Information worth Sharing

I had a very interesting meeting with a Neurologist who specializes in sleep disorders at Vanderbilt Medical Center today. I showed her my Resmed software report over the last several days and asked lots of questions. The information I gleaned was very valuable and I thought many of you would like to hear some of the things she had to say.

As to why my Apneas are primarily occuring in the first hour of sleep, she said that I should take those with a grain of salt. She said that everything from sighing to moving around can create Apneas on the software. She said that people sigh a lot when they first lie down to sleep. And she said that when you sigh, you stop breathing for longer than normal. She's right. Try sighing and see how long you go before taking another breath. She also said that any kind of turning can create an Apnea, which some of you have implied on your posts about this topic. I asked her if it came from my body moving into a slower type of breathing. She said no. I find it hard to believe that she would know definitively that there are no Apneas when slowing down your rate of breathing. Seems it would be more reasonable to say "It's not likely". But she wasn't arrogant by any means. She took lots of time with me and answered all of my questions and really tried to help me in my journey to better sleep.

APAP vs. CPAP-She said that they prefer a straight CPAP mode as opposed to APAP mode because you have to experience Hypopneas or Apneas before it will Titrate upwards, and then it Titrates down again only to have to go back up again only if you have more Apneas; and the goal is to eliminate Apneas. She said that if you can find a pressure you can live with that is also effective (try 3-4 nights at each pressure before deciding), then you will most likely have better results in a constant CPAP pressure. She wasn't against APAP and certainly understood the comfort factor, but she liked the results better with CPAP.

Central Apneas causing Death-She was emphatic about this. She said that Central Apneas do not cause death. Now this surprised me. One of the reasons I wanted the sleep study was because I wanted to make sure that my Apneas were not from Central Apneas. She said that with all types of Apnea you do wake up. And that spouses who lie awake at night worrying that their spouse will die from cessation of breathing should go back to sleep because they will NOT die from Apnea. She said the way Central Apnea kills people is that it causes heart arrythmias and that is what eventually kills people. I mentioned Reggie White and she said that that was from the heart arrythmia issue. (BTW, I had a sleep study 7 years ago and was diagnosed with Severe sleep Apnea-64 per hour. My AHI now ranges from 2-10 AHI each night
and I'm trying to get it below 5. So far it seems like I'm getting much better results with the Resmed s8 Auto II than with the Respironics M Series A-Flex.)

As to my daytime dizziness-She acknowledged that CPAP can cause dizziness because of the pressure it creates in the ears. However I have been using APAP and am not sure if it's with APAP and CPAP or just CPAP. She was a little perplexed by the dizziness thing however. After having just gone through their Balance Disorder clinic and having all tests negative, I decided it could be Apnea problems. And I told her that last Sunday when I had NO Apneas during my sleep, I had NO dizziness the next day, NO fatigue, NO brainfog and felt incredible. Don't know what the magic was that day, but man do I want it back. I have read from many of your posts that you just have to hang in there and it will get better over time.

While I know the doctor is not God, she has a lot of good data and has seen a wide variety of sleep disorder patients. Unless someone has some facts to the contrary and can show supporting data or share conflicting advice from another good sleep specialist M.D., I'm going with what she told me. Just as a side note, I started switching my healthcare over to Vanderbilt-a teaching and research medical center and have gotten superior results compared to the other local hospitals and doctors in town who whisk me in and out of their office in no time flat. At Vanderbilt, they are never in a hurry, are very thorough, are not afraid to run tests, are generally more curious, and do their best to get to the bottom of the problem. So, I say if you aren't getting the satisfaction you desire, go to a teaching medical center if you're near one. Hope this info is helpful to someone who has lots of questions like me.

Wow, it sounds like you have an excellent doctor there. I'm jealous! (And I hope to be among your rank very soon.)

On the dizziness issue, I had something similar going on several months ago. Mine wasn't really dizziness, per se; I never lost my balance, but I would suddenly feel extremely light-headed and needed either to grab something to stabilize myself (like the kitchen counter or the back of a chair) or sit down quickly. I went through a bunch of tests, all negative. Then a friend told me about a procedure she had done which fixed her dizziness problem almost immediately. It's called the Epley Maneuver. I asked the neurologist I was seeing if he knew about it and could perform it for me, but he was unfamiliar with it. So I hit YouTube and, believe it or not, found videos that demonstrated how it's done. You can do it on yourself, which I did; I just made sure I was laying in the middle of my bed so that, if I became dizzy or lightheaded when I sat up, I wouldn't be in any danger. I laid on my back and tucked my pillow under my shoulders so that my head was "free" and I could move it the way the video instructed.

I don't know if it'll help you, but it sure fixed me up in a hurry. Do it a couple of times, if need be. Here's a link to the video I found: https://www.youtube.com/watch?v=pa6t-Bpg494 Click on the "more info" link to read more about it. Hope it helps.

Thanks for sharing Bleeping Beauty! I'll check out the video. I'm familiar with the maneuver. Vanderbilt has the #1 Audiology and Balance Disorders Clinic in the country. I don't know how they can tell, but after their tests, they said I did not have BPPV with the displaced crystals and therefore would not benefit from the maneuver you mention. HOWEVER, I've wondered..."what if they're wrong". So, I might try it. I'll do a little research first though to make sure I don't displace the crystals by doing it. So, in the end, did it help you?

