Sleep Apnea, to treat or not to treat!!!

[cyklopps]

Here are some thoughts from someone new to this forum. I have been diagnosed with moderate to severe sleep apnea. But I unlike many on this forum, I feel fine and have no symptoms other than loud snoring which my wife tolerates. I dread the thought of lying in bed nightly looking like a military fighter pilot with a machine humming by my side; never again able to enjoy the night smells or my wife's garden in the morning.
I know life is full of risks and trade offs especially in medicine. If it were not for my fear of stroke or hear attack I would not treat my problem.
I also have a degree of skepticism about such a relatively new disease that huge numbers of us now have. My cardiologist brother in law tells me with a twinkle in his eye that he has never sent a patient for a sleep study that has come back negative. Yet I know he is concerned. But medicine is full of fads that come and go over the years. Anyone here who has ever see the movie "The Road to Wellsville" with Anthony Hopkins knows what I am talking about!
So how strong is the data on heart attacks or strokes for an otherwise healthy 64 year old with untreated sleep apnea? Has there been enough study of risks for different kinds of patients that I might enable me to do a personal risk assessment and decide what CPAP might be worth to me in terms of longevity verses quality of life.
Finally, I would enjoy hearing from others who like me have ponderd this issue how you arrived at an answer. Phil

[Pugsy]

I didn't dig very deep to see what would happen if I didn't choose to follow this treatment so I can't help.

It was enough for me to know that they think Reggie White died from complications to his heart from untreated OSA.
Besides knowing my luck if there was just a one percent chance chance of stroke that left me a vegetable or heart attack, that would be what happened to me. Even if a very small risk, I wouldn't want to take it. It was enough for me to know that with the Oxygen desats I had, it would cause damage to my body. It was obvious and I didn't want to do further damage.

[Pad A Cheek]

Hello Phil,
You are probably pretty normal in trying to evade the use of CPAP machine and interface. There are things about this treatment for sleep apnea that are not pretty, or sexy. The feeling that you are fine except for some snoring is also pretty common.
If you underwent a sleep study and were told you have moderate to severe sleep apnea, not treating it is just denial.(the fact that your brother has never had a person come back negative for sleep apnea, may say more for his ability to evaluate the person based on their features and symptoms)
My husband had a sleep test and he does not have sleep apnea, and I know of at least 2 others who did as well.
Being treated effectively for sleep apnea increases your quality of life from now to the end of your life.
You may or may not be waking up in the night to use the bathroom, that is caused by fluid build up around your heart, and your body wants to get rid of it to protect your heart. Since I have been using CPAP, I never get up to use the bathroom. I sleep all night long and wake rested and refreshed.
You can expect any risk of Hypertension to be reduced, and the same goes for Coronary Disease, Stroke, and Diabetes. There are many clear studies that show the increased risk of untreated sleep apnea in these areas. Another thing, sleep apnea is a progressive attack on your system, it gets worse and the symptoms that start out silent become more openly obvious. As we age all of our tissues sag, our throats do as well. You do not have to be overweight to have sleep apnea, although many people are. Treating sleep apnea allows you more energy and more clear thinking to take charge of your life. Untreated sleep apnea affects your decision making as well.

I hope you get the treatment that you need and can come back in a few months to tell us that it did indeed make a difference.

Karen

[Tired Linda]

I feel fine and have no symptoms other than loud snoring which my wife tolerates.

I thought the same thing, until I had been on therapy a couple of months and found out what it was like to really sleep. I don't ever remember sleeping the way I do now. As far as the snoring, my husband tolerated it, also. He'd give me a poke or shove until I turned over and stopped. Getting a sleep test and starting therapy was the best thing I ever did. I don't snore anymore and the covers aren't ripped off the bed in the morning. My husband says its been months since I've kicked him. I finally realized that was disrupting HIS sleep, too.

I dread the thought of lying in bed nightly looking like a military fighter pilot with a machine humming by my side;

I dreaded the thought of having to sleep with a mask and machine, mostly because my husband is really queasy about medical stuff. Turns white driving into the parking lot of the clinic or hospital and starts shaking walking in the door. He looked over all the equipment when I brought it home, helped me set it up, and it hasn't been a problem since. He considers the vent from my mask his own personal air conditioner.

