Newbie (Hello!)

Hello all,

I'm new to the forum and had a quick question that I could hopefully get input from you all on.

I've been looking into sleep issues for awhile due to daytime fatigue, stress/anxiety, low mood, and waking up after 9-10 hours sleep every night feeling very unrefreshed and tired every morning. I finally saw a sleep doctor who referred me for a sleep study. However, money for the sleep study is a concern, and I was curious if my sleep behaviors sounded like apnea/a sleep disorder, or whether when I describe my sleep it will sound within normality, and maybe my problem is just a stress/psychological/mental one and not related to sleep.

I have recorded audio of my sleep for about 10 nights. Every night I wake up every 30-50 minutes for long enough to take a deep breath, shift around in bed, and back to sleep (about 10-15 seconds of disturbance). I never make it 60 minutes straight without waking up. Usually my breathing sounds more and more loud/labored as I approach waking up, then sometimes it sounds like I stop breathing briefly. Then I take a deep breath as I wake/shift in bed.

I thought it might be OSA, however I also tried sleeping sitting up, and another time with an over-the-counter mandibular advancement device (keeps jaw forward); during these nights my breathing was quiet, as if my throat was not closing off at all, but I still had awakenings on the same time schedules. So I thought it could be central sleep apnea.

I'm not looking for a diagnosis, I know only a sleep study can do that. I just wanted to see if this was in the realm of sleep disorders, or if this sounds normal and not apnea related, since it doesn't sound like I'm stopping breathing more than 1-2 times an hour. It sounds different than how I've heard sleep apnea described, but the awakenings seem like they would be messing up my sleep cycles or deep sleep.

Thanks so much for your help!

**by the way, I'm in my 20s, male, lean/in good shape

Using an MAD and/or sleeping in a recliner will both lessen apneas, so don't take that as a bad thing - maybe you did them instinctively!

But your recordings, etc. are not enough (or honestly good enough) to diagnose anything, and if you can get your MD to refer you to a sleep lab, it would be best. If you have no money or insurance, however, there are other ways to test things, certain machines with good instructions, etc... but you generally need a script to get a machine unless you get lucky on Craig's List or somewhere like Secondwind.com... but you'd need to know what to ask for (and what not) so we could help there... the wrong machine won't help.

Take 15 minutes and review this youtube video it will help you understand what maybe going on with with you.
https://www.youtube.com/watch?v=-gie2dhqP2c

This video put the whole thing in perspective for me. It should be required viewing for any one who is new.

I wish you well

Sounds like OSA to me and the sleep study will confirm or not. Get the study so you know. If you do have apnea there's a real good chance you have to go back for a second sleep study called a titration study. During that study, you'll put on a mask and the study will determine what your pressure setting should be. If you have apnea (and I certainly hope you don't - maybe you have a condition that can be treated) educate yourself and we'll help you along your journey. Again, I hope you don't have apnea. I wouldn't wish this on anybody.

Sheriff

Thanks for the replies so far!

Bill44133, that video is great, I've been researching the topic for the last few months and that video is so much clearer than any of the other explanations I've seen. Thanks for passing that along.

If I get a sleep study and only have 1-3 apneas an hour, or maybe just limited airflow throughout the night, would that be severe enough that I would be prescribed a CPAP or other breathing machine?

No - you'd have to score higher to get a machine, so you do want to think about other med. possibilities that even at your age could be going on... have you had comprehensive labwork lately? Anything else at all you can think of that might make a difference, whether or not it necessarily seems reasonable?

Oh, and sleeping on your back will definitely cause more apneas (with or without snoring), and while they may ask you to do it in a lab test, it's to get a baseline reading, not because it's otherwise good, so if you do it, try not doing it, maybe with something in behind you to help, and see if you feel any better.

[quote="stephen_s"]Thanks for the replies so far!

Bill44133, that video is great, I've been researching the topic for the last few months and that video is so much clearer than any of the other explanations I've seen. Thanks for passing that along.

If I get a sleep study and only have 1-3 apneas an hour, or maybe just limited airflow throughout the night, would that be severe enough that I would be prescribed a CPAP or other breathing machine?[/quote]

5 apneas or less is considered normal, my sleep study was mixed.. AHI (apnea hypopnea index) showed 54/hour on my back, much less on my side, with an overall score of 11, which is considered mild OSA. Since I've been on CPAP, my average AHI is less than 5. Most nights it is less than 3. Without the CPAP, which happened recently when I accidentally left my machine on an airport shuttle, I didn't sleep well, woke up a lot. Got the machine back in the morning, thank goodness!

