Do you think I have sleep apnea?

I am nervous to see the doctor. Now I do have some weight I'm trying to lose. Should I try to lose the weight first (even though it's been a struggle) or should I see the doctor about sleep instead? Because based on what I've been reading sleep apnea is usually caused by being overweight.

So here is what I experience. First, I don't get to sleep easily at all ever, even when I'm tired. I have to be exhausted before I sleep. I can't just hop in bed and fall asleep at will. Doesn't work like that for me. Not possible. So for me sleep happens when my brain can't take being awake any longer and it doesn't happen until about 4-5 am usually or later.

I usually do get close to 7 or 8 hours, but the quality of the sleep is very bad. When I wake up, I can literally feel that my brain and my body is suffering from this sensation of being choked of oxygen and blood flow. I'll try to reiterate what I mean. I wake up and it feels like my brain has been shot out of a cannon and is dying for some air. I feel choked of air. And keep in mind this is not just sometimes, it's every single day. And it's been this way for years. My body will feel like it's lacking blood circulation after I wake up because the brain doesn't have oxygen. This carries on throughout the day and as a result I feel very fatigued and it's quite frustrating and annoying. I feel hopeless at times. And I have been tested for blood sugar, allergies, thyroid, blood pressure, cholesterol, and iron/vitamin levels. All of the tests were fine.

Also to add to that, I'll usually feel better around 5 pm. Blood starts to come back in the brain. However, I'm still pretty fatigued overall but I do manager to exercise everyday because I force myself.

So there you have it. I have not gotten a restful nights sleep in years. It doesn't matter what I do or if I sleep 9 hours. But is this sleep apnea? Because here's the thing. I don't sleep very easily at all, so therefore I don't nap in the day because napping is virtually impossible. People with sleep apnea just start falling asleep in the middle of the day. That's virtually impossible for me because I'm pretty much the anti fall asleep early guy.

Now my neck is more than 17 inches. They say that if you have a bigger neck, you can have sleep apnea. I definitely feel like my airways are restricted and that it's harder to breathe. So is there any point to seeing the doctor if he can't help you other than to tell you to loose some weight and you're already doing that? I saw a video today at the gym that read if you have sleep problems to see a doctor immediately. What can the doctor do for me if weight is the reason you have sleep apnea? Is surgery a recommendation if you have narrow airways? How bout tonsil removal?

Now here is the kicker..... Because of these symptoms it's hard to lose a lot of weight. Can the doctor help me at least get oxygen in my brain so I can feel better when I'm exercising? I'm just tired of feeling horrible. I want some relief. Of course I will continue my hardcore fitness and nutrition, but I need some help along the way. Should I see the doctor?

I know exactly what you are talking about. I suffered the same type of fatigue for a number of years so much so that I would doze off in the day during meetings, driving etc. Finally I visited the doctor, got my sleep study done ( at home), and now using CPAP since 4 months. This is one medical equipment I know which changes a person's quality of life overnight. In your case I strongly recommend you to see your doctor. You will not regret anything.

Raheel wrote:I know exactly what you are talking about. I suffered the same type of fatigue for a number of years so much so that I would doze off in the day during meetings, driving etc. Finally I visited the doctor, got my sleep study done ( at home), and now using CPAP since 4 months. This is one medical equipment I know which changes a person's quality of life overnight. In your case I strongly recommend you to see your doctor. You will not regret anything.

Thanks, but as I mentioned in my post, I don't doze off in the day. I may feel choked of oxygen, but since I have such a hard time falling asleep until late, I don't nap or doze off. Because I am not able to do that. I can't take a nap. So could I still have apnea if I have an inability to take a nap? I wouldn't say I feel sleepy during the day or ever tbh because if I was very sleepy I'd be falling asleep. But I feel tired, fatigued, and also I feel unrefreshed. So do I have sleep apnea or sleep insomnia? Could I have insomnia if I'm sleeping close to 8 hours? I'm so confused. What if I don't have all of these things? What will the doctor do for me? I need help, I feel fatigued and choked of oxygen when I wake up. And this affects my muscles too, like I won't be able to lift weights properly and breathe into my repetitions because I'm choked of proper easy breathing. I can do lots of cardio though, but the overheard weights are hard for me.

DO you smoke or have a history of smoking? What is your age if you don't mind me asking?

There are two ways I am aware of where you will Come to know whether you have sleep apnea. Usually the partner will be the first one to notice. The other way is to have a sleep study.

