Could Apnea Be Causing my Daytime Symptoms?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
RyanMW
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Could Apnea Be Causing my Daytime Symptoms?

Post by RyanMW » Tue Nov 18, 2014 9:27 pm

To inform those who are unfamiliar with my previous post history, I've had two sleep studies now and returned an AHI of 5.7. I am not on CPAP yet but am hoping to be soon.

I wake up feeling extremely sore. I am depressed and lethargic during the day, and most importantly for this question, I have a very difficult time breathing out of my nose and next to no stamina during simple cardiovascular activity.

I am 30 years old, male, 5' 8'' and 190lbs. I work out 5 days a week, a mix of cardiovascular and lifting routines. I have been doing this since August. I am on a calorie restricted diet (1700kcal/day) and eat mostly vegetarian.

Despite all of the above, I can not lose weight. Most importantly, I have an EXTREMELY difficult time breathing out of my nose. Despite running or biking or boxing 3-4 days a week, my cardiovascular stamina has not improved at all. I still get winded going up the stairs! I find it difficult to breathe out of my nose when I am stagnant, and when I am putting in cardiovascular work, it is next to impossible.

I told this to my ENT and he looked at my nose and noted that despite a very minor deviation of my left septum, I have no structural issues that could be causing this.

What is going on here? Could my apnea be causing this, or is it vice versa? What is likely the issue with my nose? Could it be something like chronic sinusitis? My ENT was not of much help. He just said "well, there's nothing structurally wrong, so..." I don't have much of a choice of ENT because I am on medicaid currently.

Thanks for any help and I apologize for the length!

Mike

VictorC
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by VictorC » Tue Nov 18, 2014 9:50 pm

I wouldn't even offer a guess as to your nasal issues. Depression and lethargy definitely do sound like they could be symptoms of OSA or some other sleep disorder, but I am not sure about the others.

With regard to your aerobic fitness and weight loss, I really wonder if you're eating enough. I'm 5'7", 206lbs, and I can eat about 1700 calories per day while still trying to maintain a 500 calorie deficit per day. And that is for days when I don't work out. If you are working out vigorously while maintaining a strict diet like that you may be unintentionally starving yourself. When you do that your body can short circuit your weight loss because it will think that it needs to hoard its energy reserves in order to survive. If you are on a strict diet you may already be using a site like MyFitnessPal. If not it is a good tool to use. You might also consider scheduling an appointment with a dietician to make sure you are getting all the nutrients you need to sustain your workouts.

I hope that helps.

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RyanMW
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by RyanMW » Tue Nov 18, 2014 9:52 pm

VictorC wrote:I wouldn't even offer a guess as to your nasal issues. Depression and lethargy definitely do sound like they could be symptoms of OSA or some other sleep disorder, but I am not sure about the others.

With regard to your aerobic fitness and weight loss, I really wonder if you're eating enough. I'm 5'7", 206lbs, and I can eat about 1700 calories per day while still trying to maintain a 500 calorie deficit per day. And that is for days when I don't work out. If you are working out vigorously while maintaining a strict diet like that you may be unintentionally starving yourself. When you do that your body can short circuit your weight loss because it will think that it needs to hoard its energy reserves in order to survive. If you are on a strict diet you may already be using a site like MyFitnessPal. If not it is a good tool to use. You might also consider scheduling an appointment with a dietician to make sure you are getting all the nutrients you need to sustain your workouts.

I hope that helps.
I do use myfitnesspal, it's great. I had thought that "starvation" mode was a myth, according to what I'd read most recently. When I do cardio, i feel like I have the adequate energy, but it's just that my breathing becomes very labored, especially when running. Breathing through my nose is totally inadequate and breathing through my mouth fatigues me quickly and hurts my lungs.

tan
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by tan » Tue Nov 18, 2014 10:36 pm

RyanMW wrote:To inform those who are unfamiliar with my previous post history, I've had two sleep studies now and returned an AHI of 5.7. I am not on CPAP yet but am hoping to be soon.

I wake up feeling extremely sore. I am depressed and lethargic during the day, and most importantly for this question, I have a very difficult time breathing out of my nose and next to no stamina during simple cardiovascular activity.

I am 30 years old, male, 5' 8'' and 190lbs. I work out 5 days a week, a mix of cardiovascular and lifting routines. I have been doing this since August. I am on a calorie restricted diet (1700kcal/day) and eat mostly vegetarian.

Despite all of the above, I can not lose weight. Most importantly, I have an EXTREMELY difficult time breathing out of my nose. Despite running or biking or boxing 3-4 days a week, my cardiovascular stamina has not improved at all. I still get winded going up the stairs! I find it difficult to breathe out of my nose when I am stagnant, and when I am putting in cardiovascular work, it is next to impossible.

