It's amazing how many times I see a sleep report with no REM sleep. The patient was then put on CPAP (on the same night) and the amount of REM sleep which appears soon after starting CPAP is amazing. This is known as "REM rebound." The body is just craving for it
Link between OSA and the "beer gut"
During my sleep study I had *no* REM sleep all night till just before she woke me at 6:15 "as we saw you were waking up anyway".
My natural politeness woke up before I did, but I was *not* happy with her!
I was actually quite angry. Perhaps she was getting her own back for all my toilet runs!! (Actually she was sweet and kind, quite new, and probably didn't understand the REM craving of OSA).
My natural politeness woke up before I did, but I was *not* happy with her!
I was actually quite angry. Perhaps she was getting her own back for all my toilet runs!! (Actually she was sweet and kind, quite new, and probably didn't understand the REM craving of OSA).
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[quote="split_city"]................
exactly, it's a vicious cycle! This I believe is why a lot of OSA patients have depression
exactly, it's a vicious cycle! This I believe is why a lot of OSA patients have depression
Rooster
I have a vision that we will figure out an easy way to ensure that children develop wide, deep, healthy and attractive jaws and then obstructive sleep apnea becomes an obscure bit of history.https://www.youtube.com/watch?v=0ycw4uaX ... re=related
I have a vision that we will figure out an easy way to ensure that children develop wide, deep, healthy and attractive jaws and then obstructive sleep apnea becomes an obscure bit of history.https://www.youtube.com/watch?v=0ycw4uaX ... re=related
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GuestForADay
Hello split-city,
Thanks again for your responses - lots of good info.
What do you think of exercises to help with sleep apnea? For example the didgeridoo: http://www.sciencedaily.com/releases/20 ... 094017.htm There are some claims out there for singing lessons, too.
Yes, somewhat desperate, otherwise would not have brought it up the subject.
Thanks again for your responses - lots of good info.
What do you think of exercises to help with sleep apnea? For example the didgeridoo: http://www.sciencedaily.com/releases/20 ... 094017.htm There are some claims out there for singing lessons, too.
Yes, somewhat desperate, otherwise would not have brought it up the subject.
[quote="split_city"]
There is an area of sleep studies which is looking at the "arousal threshold." Some people have a low arousal threshold (perhaps in your case) or a high threshold. There are several factors which influence the arousal threshold including:
1) sleep stage
2) drug use
3) alcohol use
4) sleep deprivation
Studies have looked at what induces an arousal. These include:
1) CO2 levels
2) Oxygen levels
3) Upper airway resistance
4) Respiratory drive i.e. how hard you're breathing
5) Respiratory muscle activity
4) Fatigue of respiratory muscles
Interestingly, it was shown by our group that hypoxia impacts upon this arousal threshold. Furthermore, another group showed that despite different chemical stimuli i.e. CO2 and hypoxia, subjects aroused at the same respiratory drive (measured by oesophageal pressure). While a different group concluded that arousal was triggered at a certain point at which the diaphragm became fatigued.
Our lab has looked at whether arousal is good or bad. It's good because it allowed restoration of airflow and also prepares us for the "fight or flight response." How is it bad though?
1) Breathing rate is generally regulated by CO2 levels in the blood
2) You stop breathing when CO2 in your blood falls below a certain level (apnoea threshold).
3) When you arouse, you hyperventilate due to increased CO2 in the blood.
4) Typically, you blow off so much CO2, the CO2 levels fall below the apnoea threshold and then you begin to hypoventilate
5) At the same time, your upper airway muscles are switched off due to low CO2 levels
6) When falling back asleep, a number of people develop a central apnoea.
7) CO2 builds so breathing starts again, but the muscles are still turned off --> allowing for upper airway collapse.
Arousal is triggered, followed by hyperventilation etc...and cycle begins again
Kind of got off the track but I thought it would be good to discuss. Sleep architecture is controlled by a number of systems. It all comes down to which side the seesaw is tilted i.e. hormones which control sleep versus those which control wakefulness. A lot of work has been done in this area. However, this isn't something I have studied in any great detail
There is an area of sleep studies which is looking at the "arousal threshold." Some people have a low arousal threshold (perhaps in your case) or a high threshold. There are several factors which influence the arousal threshold including:
1) sleep stage
2) drug use
3) alcohol use
4) sleep deprivation
Studies have looked at what induces an arousal. These include:
1) CO2 levels
2) Oxygen levels
3) Upper airway resistance
4) Respiratory drive i.e. how hard you're breathing
5) Respiratory muscle activity
4) Fatigue of respiratory muscles
Interestingly, it was shown by our group that hypoxia impacts upon this arousal threshold. Furthermore, another group showed that despite different chemical stimuli i.e. CO2 and hypoxia, subjects aroused at the same respiratory drive (measured by oesophageal pressure). While a different group concluded that arousal was triggered at a certain point at which the diaphragm became fatigued.