Weight may be a result of apnea, not the other way around - that's an old story and many people with apnea are skinny, but due to anatomic reasons (jaw structure) have apnea. What you definitely do need is a referral for a sleep study (an overnight at a lab where they test you while asleep) to find out if you have apnea, something else, and/or whether the standard treatment for apnea would be appropriate for you. And your MD should have already set this up for you! If it's the doctor who said it's all about weight, find another doctor who's in the 21st century about apnea... you need to take care of this now.

Julie wrote:Weight may be a result of apnea, not the other way around - that's an old story and many people with apnea are skinny, but due to anatomic reasons (jaw structure) have apnea.

I can vouch for this! I'm not sure if it's my jaw structure or something else, but I started out very thin and when all this sleep stuff started happening, I started gaining weight. I'm now at about 30 pounds I've gained over the past year and a half or so.

Yopu may have Sleep Apnea, but the only way to be sure is with n overnight sleep study. Weight or large neck is not necessarily a sign of SA. There are 100 pound women and children that have SA.

Enchanter,

The short answer to your question is: Yes, I think you have a very high probablity of having obstructive sleep apena (OSA). And that you need to be tested for it. And if you do have it, you need to treat it with PAP therapy.

The long answer:

Enchanter wrote:So is there any point to seeing the doctor if he can't help you other than to tell you to loose some weight and you're already doing that? I saw a video today at the gym that read if you have sleep problems to see a doctor immediately. What can the doctor do for me if weight is the reason you have sleep apnea? Is surgery a recommendation if you have narrow airways? How bout tonsil removal?

The point of seeing the doctor is to request getting a sleep test done. As we'll see in a few minutes, you have a much higher than average risk of having obstructive sleep apnea (OSA). And if you have OSA, it needs to be treated. The only way to diagnose OSA is by getting a sleep test done.

If you do turn out to have OSA, then you need to treat it. The preferred way to treat OSA is by PAP therapy. Yes, PAP therapy has a bad reputation: "You expect me to sleep with that on my face for the rest of my life?" is, alas, a common reaction to being told you have OSA and that you should treat it with PAP.

But PAP really is the most effective therapy out there for OSA and it involves nothing more than cleverly pushing a small bit of plain old ordinary room air down your airway when you're asleep.

The other ways of treating OSA either work in a limited number of cases (custom made and expensive oral appliances designed to hold the jaw further forward during sleep), have high risk of out right failure (surgical proceedures touted by many ENTs), or are out-right snake oil (treatments pushed by anti-CPAP websites, of which there are plenty.)

There is no surgery that will widen a naturally narrow upper airway: The surgical options involve redesigning things in an effort to make it harder for the tongue and upper palate to fall back into the airway when you are asleep. Tonsil removal will work to treat small children with OSA, but it does not do anything to treat OSA in adults. If there is some other medical reason for removing the tonsils, great. But expecting a tonsiletctomy to solve an adult's OSA problem is wishful thinking.

Now here is the kicker..... Because of these symptoms it's hard to lose a lot of weight. Can the doctor help me at least get oxygen in my brain so I can feel better when I'm exercising? I'm just tired of feeling horrible. I want some relief. Of course I will continue my hardcore fitness and nutrition, but I need some help along the way. Should I see the doctor?

If you have OSA, then getting it diagnosed and starting PAP therapy will take care of any O2 desaturations you are experiencing at night. For many people, starting CPAP therapy does improve the daytime energy levels quite a bit. But it's important to understand that for most people it takes a few weeks to a few months of PAPing before the daytime symptoms improve significantly. A few people start to feel better right away. A few people (like me) take much longer than average to start feeling better. But most new PAPers do see real improvement in terms of daytime energy levels within the first couple of months of PAPing---provided they use the machine every night, all night long.

Now to analyze what you've written in terms of your RISK of having OSA:

I usually do get close to 7 or 8 hours, but the quality of the sleep is very bad. When I wake up, I can literally feel that my brain and my body is suffering from this sensation of being choked of oxygen and blood flow. I'll try to reiterate what I mean. I wake up and it feels like my brain has been shot out of a cannon and is dying for some air. I feel choked of air. And keep in mind this is not just sometimes, it's every single day. And it's been this way for years. My body will feel like it's lacking blood circulation after I wake up because the brain doesn't have oxygen.