The machine sits on a Rubbermaid stool at the side of the bed and is well below the top of the mattress. Neither one of us hears the machine when it's on.

never again able to enjoy the night smells or my wife's garden in the morning

Dont' get too far ahead of yourself...I woke up to corned beef and cabbage in the crock pot yesterday morning, and I wear a full face mask

[Pugsy]

never again able to enjoy the night smells or my wife's garden in the morning.

Being masked up does not prevent aromas or odors from reaching the nose. When my husband gets up before me and makes coffee the aroma of the coffee comes through and I often wake to it. Also doesn't prevent odors from the dog or husband passing gas..

[Lizistired]

What prompted you to have a sleep study?
Do you have a copy of the full report from your study?
Have you had a titration yet?
I think you will have to look at the study results. Arrousals, O2 desaturations, apneas. It can be quite enlightening. I didn't know I woke up 112 times a night. I didn't know I stopped breathing. I didn't know my O2 dropped to 81%. I just knew I didn't sleep well and woke up thinking wierd stuff that didn't make sense.
If you don't believe that you need it, compliance will be difficult. My sleep doc didn't go over the results of anything with me until I had been on the machine for 30 days. It's best to get the results and see for yourself.

[Tip10]

For me, for a long time I never felt there was any problem at all -- basically ignored all the signs.
Wife was the one to note to my Doc that I seemed tired a lot more than she thought normal, he suggested the sleep study -- i took it to make wife happy.
Sleep test showed severe (96 events going to 124 supine) with O2 desats to 62%.
Treatment is not an option for me -- its a must.

[roster]

My cardiologist brother in law tells me with a twinkle in his eye that he has never sent a patient for a sleep study that has come back negative. Yet I know he is concerned.

What is his concern????

[tschultz]

I know I for one certainly wish I knew several years ago what I know now - untreated OSA can (and will) cause a whole cascade of other health issues.

In 2005 I was diagnosed with moderate sleep apnea, an AHI of around 70 if I remember right, but surprisingly still had good sleep quality numbers as I spent most of my sleep cycles in regenerative and REM sleep. I figured that OK, big deal so I snore a bit (well maybe a lot) but like everyone else thought to myself "what's a little lost sleep?" So I did nothing about my apnea, after a while my wife started sleeping in another room every night but over time we got used to things. She would nag me every once in a while but I continued to do nothing about it. Having seen a very poor sleep doctor did not help the situation but looking back that should not have stopped me - it was an excuse as much as anything else.

Over the past few years I have seen my weight continually increase, and over the last year the increase accelerated. I started to have other health related issues such as an electrolyte imbalance, increased blood pressure, and was starting to feel unwell overall. Then I started to get serious about trying to lose some weight, changed my diet with the help a dietitian, increased exercise somewhat but still the weight was increasing.

Then last September after seeing my family doctor we discussed that sleep apnea may be the root cause of many of my issues and she scheduled a sleep study for me at a different lab of my choosing. My sleep study was done in mid November and in mid December I saw the new sleep doctor and was promptly told that I had severe sleep apnea with an AHI of 119, was getting absolutely no regenerative or REM sleep, and was scheduled for a CPAP titration a couple of days later.

By then I was continually tired, often falling asleep if sitting idle for anything including watching TV. I was starting to miss time from work for health related issues and I knew I was going down hill. While waiting for my titration results I purchased a pulse-oximiter and was astonished that the first night wearing it my oxygen levels were dropping to as low as 58% and averaged in the low to mid 80% range most of the night. After a few days of collecting oximter data I met with my family doctor and she became very concerned, offering to admit me to hospital for oxygen if I got any worse. Between my doctor and myself we pushed very hard to have my results expedited and finally on 5 January 2011 I started CPAP.

I would be lying if I said I was looking forward to wearing that mask and hose every night for the rest of my life. However I also knew if I did not do so my life would be shorter because of it. I do believe I quite literally had one foot in the grave already.