And by the way, I'm jealous that you live in Arizona. You have phenomenal alternative and complementary medicine and doctors there. You have Andrew Weil and his clinic full of complementary medicine doctors as well as Mark Starr, who wrote Hypothyroidism Type II. That book is groundbreaking and I've given 6 copies away. Even my internist likes it. He thinks that 50% of the U.S. population is Hypothyroid. Let's say he's wrong and it's only 10%. That's still huge. I've seriously considered traveling to AZ to see him. But first I want to resolve the sleep apnea problems to see what I can resolve.

spookydoo wrote:Thanks for sharing Bleeping Beauty! I'll check out the video. I'm familiar with the maneuver. Vanderbilt has the #1 Audiology and Balance Disorders Clinic in the country. I don't know how they can tell, but after their tests, they said I did not have BPPV with the displaced crystals and therefore would not benefit from the maneuver you mention. HOWEVER, I've wondered..."what if they're wrong". So, I might try it. I'll do a little research first though to make sure I don't displace the crystals by doing it. So, in the end, did it help you?

Glad to share. Yes, it worked like a charm for me. I did it twice, and I haven't had a spell of light-headedness since. As I said, I laid in the middle of my bed with my pillow scrunched under my shoulders. It was quick and easy, and it worked! (I was also told that I didn't have BPPV, so don't let that stop you. Yes, do some research and see if it's something you want to try. If you go for it, I really hope it works for you. I was amazed at how simple it was to fix what can be a debilitating problem.)

And by the way, I'm jealous that you live in Arizona. You have phenomenal alternative and complementary medicine and doctors there. You have Andrew Weil and his clinic full of complementary medicine doctors as well as Mark Starr, who wrote Hypothyroidism Type II. That book is groundbreaking and I've given 6 copies away. Even my internist likes it. He thinks that 50% of the U.S. population is Hypothyroid. Let's say he's wrong and it's only 10%. That's still huge. I've seriously considered traveling to AZ to see him. But first I want to resolve the sleep apnea problems to see what I can resolve.

I understand the jealousy. I lived in Boston and was totally spoiled by the superior medical care to be found there. But for me, the nature and the natural beauty drew me out here, although I experienced quite a bit of culture shock after I moved. Aridzona is an interesting place, with lots of wildlife, many creepy insects, and stunningly beautiful scenery.

I'm a bit of a distance from UofA but, if you DO come out this way at some point, let me know. I'll give you the nickel tour of my area, if you'd like. (I'd be of no use re: Phoenix.) It's peace and quiet here, where I live, with a zillion stars in the sky every night, and mountains all around. If you do come to visit, come between October and April, if you can; Phoenix weather is truly hellish for six months of the year.

Spooky.....

....I have some clues for you.....

Because i have small Eustachion Tubes, I have never been able to experience scuba diving.....because I can't easily equalize the pressure in my ears.

Most of the time, I sleep on my side......and I sometimes have one ear that is stopped up (Eustachion Tube blocked) when I wake up.

Sometimes, I experience vertigo dizziness as the cabin pressure is changed (reduced) when I'm flying.

I have also experienced vertigo when I'm piloting a light plane......while ascending.

My cure for the vertigo....in both cases....is to pressurize both ears by forcing air into each Eustachion Tube.....to equalize both ears at the same time....and with the same pressure.

The vertigo happens when one ear has more internal pressure (Eustachion Tube blocked) than the other ear.

My conclusion is......that vertigo dizziness might be caused by a situation in which......one ear has a different internal pressure...than the other.

I realize that my experiences may not be anything like your difficulty, but I thought I'd pass the info along.....just on the outside chance that it might help.

Gerald

Spooky, thanks for sharing all that!

Gerald wrote: ....because I can't easily equalize the pressure in my ears.

My cure for the vertigo....in both cases....is to pressurize both ears by forcing air into each Eustachion Tube.....to equalize both ears at the same time....and with the same pressure.

Gerald, what method(s) of forcing air seem work best for you? Thanks as well.

Interesting supporting article:
http://www.jaoa.org/cgi/content/full/108/5/260

[quote="spookydoo"]As to my daytime dizziness[/quote]

Hi - can I just mention something that happened to me? After awhile on Cpap therapy I also experienced some dizziness - not everyday, say about every 2nd day. Well, I take HighBloodPressure tablets and when I changed the dosage (myself) all dizziness are gone! So, what I want to say is that your health gets better when on CpapTherapy and one must then change other meds to suit your 'better' health.
GoodDay -

i'm not trying to be a smart *ss but,
you mentioned that centrals don't cause death. but you go on to say that they cause heart arythmias which do.
so did the chicken lay the egg?........ and also an apnea (despite the cause,central, osa or other) is a cessation of breathing for a predetermined time at which end the person resumes breathing. so if you die you don't restart breathing therefore it was not an apnea.

just an observation from an oxygen deprived brain.

good luck with your therapy i wish we all had doctors like that.

Thanks for the info Spookydoo. That explains our initial apnea onslaught at night. I just may switch to CPAP from APAP as a trial after reading that. I'll give it a 3-4 night try and see what happens.