These are indeed common symptoms of untreated OSA and the fact that you are experiencing means you are at much higher risk of actually having OSA.

And keep in mind this is not just sometimes, it's every single day. And it's been this way for years. My body will feel like it's lacking blood circulation after I wake up because the brain doesn't have oxygen. This carries on throughout the day and as a result I feel very fatigued and it's quite frustrating and annoying. I feel hopeless at times. And I have been tested for blood sugar, allergies, thyroid, blood pressure, cholesterol, and iron/vitamin levels. All of the tests were fine.

Unexplained daytime fatigue is a major symptom of untreated OSA. Since the fatigue is not explained by a lot of the usual suspects, that points to a high risk of OSA being the culprit. Untreated OSA also increases the risk for mood problems and depression. In other words, the "feeling hopeless at times" is also a symptom that points to a higher risk of having OSA.

Now my neck is more than 17 inches. They say that if you have a bigger neck, you can have sleep apnea. I definitely feel like my airways are restricted and that it's harder to breathe.

Having a large neck increases the risk of having OSA quite dramatically. If the airway is feeling restricted when you are awake, that also increases the risk of OSA quite dramatically.

Now I do have some weight I'm trying to lose. Should I try to lose the weight first (even though it's been a struggle) or should I see the doctor about sleep instead? Because based on what I've been reading sleep apnea is usually caused by being overweight.

Being overweight increases the risk of having unteated OSA. The correlation between being overweight and having OSA is pretty strong. But the causation direction data is much more muddled.

First, a lot of OSA patients are of normal weight when they first develop the OSA. There is some real evidence that people of normal weight with untreated OSA are at very high risk of gaining weight. And once they become overweight, the OSA typically gets worse. Which leads to more weight gain. Which leads to worsening OSA. Which .... It's a viscious cycle.

There is also some evidence that some people who do NOT have OSA when they at a normal weight develop OSA when they pack on a lot of extra pounds: The excess tissue in and around the neck makes it harder for the muscles around the airway to keep it open once they start relaxing during sleep. And once the excess weight leads to the start of the OSA, the OSA tends to lead to more weight gain. Which makes the OSA worse. Which leads to more weight gain. Which makes the OSA worse. Which ... It's a viscious cycle.

So there you have it. I have not gotten a restful nights sleep in years. It doesn't matter what I do or if I sleep 9 hours. But is this sleep apnea? Because here's the thing. I don't sleep very easily at all, so therefore I don't nap in the day because napping is virtually impossible. People with sleep apnea just start falling asleep in the middle of the day. That's virtually impossible for me because I'm pretty much the anti fall asleep early guy.

While people with untreated sleep apnea often have problems with daytime sleepiness, there are plenty of people with untreated OSA who do NOT have excessive daytime sleepiness as a symptom. I was one of those people.

But bad sleep is, itself, a high risk of havng OSA. For many OSA sufferers, the main symptoms are just bad sleep---in the sense of waking up not feeling rested or refreshed after a full night's sleep AND some combination of daytime fatigue (tiredness), lack of daytime energy, problems with brain fog (focusing), and daytime sleepiness. Both Dr. Krakow and Dr. Park have written books for the mass market that explain the connection between untreated OSA and bad sleep.

Dr. Krakow's Sound Sleep, Sound Mind is mainly about insomina, but the second half of the book is a solid introduction to how untreated OSA can lead to insomnia.

Dr. Park's Sleep Interrupted is a layman's introduction to exactly how OSA causes bad sleep.

In both books, there's also a detailed explaination on how PAP works to prevent the apneas from happening in the first place.

So here is what I experience. First, I don't get to sleep easily at all ever, even when I'm tired. I have to be exhausted before I sleep. I can't just hop in bed and fall asleep at will. Doesn't work like that for me. Not possible. So for me sleep happens when my brain can't take being awake any longer and it doesn't happen until about 4-5 am usually or later.
...
Also to add to that, I'll usually feel better around 5 pm. Blood starts to come back in the brain.

You may have more than one sleep disorder. It's possible that you may have a combination of both untreated OSA and something called delayed sleep phase. It's also possible (but not likely) that you only have garden-variety chronic primary insomnia with no identifiable cause. But only a sleep study can sort it all out.

