Sleep study UPDATE and insomnia UPDATE!

[robysue]

The Signs and Symptoms of Silent Acid Reflux
http://acidrefluxdefeated.com/the-signs ... id-reflux/

silent acid reflux can also cause choking, coughing, and other throat related issues. Although commonly referred to as silent reflux, the actual term for this particular form of acid reflux is Laryngopahryngeal reflux (LPR).
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What are the symptoms of LPR? Symptoms almost always occur in the throat and are usually felt because, unlike the esophagus, there is no protective lining in the throat.

Common symptoms that may be experienced include:

o Chronic coughNope. Never had a chronic cough before or after CPAP

o Asthma-like symptomsNope. Never had any Ashma-like symptoms. (And I do know what asthma is like since I've got relatives with ashma

o RegurgitationNever been a problem for me

o Sour or bitter flavor in the mouthNope. Not until I started taking topiramate, and "bad taste in mouth" is a major, common side effect. And the taste in my mouth is metallic---like the topiramate side effect bad taste is supposed to be.

o Frequent need to clear the throatNever been an issue for me.

o Consistent mucous in the throatBad head colds and ragweed and tree pollen aside, mucous in the throat is not a particular problem.

o Burning sensation or pain in the throatBurning sensation? Only if I drink hot tea that's not cooled off sufficiently. In other words, this is not a problem and never has been. Pain in throat? Only very rarely and it's always been short term and associated with very severe upper respriatory infections. The kind the PCP does a strep test for. Last time I had a strep test done would have been maybe four or five years ago? Or longer.

o Sore throatAgain, extremely rare for me. And associated with very severe upper respiratory infections that are bad enough to send me to my PCP. Maybe once every couple of years or so.

o Hoarseness and possible loss of voiceAs I've gotten older I've noticed that at the beginning of every fall semester I do have to get the voice back into shape. And bad colds tend to affect the voice more than they used to when I was in my 30s and 40s. But hoarseness is not a daily problem for me. Right after starting CPAP, however, my voice did get extremely hoarse---when the pressure was set at a constant 9cm. And pre-CPAP, sleeping under a blowing fan in the summer time for several nights in a row has always been able to trigger some hoarseness. Blowing air and my windpipe don't seem to like each other very well

o Difficulty swallowingDepends on what this means exactly. Throughout my entire life I've had a well developed gag reflex. And so I've always taken small bites and have chewed my food very thoroughly. And when I do that I have no trouble at all swallowing. So I don't have any problems with choking on food that I eating the way some people do. But people find the size bites I take look ridiculously small. [An example: I will eat a grape by biting it in half.] I can usually swallow pills the size of a standard OTC ibuprophen tablet without much problem, but elongated pills can go down wrong. The standard calcium supplements, on the other hand seem like horse pills to me and I have to bite them in half in order to get them down. The texture of outside coating of a pill also seems matter too. For some reason I have more trouble swallowing gel capsules than solid pills of the same size.

o Post-nasal dripOk, this one I'll admit I have. With nasal allergies to pollen, dust, mold, mildew, however, it's not exactly unexplained. And yes, I do know I've got allergies because I've got the sneezing and red eyes to go along with the post-nasal drip.

o Pain in the ear and/or consistent ear infectionsAs a kid I had chronic ear infections when I was between five and seven. I've had more ear infections as an adult than normal. But I would not describe them as "consistent" since I can go several years between them. Can't actually remember the last time I had a real ear infection. Pain in the ear? Do you mean pressure pain---i.e. trouble popping the ears? Or something else? Sometimes I have trouble popping my ears and that can lead to temporary pain that goes away when the ears finally pop. And then occasionally there's painful tinnitus---but the tinnitus pain is really more of a "headache" than an "ear" pain.

o NauseaIf the vertigo gets really, really, really, really, really severe, I'll have just a touch of nausea. Otherwise, never, ever. Unless I've got a genuine case of the the flu. [And I'm unlucky enough to get the flu about once every four or five years---usually on a year when I either forget to get the shot or when, like last year, the shots and the flu season are out of sync: By the time the flu vaccine was available here in Buffalo in 2009-10, everybody in our family had had the flu and been over it for over a month.]

o HeartburnVery rarely do I get heartburn. If I eat too much, I'll get it. If I really eat something way too spicy I'll get it. If I eat something with way too many tomatoes in it I'll get it. But it's not a common occurence. I can go several weeks between attacks of heartburn

A silent acid reflux sufferer may experience some or all of these symptoms.

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[Big S]

Congrats on progress. You are a great example on how to attack a difficult problem.

[robysue]

One thing I never had was the air in the stomach, but from what I've read it can be pretty painful at times. Might I ask why you are on topiramate? I used to be on it for chronic headache and very mild seizures, but was able to wean off it once I had the apnea treated.

Migraine related vertigo. I've had mild migraines most of my adult life---easily managed for the most part by taking to bed for a couple of hours in a quiet dark room, OTC ibuprofen occasionally, and knowing my triggers. But about a year or so ago, I started having some alarming vertigo spells that go far beyond my usual daily background dizziness that I've had for years, and the vertigo had been steadily getting worse as the year wore on. In November, my PCP referred me to an ENT, who ordered a full round of tests, including both and MRI and CAT scan, and the ENT had an interesting idea based on the audiology testing, but the CAT scan of my semi-circular canals eliminated it. And at that point, the ENT decided the vertigo was most likely being caused by something neurological, so he sent me to a neurologist. Based on the negative test results and the positive migraine medical history, the neurologist's working diagnosis is migraine induced vertigo: his idea is that the migraines have become more or less chronic, but they are not causing pain---they are manifesting themselves as vertigo. So the topirimate is to help prevent the migraining in the longer term, and thus reduce the number of vertigo episodes. At the same time I'm also doing a round of vestibular rehabilitation since there was a very minor weakness found on one side in one of the tests the ENT ordered---but the weakness was not great enough to explain the severe episodes of vertigo I'd been experiencing this last year. Between the topirimate and the vestibular rehab, the frequency and severity of the vertigo spells decreased substantially in the last six to eight weeks. My next follow up with the neurologist is in early March. I'm pretty sure we'll be discussing where we go from here re the topirimate since he has told me that it might take several weeks or a few months to see much difference, but I also don't think he intended for me to be on topirimate for more than one year total. He also warned me about some of the side effects---in particular the need to keep myself well hydrated and the fact that some people lose weight and that I have no weight to lose. He wants me to watch the weight carefully (I am) and let him know if that becomes a problem. (It hasn't yet, but it will be a problem if I loose another 3 or 4 pounds since then I'll clearly be below 100. And I am most definitely NOT healthy when my weight drops below 100.) And the dose has already been reduced twice because of some adverse side affects.

[Cindy Lou Who]

That really is good to hear, robysue.

Hope "sleep" keeps getting smoother and smoother for you.

robysue, I second the motion! Congrats!
Cindy