Headed for Sleep Study, Breathing Question

[steveinmaine]

I joined this forum a couple years ago, when my father began CPAP, and now it seems it may be my turn to join your ranks as an official CPAP user in that I’ll be seeing my doctor in a few days for a possible referral for a sleep study. Before I go in, though, I’d like your feedback on what I might have going on.

What happened is, I always suspected I had some sleep apnea because even though I sleep on my side, I’d wake up gasping once a week or so. Then this summer the quality of my sleep really sank, so that I’d get up and feel I hadn’t slept at all. My concentration and memory were shot.

So, to see what might be going on, I started recording my breathing for a few hours each night.

It turns out that I do have obstructive apneas – they nearly always occur right after I halfway wake up and then swallow or smack my lips or something, and the breath will be cut off for about thirty seconds.

The thing is, those apneas are less than one an hour, and that what I have a great deal of instead are out-breaths that rasp and wheeze, as if they’re being blocked, but seldom all the way. And this is what wakes me up. The only times I snore on the in-breath are when I happen to roll on my back, and then it's snoresville.

So my question is, is this the same as obstructive sleep apnea, and is it treated the same way?

If you're curious, you can check out this video I posted, which shows both the sleep patterns and their sounds.

https://www.youtube.com/watch?v=I8X7lV-RjPI

[kaiasgram]

Hi Steve -- I saw your post earlier today and noticed that no one has responded yet. I listened to your youtube recording. I recognized your exhalation sound as what I have heard on the few occasions when I've actually woken myself up (vs. "snoring"). I got curious enough to shoot your question over to Jason at freecpapadvice.com. Jason is a registered sleep tech and I'm hoping he'll stop by with some feedback for us. We have a few professionals here too, so hopefully you won't have to wait too long for some answers.

From the very quick search I did after seeing your post I got the impression that the airway can close during inhalation and/or during exhalation, and it's obstructive apnea in both cases. And in both cases positive airway pressure functions to splint the airway and hold it open so we can inhale and exhale. I'm looking forward to learning more, thanks for posting this question and your recording.

[kteague]

That raspy wheezing you describe could be hypopneas, where the breathing is compromised but not totally obstructed. Hypopneas can disrupt sleep and cause oxygen levels to drop. Your sleep study will determine if that's what you're hearing. If what you're experiencing meets the criteria for hypopneas, they are counted in determining if a diagnosis of obstructive sleep apnea applies. Let us know how this pans out for you.

[Mr Concerned]

That raspy wheezing you describe could be hypopneas,

Couldn't it also be Central Hypopneas? If he is mixing Polamidone and Heptanone he could very well be on his way to full blown respiratory failure in just a few hours. Better take a history so we can see what we are dealing with here.

[Julie]

Do you have any trouble when you're awake? Problems with exhaling can be caused by asthma, with or without OSA.

[Therapist]

I’ll be seeing my doctor in a few days for a possible referral for a sleep study

Just do it and quit fretting about it.

An internet forum is no place to get a diagnosis. (But it is a great place to learn how to use CPAP properly.)

One man said on here that you come to the forum thinking you might have sleep apnea and within a few hours you are diagnosed with ten other conditions. I see someone has already "given you asthma".

Go get the sleep study and then come back here to make sure you get the correct model CPAP machine.

[ChicagoGranny]

come back here to make sure you get the correct model CPAP machine.

Yes, very important!

[steveinmaine]

Many thanks.

I do breathe well during the day, so it would seem there's no problems with the nasal passages or asthma.

And I'm well aware of the dangers of looking for medical advice on the web (or even looking up symptoms at the Mayo Clinic, which can send one down a rabbit hole of worry). I was simply hoping someone else might also have had this issue and so help me be able to explain it to my doctor in how it's different than the usual OAS.

In fact, I did find a couple posts here from a few years ago with people with the same issue, trying to understand it. It was good just to hear that I'm not alone in it.

I'll let you know how it goes.

[steveinmaine]

I may have just figured out something. I was trying to see if I could imitate the sound for my doctor, and I could. It's a strong pressure in the back of the mouth, and gives that exact same rasp/wheeze/squeak sound. And I could breathe in fine between the out-breaths, just as I do in my sleep.

Now, I read that an overbite can cause trouble with sleep apnea, in narrowing the throat, and I do have one.

So after a couple rasp/wheezes, I pushed my jaw forward, and then I couldn't make the sound. Could only feel the air flowing up through my throat. And when I brought my jaw back? Instantly blocked.

[chunkyfrog]

That does sound familiar.
Can you bring raw audio with you to play for the doctor?
I would leave the wave image and play-by-play (just to leave something for the doctor to analyze).

[Not Fade]

Now, I read that an overbite can cause trouble with sleep apnea, in narrowing the throat, and I do have one.

That is pretty much what my sleep doctor thinks causes nearly all cases of obstructive sleep apnea (OSA). The mandible doesn't develop fully for various reasons. This leaves the base of the tongue further down in the airway and the airway is more likely to collapse when sleeping. Also, in the worse cases, breathing will be limited and uneven during waking hours.

This is one of the reasons that MAS (http://en.wikipedia.org/wiki/Mandibular ... ent_splint) can successfully treat some cases of OSA.

It is good to get yourself educated in the forum, but I agree that too much fretting at this stage is counterproductive. Relax for the study and let the medical pros do their work.

When you get all the results and the prescription the forum can help you be successful with therapy.

Has sleeping position been mentioned? (Sorry I did not read all the posts.) For many people sleep apnea is most severe when sleeping on the back. You should try to avoid the back position until you get your therapy running. But they will want you to sleep on your back during the sleep studies in order to capture worse-case data.

Good luck.

[steveinmaine]

Good idea, chunky frog, and thanks for the info, Not Fade. That may well be where I'm headed.

I do avoid sleeping on my back. And also, I'm not fretting! LOL. Serious - I just have a scientific background, and love playing with charts and all, and so was curious to see what I could find out before going in.