I told this to my ENT and he looked at my nose and noted that despite a very minor deviation of my left septum, I have no structural issues that could be causing this.

What is going on here? Could my apnea be causing this, or is it vice versa? What is likely the issue with my nose? Could it be something like chronic sinusitis? My ENT was not of much help. He just said "well, there's nothing structurally wrong, so..." I don't have much of a choice of ENT because I am on medicaid currently.

Thanks for any help and I apologize for the length!

Mike
1. working out 5 times a week and vegan, calorie-restricted diet? The mix does not sound too good for me. I imagine I would have similar symptoms;
2. ok, your AHI is slightly above 5 and with your symptoms, CPAP officially fits your profile. Low AHI means not particularly much. What was your RDI?

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SGearhart
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by SGearhart » Tue Nov 18, 2014 10:46 pm

To add to Tan's above pot, what are/were your O2 levels?

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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by Captain_Midnight » Tue Nov 18, 2014 10:48 pm

Ryan, your symptoms are consistent w many here (of course, nobody in an online forum can know for certain). Hopefully, a well-prescribed xpap therapy will help you.

As far as weight loss and that vegetarian diet? I'm normally reluctant to give diet advice (it's akin to religion or political advice) but at least consider trying a diet w lower carbs and higher protein. Lots to choose from, I do the Zone with consistent success.

.

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Julie
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by Julie » Tue Nov 18, 2014 10:58 pm

Ryan, despite all the helpful advice here, the fact is you seem to be having issues that potentially could be serious, Osa/Cpap or no Osa/Cpap. When's the last time you actually saw a cardiologist? Not an ENT guy, not a sleep guy, not your GP, but a cardiologist? Make an appt. and get it overwith - at least you'll have ruled out the most worrisome symptoms.
Last edited by Julie on Wed Nov 19, 2014 5:21 am, edited 1 time in total.

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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by zoocrewphoto » Wed Nov 19, 2014 4:18 am

You might have a doctor check you for asthma. There are different triggers, and exercise is one of them. I had a pleasant surprise awhile back when my new doctor put me on a daily inhaler. I found I could breathe through my nose better during the day. I can actually close my mouth for awhile, while moving, instead of having it to keep it slightly open to get enough air. I have no idea while inhaling a medication into my lungs has helped my nasal breathing, but it has improved. It also got worse again when i misplaced my inhaler for several days.

The doctor can check your lung capacity and see if it is normal. And if not, try medication to see if it improves.

My nasal passages are clear, but narrow. All of my airways are narrow. So, add in the asthma with allergy, humidity, and exercise triggers, and I have problems with air flow.

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Who would have thought it would be this challenging to sleep and breathe at the same time?

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archangle
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by archangle » Wed Nov 19, 2014 10:45 am

Welcome. Read the links in my signature line for hints on how to not get screwed by the DME (CPAP salesman), and how to get a good, data capable CPAP.

Be careful that you don't fall into the trap of apnea tunnel vision. Just because you have apnea and it's causing some of your problems doesn't mean you don't have other health problems as well. Even doctors fall into this trap.

Treat your apnea and observe the results, but always consider your symptoms and watch out for symptoms caused by something other than apnea. Even if something you have is one of the symptoms of apnea, it may also be caused by other problems. Eliminating apnea is probably a good step in figuring out what your problems are. You probably need it, even if it isn't the cure for the problems you mention.

This makes it even more important to get a good, fully data capable CPAP machine so you can tell how well your therapy is working.

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musculus
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by musculus » Wed Nov 19, 2014 3:07 pm

RyanMW wrote:To inform those who are unfamiliar with my previous post history, I've had two sleep studies now and returned an AHI of 5.7. I am not on CPAP yet but am hoping to be soon.

I wake up feeling extremely sore. I am depressed and lethargic during the day, and most importantly for this question, I have a very difficult time breathing out of my nose and next to no stamina during simple cardiovascular activity.

I am 30 years old, male, 5' 8'' and 190lbs. I work out 5 days a week, a mix of cardiovascular and lifting routines. I have been doing this since August. I am on a calorie restricted diet (1700kcal/day) and eat mostly vegetarian.

Despite all of the above, I can not lose weight. Most importantly, I have an EXTREMELY difficult time breathing out of my nose. Despite running or biking or boxing 3-4 days a week, my cardiovascular stamina has not improved at all. I still get winded going up the stairs! I find it difficult to breathe out of my nose when I am stagnant, and when I am putting in cardiovascular work, it is next to impossible.

I told this to my ENT and he looked at my nose and noted that despite a very minor deviation of my left septum, I have no structural issues that could be causing this.

