Slurred speech and mental sluggishness that worsens with sleep

Hi All,

So my story goes back many years but I will try to condense it as best as possible!

I have only recently started CPAP therapy having been diagnosed with very mild sleep apnea. However, this most has less to do with CPAP and more to do with the symptoms that I have experienced over the years and long before CPAP that hopefully somebody on here may be able to identify with and give me a possible cause. My googling of my symptoms brought me to a post (see link below) from 2017 that really resonated with me.

viewtopic/t157797/Lack-of-mental-focus- ... -CPAP.html

- Getting 7+ hours sleep leaves me mentally very slow with poor memory and concentration. That has been the way for about 15 years. But over the last 3 years I have noticed that my speech has also begun to be affected. At first I would find that I would struggle to find words mid-sentence and would only very occasionally slur a sentence or a 3 or 4 syllable word. However, over the last 6 months or so I have noticed that I am struggling to articulate speech more and I am slurring much more to the point that before I speak I really have to plan out the sentence and almost recite it to make sure that I don't slur anything. So it's difficult for me to speak naturally (think and speak at the same time) anymore. I find that saying 2 words back to back that begin with the same letter can be troublesome for me. For example, in saying "I think England will win" the "will win" becomes morphed into something incomprehensible.

- The same trend is true for the physical side of things. Getting those 7+ hours leaves me noticeably weaker than I would have been before I went to bed the night before. So if I had to stand for any length of time in the morning I would have a strong desire to sit down. It's also worth mentioning that 12 years ago I started some light jogging at the advice of my doctor at the time. When I say light jogging I mean 20 lengths of my back garden which amounted to about 400 yards. This seemed to put me into some kind of catabolic state as over the next 4 months I gradually became colder (shivering in July cold), weaker and lost a good 20 lbs. I went from 150 lbs to 130. Needless to say I wasn't getting any fitter either. 400 yards was still my limit. So that didn't work out too well for me! Btw I am male and I was 25 at the time.

- The above is also true for daytime naps. So I would get sleepy around late afternoon by which time I would be in better shape mentally and physically and my speech would be much better. However, while taking a 30-60 min nap would relieve my drowsiness it seems to bring back the mental sluggishness and physical weakness.

- Similar to what the previous poster from 2017 shared, getting just the 5-6 hours sleep will leave me much sharper in the morning, along with having much better tolerance for physical exertion. Of course the downside is that I would be drowsy. In other words this state would be like a sleep deprived healthy person.

So if I was to sum up everything in one sentence it is that SLEEP IS TOXIC TO MY BODY.

I have plenty of more details to share for those of you who are interested and may be able to offer up some theories and hopefully solutions.

Thanks!

Get your GP to refer you to a neurologist who will know what kind of tests, etc. to give you re your symptoms. You may even have had a small stroke (transient ischemic attack) affecting your speech, but not been diagnosed. Right now you're assuming some things, not addressing others (or addressing them wrongly) and Google is not a doctor. You need to be proactive about your life and find out why you have certain symptoms and whether or not other things should be looked at. Don't wait around, don't ask friends (or Google), do get that referral and then come back to this thread please if you choose and give us results.

+1 for Julie's answer

Also, NOT sleeping is toxic to your body. I know you expressing what you feel, but you need to be very proactive on this. Your symptoms, even if they get better during the day, are very troubling. A neurologist is absolutely the way to go.

Answers for neuro problems are not always fast, but they will now the best path to take. It took my daughter over a year and a half to reach a diagnosis and treatment plan that works. Trust me when I tell you that was a VERY trying process.

I'm not saying that will happen for you, I *am* saying you must start and follow through to get this understood.

@Julie and @khauser

Thanks both for your input. I have gone down the neurologist route a number of years ago which was another dead end. Albeit that was long before the slurred speech kicked in. I would feel like I'm going full circle but there's nothing to lose by going back I suppose!

Ironso83 wrote: ↑

Fri Jul 10, 2020 10:20 am

@Julie and @khauser

Thanks both for your input. I have gone down the neurologist route a number of years ago which was another dead end. Albeit that was long before the slurred speech kicked in. I would feel like I'm going full circle but there's nothing to lose by going back I suppose!

Back to my daughter's ordeal: We tried and 'fired' several neurologists. Some of them were great with patients, but couldn't make any progress.

If you do not have an explanation for this, I will make this suggestion: Find a teaching hospital and reach out to the HEAD of the neurology department. It make (probably will) take longer to get an appointment, but will be worth it. Teaching hospitals generally have more up to date training.

You (and your trusted friends and family) are your one and only best advocate. Unfortunately you can't rely on your primary care doctor (too busy in today's money-driven medicine plan). You have to keep trying.

Now if you have been told what's going on and that there's no further progress, that's a different issue. But if all you get is the equivalent of "we don't know" I'd keep looking.

I will join the chorus: slurred speech is a very serious symptom that deserves immediate medical attention. Please read about this symptom: https://www.mayoclinic.org/diseases-con ... c-20371994

When you visit the doctor, I would advise you to sort your symptoms/experiences by how long you have had them. That could just be a matter of slightly rearranging and clarifying the narrative you've given here.