Our lab has looked at whether arousal is good or bad. It's good because it allowed restoration of airflow and also prepares us for the "fight or flight response." How is it bad though?
1) Breathing rate is generally regulated by CO2 levels in the blood
2) You stop breathing when CO2 in your blood falls below a certain level (apnoea threshold).
3) When you arouse, you hyperventilate due to increased CO2 in the blood.
4) Typically, you blow off so much CO2, the CO2 levels fall below the apnoea threshold and then you begin to hypoventilate
5) At the same time, your upper airway muscles are switched off due to low CO2 levels
6) When falling back asleep, a number of people develop a central apnoea.
7) CO2 builds so breathing starts again, but the muscles are still turned off --> allowing for upper airway collapse.
Arousal is triggered, followed by hyperventilation etc...and cycle begins again
Kind of got off the track but I thought it would be good to discuss. Sleep architecture is controlled by a number of systems. It all comes down to which side the seesaw is tilted i.e. hormones which control sleep versus those which control wakefulness. A lot of work has been done in this area. However, this isn't something I have studied in any great detail
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split_city
- Posts: 465
- Joined: Mon Apr 23, 2007 2:46 am
- Location: Adelaide, Australia
I'm sure there is Rosemary. We do have a few people looking at the psycholgical side of insomina but not so much in regards to sleep apnoea at this stage. But I'm sure there will be studies down the track. Our lab primarily is looking at the physiology of sleep apnoea while a few researchers are more into the clinical side of things. I'm focussing on diaphragm position, lung volume, the amount of stretch on the upper airway and activity of a muscle under the tongue. Another PhD student is looking at arousal and whether it's good or bad. While our remaining researchers are investigating a aspects of central sleep apnoea, the cardivascular risks associated with sleep apnoea and also sleepiness, alcohol and driving. Very exciting times ahead
So, you are looking more at muscle / tissue action or reaction???I'm focussing on diaphragm position, lung volume, the amount of stretch on the upper airway and activity of a muscle under the tongue.
Do I have it right?
That is interesting. I have Mitral Valve Prolapse (MVP) with Dysautonomia, or MPV Syndrome. One of the characteristics of folks with this Syndrome is that the connective tissue is more flexible than 'normal'. I think, although I cannot prove it, that my airway simply collapses at night, at least partially. I think that is what causes my Apnea. I could probably have my airway tested, but it doesn't sound like a pleasant procedure.
I am looking forward to hearing about your findings.
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split_city
- Posts: 465
- Joined: Mon Apr 23, 2007 2:46 am
- Location: Adelaide, Australia
I'm not looking so much at muscle structure, but more muscle activity/function. There have been a few studies looking at the difference between the structural properties (i.e. muscle fibre types) of the genioglossus muscle (a muscle which acts to keep the airway open) between OSA patients and non-OSA individuals.
There really hasn't been a lot of work looking at the structural properties and connective tissue surrounding the upper airway. Unfortunately, studies like this would be very difficult to get ethical approval. Furthermore, there aren't a lot of animals that have sleep apnoea (British Bulldog is one animal which can present OSA).
The genioglossus is known to be hyperactive in OSA patients during wakefulness, which is thought to act as a complensatory reflex for OSA patients having a smaller airway. However, this activity drops off dramatically when OSA patients go to sleep. This has been considered one explanation for what causes OSA.
There really hasn't been a lot of work looking at the structural properties and connective tissue surrounding the upper airway. Unfortunately, studies like this would be very difficult to get ethical approval. Furthermore, there aren't a lot of animals that have sleep apnoea (British Bulldog is one animal which can present OSA).
The genioglossus is known to be hyperactive in OSA patients during wakefulness, which is thought to act as a complensatory reflex for OSA patients having a smaller airway. However, this activity drops off dramatically when OSA patients go to sleep. This has been considered one explanation for what causes OSA.
You can actually estimate the pressure on the abs due to fat.
The physical formula is given by P = rho.g.h
Rho is density, in this case it's the density of fat.
The density of pure fat is in general 0.9 H2O but since body fat contains water too, we can take it approximately 1 H2O.
g is gravitational constant.
h is height, while lying on back it is the thickness of the fat on and below the abs (there is fat below the abs as well).
As a result everybody can predict his/her pressure by measuring the thickness of the fat tissue on the abs.
For example I have about 5cm (2") fat on my abs.
If the fat below the abs about 2cm, my total pressure is about 7cm H2O.
My APAP pressure range is 10.5-12cm.
So the medical people should explain why I need the extra 5cm H2O pressure during REM.
The physical formula is given by P = rho.g.h
Rho is density, in this case it's the density of fat.
The density of pure fat is in general 0.9 H2O but since body fat contains water too, we can take it approximately 1 H2O.
g is gravitational constant.
h is height, while lying on back it is the thickness of the fat on and below the abs (there is fat below the abs as well).
As a result everybody can predict his/her pressure by measuring the thickness of the fat tissue on the abs.
For example I have about 5cm (2") fat on my abs.