What is going on here? Could my apnea be causing this, or is it vice versa? What is likely the issue with my nose? Could it be something like chronic sinusitis? My ENT was not of much help. He just said "well, there's nothing structurally wrong, so..." I don't have much of a choice of ENT because I am on medicaid currently.

Thanks for any help and I apologize for the length!

Mike
Nasal congestion is obviously a problem for you. Why not address first that and see if the sleep quality and energy improve?

Nasal congestion can cause Respiratory Effort-Related Arousalespiratory (good to check your RDI as Tan suggested) and poor sleep, on the other hand, poor sleep quality make the nasal congestion worse.

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RyanMW
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by RyanMW » Wed Nov 19, 2014 5:19 pm

musculus wrote:
RyanMW wrote:To inform those who are unfamiliar with my previous post history, I've had two sleep studies now and returned an AHI of 5.7. I am not on CPAP yet but am hoping to be soon.

I wake up feeling extremely sore. I am depressed and lethargic during the day, and most importantly for this question, I have a very difficult time breathing out of my nose and next to no stamina during simple cardiovascular activity.

I am 30 years old, male, 5' 8'' and 190lbs. I work out 5 days a week, a mix of cardiovascular and lifting routines. I have been doing this since August. I am on a calorie restricted diet (1700kcal/day) and eat mostly vegetarian.

Despite all of the above, I can not lose weight. Most importantly, I have an EXTREMELY difficult time breathing out of my nose. Despite running or biking or boxing 3-4 days a week, my cardiovascular stamina has not improved at all. I still get winded going up the stairs! I find it difficult to breathe out of my nose when I am stagnant, and when I am putting in cardiovascular work, it is next to impossible.

I told this to my ENT and he looked at my nose and noted that despite a very minor deviation of my left septum, I have no structural issues that could be causing this.

What is going on here? Could my apnea be causing this, or is it vice versa? What is likely the issue with my nose? Could it be something like chronic sinusitis? My ENT was not of much help. He just said "well, there's nothing structurally wrong, so..." I don't have much of a choice of ENT because I am on medicaid currently.

Thanks for any help and I apologize for the length!

Mike
Nasal congestion is obviously a problem for you. Why not address first that and see if the sleep quality and energy improve?

Nasal congestion can cause Respiratory Effort-Related Arousalespiratory (good to check your RDI as Tan suggested) and poor sleep, on the other hand, poor sleep quality make the nasal congestion worse.
I believe my RDI was 28. I've gone to my GP and an ENT about my nasal congestion but aside from giving me a steroid nose spray that did absolutely nothing, they haven't been very helpful. I'm going to make an appointment to see my GP and ask about asthma and possibly get an inhaler as suggested above. Thanks.

tan
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by tan » Wed Nov 19, 2014 5:46 pm

RyanMW wrote:
I believe my RDI was 28.
That is it, your sleep's primary enemy.

RyanMW
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by RyanMW » Wed Nov 19, 2014 9:15 pm

tan wrote:
RyanMW wrote:
I believe my RDI was 28.
That is it, your sleep's primary enemy.
Okay cool, primary enemy identified . What would the course of action be now?
1. Check for possible asthma at GP and maybe get an inhaler
2. Get CPAP?

tan
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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by tan » Wed Nov 19, 2014 11:31 pm

RyanMW wrote:
tan wrote:
RyanMW wrote:
I believe my RDI was 28.
That is it, your sleep's primary enemy.
Okay cool, primary enemy identified . What would the course of action be now?
1. Check for possible asthma at GP and maybe get an inhaler
2. Get CPAP?
Yes, both. Were i you, i would ease on physical exercise until you check both the options.

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Re: Could Apnea Be Causing my Daytime Symptoms?

Post by rsp5820 » Thu Nov 20, 2014 7:16 am

Ryan,

Try a neti pot - sometimes up to 5 times a day, but generally once in the morning, and after any heavy dust/allergen/pollution exposure. Make your own saline with warm distilled water. Never use chlorinated water. Very cheap, very easy to use, very effective.

The very effective and simple Waterpik models I have are no longer available:
http://www.amazon.com/gp/product/B003QY ... UTF8&psc=1
Apparently Waterpik had a big recall on a battery powered model (which is really a silly idea, not at all useful) so apparently they dropped their entire product line.

But the following looks similiar.
http://www.amazon.com/NeilMed-NasaFlo-U ... s=neti+pot

But even the cheapo models at drugstores work, just messier.

You can also use vitamin C powder (just a smidge) if you have any infection in the sinuses or throat.

Simple nasal saline spray is sometimes useful throughout the day
http://www.amazon.com/gp/product/B00005 ... UTF8&psc=1