One poster mentioned the possibility of going back for a second study, titration, if the diagnosis is OSA. Some sleep centers do a split-night study, which includes the diagnostic study and the titration. Mine was a split study, so you might want to ask about that. If you have insurance, you can ask them what coverage they provide for OSA.

Since you already have audio recordings, watch this youtube of the audio recording of someone with severe apnea: https://www.youtube.com/watch?v=9bFTcmREtqQ

stephen_s wrote:If I get a sleep study and only have 1-3 apneas an hour, or maybe just limited airflow throughout the night, would that be severe enough that I would be prescribed a CPAP or other breathing machine?

Hi Stephen -- It is not correct to assume that 1-3 apneas per hour means that you would not be prescribed a cpap machine, or that you don't have sleep-disordered breathing. And "just limited airflow" may be a bigger deal than you think, and might even mean that you do in fact need PAP machine therapy to help keep your airway open at night.

We were recently helping someone on this forum who had only a couple of apneas in her sleep study but had an RDI (Respiratory Disturbance Index) in the moderate (approaching severe) range -- she had a sleep study and has been prescribed a PAP machine. Her RDI was due to limited air flow resulting in many awakenings/arousals throughout the night. In many instances a high enough RDI qualifies a person for PAP therapy even when very few obstructive apnea events are recorded. Some insurance companies are still trying to deny coverage in cases where the AHI is low but the RDI is not, but that limited air flow can be very damaging to your overall health. You might be interested in looking up Upper Airway Resistance Syndrome (UARS) and Respiratory Effort Related Arousals (RERAs) -- no way to know if this is what's going on for you until you get a sleep study, but you can get a better idea about how limited air flow can cause multiple awakenings, fractured sleep and nasty daytime symptoms.

Your symptoms and observations are screaming "get a sleep study" and your doctor was absolutely correct to refer you for one. Don't worry about whether you would "only" have 1-3 obstructive events per hour because there is a spectrum of sleep-disordered breathing and only a well-done sleep study can detect some of the more subtle airway problems that can still wreak havoc on your health over time.

Totally agree with this post. At my last sleep study, I had an AHI of 5.9 but the number of RERAS I had pushed my RDI to 23 which definitely indicated a need for treatment.

Good luck with your pursuit to get optimal treatment for your situation.

49er

kaiasgram wrote:

stephen_s wrote:If I get a sleep study and only have 1-3 apneas an hour, or maybe just limited airflow throughout the night, would that be severe enough that I would be prescribed a CPAP or other breathing machine?

Hi Stephen -- It is not correct to assume that 1-3 apneas per hour means that you would not be prescribed a cpap machine, or that you don't have sleep-disordered breathing. And "just limited airflow" may be a bigger deal than you think, and might even mean that you do in fact need PAP machine therapy to help keep your airway open at night.

We were recently helping someone on this forum who had only a couple of apneas in her sleep study but had an RDI (Respiratory Disturbance Index) in the moderate (approaching severe) range -- she had a sleep study and has been prescribed a PAP machine. Her RDI was due to limited air flow resulting in many awakenings/arousals throughout the night. In many instances a high enough RDI qualifies a person for PAP therapy even when very few obstructive apnea events are recorded. Some insurance companies are still trying to deny coverage in cases where the AHI is low but the RDI is not, but that limited air flow can be very damaging to your overall health. You might be interested in looking up Upper Airway Resistance Syndrome (UARS) and Respiratory Effort Related Arousals (RERAs) -- no way to know if this is what's going on for you until you get a sleep study, but you can get a better idea about how limited air flow can cause multiple awakenings, fractured sleep and nasty daytime symptoms.

Your symptoms and observations are screaming "get a sleep study" and your doctor was absolutely correct to refer you for one. Don't worry about whether you would "only" have 1-3 obstructive events per hour because there is a spectrum of sleep-disordered breathing and only a well-done sleep study can detect some of the more subtle airway problems that can still wreak havoc on your health over time.

Thank you for all for your replies, just the advice I needed. I will push ahead with the sleep study so we will see how that goes.

Thanks again, much appreciated!

stephen_s wrote:Thank you for all for your replies, just the advice I needed. I will push ahead with the sleep study so we will see how that goes.

Thanks again, much appreciated!

Good Luck stephen_s! Let us know how it all works out for you.