Now at day 72 of CPAP treatment I have seen major improvements in my health and overall well-being in general. I regret not doing something sooner but am grateful to have such a treatment available. There are no real side effects aside from scaring the cats (and my wife initially) and I feel better than I have in MANY years. It simply wearing a mask and CPAP can have as major impact on my health as it has then I can gladly get accustomed to it.

I would certainly say that if you know there is a problem then CPAP can be your friend. It should not be feared and can truly change your life for the better.
Please don't put things off like I did!

[DocWeezy]

You don't say how old you are, but nightly suffocation and poor quality sleep will eventually have a HUGE impact on your life. You may still be young enough or the OSA onset recent enough that you are not yet feeling the impact of chronic sleep deprivation, but your body cannot hold out forever without good sleep and you will eventually start feeling it.

You're lucky that you were diagnosed before OSA severely impacted your quality of life. Too bad that you're in denial because you're going to lose the advantage of early diagnosis. I feel sorry for your wife because she will lose you much sooner--to ill health, stroke, heart disease, and death. If you wait until you feel bad enough to decide that you need CPAP, you may be surprised to discover that your denial has caused true damage to your body, and you may or may not be able to recover.

It's your choice, but you should ask your wife if she will be happy to have you die sooner because of the cumulative damage that untreated OSA does to your body.

Weezy

[BlackSpinner]

Here are some thoughts from someone new to this forum. I have been diagnosed with moderate to severe sleep apnea. But I unlike many on this forum, I feel fine and have no symptoms other than loud snoring which my wife tolerates. I dread the thought of lying in bed nightly looking like a military fighter pilot with a machine humming by my side; never again able to enjoy the night smells or my wife's garden in the morning.

Ok moderate to severe - 30 -50 episode an hour. So lay down with some quiet music, eyes closed and have the wife put her hand over your nose and mouth at random 2-3 minute intervals and hold it there for 10-30 secs. How restful does that feel? That is the way you sleep right now, you may not completely wake up enough to remember but that is what is happening to your body. Then there is the O2 levels - your brain and other organs need oxygen to function and heal. (This includes That One there that keeps wifey happy) More people die on mount everest due to the effects of low oxygen then that fall off.

Plus you never know - wifey might have the hots for the fighter pilot /Darth Vader look .
If you decide not to treat it make sure your insurance policy is well paid up so she can afford a nice singles cruise after you are gone.

[HoseCrusher]

I recently listened to a cardiologist discuss why they have become interested in sleep apnea. He said that there are wonderful drugs available that are supposed to be able to treat various heart issues, but after using them for quite awhile, they don't seem to work as well as they should.

In the case of blood pressure, they should be able to treat high blood pressure with 1 or maybe 2 drugs. Instead, they are finding that they have to use 7 - 8 different drugs and often only achieve marginal success. In addition to having poor success, when you use a large number of drugs you increase the risk of an unfavorable drug interaction.

Roughly 5 - 6 years ago, they started trying to figure out what was going on.

What has been discovered is that when your heart rate suddenly increases in response to falling oxygen levels, adrenalin is released. As this adrenalin breaks down, it forms by products that attack the heart and blood vessels. Also, since the heart runs on electricity, the adrenalin over saturates the receptors in the heart with extra stimulation.

They body can normally handle this on an infrequent basis, but with sleep apnea the occurrence is several times an hour. This frequency is more than the body can handle, and it just starts to break down. This breakdown manifests itself as high blood pressure, arrhythmia, congestive heart failure, blockages in the blood vessels, hardening of the blood vessels, and so on.

There are 17 cardiologists in his practice, and he stated that they do a patient interview and when they send someone to have a sleep study, they find that 90% of those people have sleep apnea. In contrast he said that a physical stress test only finds problems around 30% of the time. His thought is that they are still missing a lot of cases and they need to be testing a lot more than they are.

When I questioned him further, I was pleased to hear that almost all those who successfully treat their sleep apnea see their cardiac issues improve, and in many cases the issues are completely resolved.

As I see it, you have a couple of choices...