The bottom line
You have a LOT of symptoms and risk factors for OSA. Given the long history of bad sleep, you need to see your doctor for a referral for a sleep test. Get the sleep test done. If it shows you have OSA, then deal with it and start CPAP. If the sleep test shows that OSA is NOT your problem, then you'll have additional information on what is not causing your problems, and that will help you and your doc to start looking in the right places.

yes, you do. get a sleep study and start treatment ASAP .

Two things you can do to get started. First, google "sleep apnea test" and try out some of the online tests and symptom lists to see how many aspects you recognize.

Second, record yourself sleeping. This can be done with a smartphone app, a tape recorder, a pocket recorder, smartpen or other device. The key factor that you may be able to hear is if you stop breathing - that is sleep apnea. Here is an audio recording on youtube that you can listen to and see what I am talking about: https://www.youtube.com/watch?v=9bFTcmREtqQ

Sleep apnea is very dangerous and not something to be ignored. The sooner you get diagnosed, the better.

Thanks guys. I think I should see my doctor and get a Sleep apnea test done. I mean why should I put this off? And what do I tell the doctor? If I already know he's just gonna look at my numbers and tell me to lose 30 pounds, do I bring up the fact I'm already working out really hard and eating healthy? Do I tell him that BEFORE he suggests that? I don't know where to start, it's a monumental thing to go to the doctor about this, it's a phobia. But then again it's my life. It's serious. But I am also apprehensive about the fact I'm so used to blood tests saying I'm fine. I will flip out if the sleep apnea test says I sleep really well when in fact that couldn't be further from the truth. What if I sleep well that one day and the test says I'm doing good when that was like the best sleeping night in years? For instance I woke up today and actually feel better than 9 out of 10 times. Still not great, but less bad.

But here is the thing. I am nervous to talk to my doctor about this. I'm partially embarrassed and don't want to seem like a failure when I tell him I try so hard and it's not my fault. In the past, doctors used to tell me it was all about just living a healthy lifestyle but I never knew it might be apnea. I'm in my late twenties. The first side effect I ever experienced when I was 19. I noticed that I couldn't lift weights because after about 6 reps it was like my brain was choking of oxygen. Probably due to neck size being over 17 inches, I dunno. But when I went to my doctor about this, all he did was set me up with a trainer and he said that he doesn't see any reason to worry. Lol, and the trainer didn't even know what I was experiencing and even thought I was alright, but I wasn't. And I'm still not. I am in much better shape than I've been in now. But it takes me forever just to improve a little bit. I think that if I woke up more refreshed, things would be much easier.

Maybe like the above poster said, I have more than one sleep disorder. Maybe I also have minor insomnia, but I also think that if my Apnea (if I have it) was treated, then my insomnia would improve over time. Because feeling more rested during the day allows you to do the things that make you fall aleep at a normal time.

Julie wrote:Weight may be a result of apnea, not the other way around - that's an old story and many people with apnea are skinny, but due to anatomic reasons (jaw structure) have apnea. What you definitely do need is a referral for a sleep study (an overnight at a lab where they test you while asleep) to find out if you have apnea, something else, and/or whether the standard treatment for apnea would be appropriate for you. And your MD should have already set this up for you! If it's the doctor who said it's all about weight, find another doctor who's in the 21st century about apnea... you need to take care of this now.

Yea I have always always felt something is literally holding me back. It's surely a vicious cycle.

Now Keep in mind that all my other tests results were really impressive. All the fitness I do and fish oils I take drove my cholesterol from 236 to 160 without drugs. I don't need blood pressure pills anymore. He took tests for thyroid, calcium levels, and blood sugar. He said I passed the test in flying colors and told me to come back and see him in 5 years.

If you are nervous saying it out loud, print off your first post and ask your doctor to read it - you did a GREAT job of listing your symptoms and writing about how you feel. That is exactly the kind of data the doctor needs. Putting this off won't help. It sounds like you have some sort of sleep problem and it very well may be sleep apnea. Sleep apnea can be treated - you can feel better and live longer if you treat it.

houstonrockets83 wrote:DO you smoke or have a history of smoking? What is your age if you don't mind me asking?

I don't smoke or do any recreational drugs. I don't take any medications now either and haven't for a long time. I only take things like fish oil and also melatonin to fall asleep a little faster. I'm in my late 20's but have been experiencing these side effects since I was 19.

Now I used to be on anti depressants. That did put weight on me, but keep in mind I haven't been on psych drugs for more than 7 years. I never can go back on the drugs because I get dependent on them.