 is an index -- an AVERAGE calculated for the entire night. It doesn't mean you stopped breathing literally 14.3 times each and every hour. You could be having no apneas or hypopneas during some hours of the night, and then be slammed with a ton of them for scattered spots through the night, when REM was trying to happen.btesterman wrote:wonder how I can stop breathing 14.3 times an hour and my husband insist I'm breathing normally.
Most people are hit hardest with apneas and hypopneas during REM sleep. REM -- rapid eye movement -- the type of sleep when we are thought to dream the most. People normally have 4 or 5 cycles into REM during the night, with each REM cycle getting longer than the last one. First REM cycle usually happens about an hour and a half after a person goes to sleep and might last just 4 or 5 minutes -- what if your husband happens to have drifted off to sleep briefly then? You could have tons of apneas and hypopneas each time you're starting into REM. Apneas/hypopneas or UARS arousals preventing you from settling into sufficient REM can certainly lead to daytime sleepiness.
In other words, sleep disordered breathing isn't always a matter of noticeably "stopping breathing" or "gasping" or even of repeated wake-ups that are long enough for a person to be aware of being awake.
Think of it like blood pressure problems or diabetic problems. Sure, there are sometimes obvious signs that a person might feel when their blood pressure is too high or low. And sometimes there are obvious signs that a person might feel if their blood sugar level is not within certain bounds. But damage can be happening with either of those things, unbeknownst to the person who is not "feeling" funny. And happening unbeknownst to the people living closely with them.
You don't have to finally HAVE a stroke or heart attack, for high blood pressure to be diagnosed and need treatment.
You don't have to actually FALL INTO a diabetic coma, for diabetes to be diagnosed and need treatment.
You don't have to noticeably STOP BREATHING during sleep, for sleep disordered breathing to be diagnosed and need treatment.
Oh, and interestingly -- untreated sleep apnea can contribute to those things -- stroke, heart attack, diabetes. And GERD.
I'd forget about the word "mild" and get CPAP treatment going.
AHI-wise, I have it a lot milder than you, btesterman, but CPAP has made a decidedly good difference for me.
Yeah...riiiight. I'm glad you added "like he knows so much about it." Hang onto your sense of humor and this message board. You're going to do fine despite his discouraging you from using a simple life-saving machine.btesterman wrote:Right now my husband just said that if I'd just do breathing exercises (plus aerobic exercising) that I wouldn't have to use the CPAP - like he knows so much about it.
Amen to what Katie said!!KatieW wrote:Perhaps he is in denial about your health, or is reacting out of fear, or doesn't like change. In any case, take care of your health, as your 1st priority. This forum is a wonderful place to come for information and support. Stay connected here.
That's the spirit! It's your health and your decisions to make about it. You're a smart lady. You found your way here and you'll find your way into good breathing while sleeping, too. Via CPAP.btesterman wrote:I have my health to consider so I'll forge on regardless.