You can ignore all of this and wait until your health deteriorates, or you can accept the sleep apnea diagnosis and work on preventing future cardiac problems.

Since a properly functioning cardiac system is necessary for a high quality of life from a physical perspective, I would think that a little prevention would be a smart choice.

On a side note, I have never had any of the classic symptoms of sleep problems, but my blood pressure was creeping up and I have an occasional run of atrial fibrillation. My cardiologist is the one that asked me about sleeping, and I told him that my wife has noticed that I stop breathing while I sleep. He got things going on me having a sleep study, but we already knew what the results would be.

Since being on xPAP therapy, I still don't have any issues with the classic sleep problems, which is expected since I didn't have any issues going into this. I do have before and after data from my pulse oximeter, and I no longer have desaturations below 90%. My blood pressure has stabilized and is dropping slightly, and I haven't had an episode of atrial fibrillation in a long time. The one change I have noticed is that I no longer get up in the middle of the night to pee.

The bottom line is that while I don't see any major changes, I am committed to xPAP treatment because I want to have a lot of time to play with my grandchildren and I am looking forward to spending time with my great grandchildren.







... although I don't usually talk about this... I love to fly and have always wanted to fly fighter jets. When I mask up and drift off to sleep, I am soaring high in the clouds and having the time of my life with my imagination running wild...

[xenablue]

Sleep studies are expensive, so it makes sense that most who have them, are referred for good reason - they, or their doctor suspects SA.

I actually know a handful of people who've had sleep studies due to snoring issues, who DON'T have any sign of SA at all.

I had a sleep study after exhausting all other avenues as to why my blood glucose was higher in the morning after a night of sleep (or not, as it seems) than it was all day, even after food. I had complained of fatigue during the day and waking up many times during the night. It was really to rule out SA to move on to more invasive tests, so I wasn't expecting a positive result.

Now, after 5 months - I sleep much better, my blood pressure is lower and my fasting glucose is showing much better numbers.

I'm confident that my next full set of labs in a month will show that I will be able to drop some of my BP and heart meds.

If all it takes is breathing well at night to be able to reduce my intake of drugs - then it's a total success IMHO.

Cheers,
xena

[LarryD]

I think Pugsey and Padacheek pretty much nailed this subject, but I thought I would tell you what my X-marine brother thought about it. His quote follow:

"Phil has the right to die anyway he wants. That's what makes us Americans. We don't need some mamby-pamby thing blowin' air up our nose to keep us from snoring. All men snore. You ever been in a barracks? All those guys snore. And real women don't complain about it."

I really love my brother, but I also love my Intellipap. Hope this helps.

Larry

[carbonman]

Finally, I would enjoy hearing from others who like me have ponderd this issue how you arrived at an answer. Phil

sung to Sympathy for the Devil
Rolling Stones

Please allow me to introduce myself
I'm something you can not see or taste
I've been around for a long, long time
Stole many a man's breathe and faith

Pleased to meet you
Hope you guess my name
But what's puzzling you
Is the nature of my game

I'm still around although you may feel fine.
I'll make damn sure you despise me,
w/claustorphobia, rhinorrhea and aerophagia,
as you fight me w/machines and masks,
oral and mandibular device.

I'll take you to the bathroom until
the day you won't ever come back.
I"ll stick around until I see it's time
for a stroke or heart attack.

Pleased to meet you
Hope you guess my name
But what's puzzling you
Is the nature of my game

I revel in your skepticism.
I laugh w/glee that you should think
I'm just a fad.
Cardiologist laugh up their sleeve,
that no one is ever returned, negatively.

Just as every patient is a casuality
you can not determine your longevity
by the data of all history, you doubt....
that I degrade the quality of your life.

Tell me baby, what's my name
Tell me honey, can ya guess my name
Tell me baby, what's my name
I tell you one time, you're to blame

So, if we should meet, alone in the night
don't be concerned, don't fear my sight,
disregard the purpose of my plight......
I'm only here to steal your life.

Pleased to meet you
Hope you guess my name
But what's puzzling you
Is the nature of my game