I also recommend writing it all out ahead of time, printing your narrative, and giving it to the doctor at your visit.

Finally, if there is someone you trust, and who may have observed some of these changes themselves, bring them with you when you visit the doctor, if that's allowed. The pandemic may make that impossible, but it can be very helpful to have someone else with whom to compare notes afterwards. And if the person has observed your behavior first-hand, their contributions to the discussion with the doctor could be very helpful.

All my best with this -- but please don't delay.

Good idea on bringing a 'friend' to maybe even write down what's suggested by the doctor - we're usually a bit anxious and can forget things once we leave.

Miss Emerita wrote: ↑

Fri Jul 10, 2020 10:53 am

I also recommend writing it all out ahead of time, printing your narrative, and giving it to the doctor at your visit.

what a great idea!

we are very lucky to have you here with your clear thinking.

I will chime in with all the others...this isn't something to be messing around with and trying to fix with minor tweaks on the cpap machine for mild OSA.

Do you take any medications at all...even OTC? I would assume medication side effects have been ruled out but sometimes some meds do some weird things to people.

Definitely go see a neurologist ....if you aren't happy with one...get another. They aren't all created equal. There are good ones and bad ones just like every where else in life. Please don't mess around with this....it's too important. Do whatever you have to do to get the ball rolling to see the specialist ASAP.
If you were my family member...I would be on the phone right now starting the ball rolling to get you checked out.

Agree with all that's been said. I had years of unrewarding experiences with doctors trying to figure out what was wrong with me. Docs would order a test, get a negative result, then "dismiss" me. Finally got the courage (or desperation) enough to tell the doctor I didn't come to them just to find out what I didn't have, so what's next because I don't want you to stop until you have answers. I've seen 5 different neurologists through the years. Please don't let a prior disappointment keep you from pressing forward.

As you are pursuing this further, can we be of any help with your CPAP treatment? If you at least make sure your therapy is optimized, it can rule out sleep apnea as being a contributor to your symptoms. Have you had in-lab sleep studies? Would be interesting to see those to see if there are any clues. It is not unheard of that being diagnosed with sleep apnea is taken as the answer when more stuff is going on that gets pushed aside.

Good luck going forward. Hope you find the answers you need.

Pugsy wrote: ↑

Fri Jul 10, 2020 11:48 am

I will chime in with all the others...this isn't something to be messing around with and trying to fix with minor tweaks on the cpap machine for mild OSA.

Do you take any medications at all...even OTC? I would assume medication side effects have been ruled out but sometimes some meds do some weird things to people.

Definitely go see a neurologist ....if you aren't happy with one...get another. They aren't all created equal. There are good ones and bad ones just like every where else in life. Please don't mess around with this....it's too important. Do whatever you have to do to get the ball rolling to see the specialist ASAP.
If you were my family member...I would be on the phone right now starting the ball rolling to get you checked out.

No I'm not on any meds. The only triggers I can think of for the slurred speech/slowed thinking is strenuous exercise. It would have been around 2017 when I started playing 5-a-side football once a week that I would have first noticed it. I would have also been slurring my words during football. My voice would also have been very weak. This would suggest to me some blood sugar issue but no abnormalities were found from bloods.

kteague wrote: ↑

Fri Jul 10, 2020 3:54 pm

Agree with all that's been said. I had years of unrewarding experiences with doctors trying to figure out what was wrong with me. Docs would order a test, get a negative result, then "dismiss" me. Finally got the courage (or desperation) enough to tell the doctor I didn't come to them just to find out what I didn't have, so what's next because I don't want you to stop until you have answers. I've seen 5 different neurologists through the years. Please don't let a prior disappointment keep you from pressing forward.

As you are pursuing this further, can we be of any help with your CPAP treatment? If you at least make sure your therapy is optimized, it can rule out sleep apnea as being a contributor to your symptoms. Have you had in-lab sleep studies? Would be interesting to see those to see if there are any clues. It is not unheard of that being diagnosed with sleep apnea is taken as the answer when more stuff is going on that gets pushed aside.

Good luck going forward. Hope you find the answers you need.

As regards my CPAP treatment the hospital is in touch with me regularly but I can certainly start challenging them with what I could be doing with the machine settings. I did a sleep study back in 2013 where nothing was identified and the very mild OSA was identified second time around only last year.

Ironso83, I'm concerned that in your two recent posts you don't mention anything about seeking medical attention for your symptoms. I'm worried about you and hope that you will see a doctor very soon.

Miss Emerita wrote: ↑

Fri Jul 10, 2020 10:38 pm

Ironso83, I'm concerned that in your two recent posts you don't mention anything about seeking medical attention for your symptoms. I'm worried about you and hope that you will see a doctor very soon.

Thanks for your concern. I have emailed a few neurologists today so I'll see what comes of that.

Excellent. In my medical system, I’d have to start with my primary care physician and get a referral. Nice that you can reach out directly to a specialist. All my best for a quick diagnosis and effective treatment.