If the fat below the abs about 2cm, my total pressure is about 7cm H2O.
My APAP pressure range is 10.5-12cm.
So the medical people should explain why I need the extra 5cm H2O pressure during REM.
I am glad to see that some people are doing research into the causes of sleep apnea. I have had sleep apnea for a long time and have reasoned that there are multiple reasons for sleep apnea although I have no proof. I have never understood why doctors do not try to diagnose sleep apnea patients to see what is causing their apnea. It could affect treatment choices. I think that my apnea is mainly caused by my tongue falling back because
1) My head is smaller than average. 6 3/4
2) I had UUV surgery twice and I do not think it did much.
3) I had surgery GA/TA to advance my tongue and it may have helped.
4) I wear a snorban device and chin strap with my cpap and it seems to help
It helps hold my jaw and tongue forward and keeps my mouth closed and helps eliminate mouth breathing.
5) My wife says I often snore and have problems when I sleep on my back.
6) I have gained weight in the middle even though I quit drinking 15 years ago because the doctor felt it would help my sleep apnea because alcohol is a depressant.
7) My doctor said that he did not think weight loss would help my apnea but I think that I wanted to hear it. I should lose anyway and could if I cut out overeating.
I could be all wrong in my self diagnosis but it is my best guess.
Anyway I think it would be good if more research and diagnosis was done on the causes of sleep apnea on a case by case basis.
GeneS
1) My head is smaller than average. 6 3/4
2) I had UUV surgery twice and I do not think it did much.
3) I had surgery GA/TA to advance my tongue and it may have helped.
4) I wear a snorban device and chin strap with my cpap and it seems to help
It helps hold my jaw and tongue forward and keeps my mouth closed and helps eliminate mouth breathing.
5) My wife says I often snore and have problems when I sleep on my back.
6) I have gained weight in the middle even though I quit drinking 15 years ago because the doctor felt it would help my sleep apnea because alcohol is a depressant.
7) My doctor said that he did not think weight loss would help my apnea but I think that I wanted to hear it. I should lose anyway and could if I cut out overeating.
I could be all wrong in my self diagnosis but it is my best guess.
Anyway I think it would be good if more research and diagnosis was done on the causes of sleep apnea on a case by case basis.
GeneS
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split_city
- Posts: 465
- Joined: Mon Apr 23, 2007 2:46 am
- Location: Adelaide, Australia
[quote="Ergin"]As a result everybody can predict his/her pressure by measuring the thickness of the fat tissue on the abs.
For example I have about 5cm (2") fat on my abs.
If the fat below the abs about 2cm, my total pressure is about 7cm H2O.
My APAP pressure range is 10.5-12cm.
So the medical people should explain why I need the extra 5cm H2O pressure during REM.
For example I have about 5cm (2") fat on my abs.
If the fat below the abs about 2cm, my total pressure is about 7cm H2O.
My APAP pressure range is 10.5-12cm.
So the medical people should explain why I need the extra 5cm H2O pressure during REM.
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split_city
- Posts: 465
- Joined: Mon Apr 23, 2007 2:46 am
- Location: Adelaide, Australia
We are doing just that . Sleep apnoea really wasn't recognised until the 70s/80s. Obviously funding is the key...no money, no research It's different from country to country. I'm in Australia and there really aren't a lot of labs here which look at the physiology behind sleep apnoea, more the clinical aspect. A well known American sleep professor (David White) is considered the guru when it comes to sleep research.[/quote]
I remember that a Doctor Sullivan invented cpap somewhere in the 70.s. I have one of the earlier machines. I think a large number of people have sleep apnea but are undiagnosed because of lack of attention to the disease. It seems to get more publicity and is starting to be better understood now so I hope more people will be diagnosed and then possibly more money will be allocated to sleep apnea research.
GeneS
I remember that a Doctor Sullivan invented cpap somewhere in the 70.s. I have one of the earlier machines. I think a large number of people have sleep apnea but are undiagnosed because of lack of attention to the disease. It seems to get more publicity and is starting to be better understood now so I hope more people will be diagnosed and then possibly more money will be allocated to sleep apnea research.
GeneS
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split_city
- Posts: 465
- Joined: Mon Apr 23, 2007 2:46 am
- Location: Adelaide, Australia
You are correct. There are lots of undiagnosed patients out there. This probably relates to the fact that a large number of people don't suffer from excessive daytime sleepiness and therefore, don't go to see their doctor.
There was a report a few years back which showed that sleep disorders and treatment for sleep disorders cost Australia close to $10billion a year. This is right up there with asthma in this country, but sleep disorders continues to be in the shadows. However, the media has started to catch on and more people are becoming aware of the issues relating to sleep disorders, particularly OSA.
There was a report a few years back which showed that sleep disorders and treatment for sleep disorders cost Australia close to $10billion a year. This is right up there with asthma in this country, but sleep disorders continues to be in the shadows. However, the media has started to catch on and more people are becoming aware of the issues relating to sleep disorders, particularly OSA.