I need help!

[JonnyH]

Hi I am Jon.

My wife's name is Penny and she has been having problems with sleeping. Sometimes she is up all night. But mostly she wakes up tired in the morning and has trouble starting the day. She says it's from muscle cramps in her back but I tell her that she only has the muscle cramps after she wakes up in the morning. She has high blood pressure and she has been treated for depression many times in the past. Now I've read that the apnea actually CAUSES depression. My problem is that I don't know the difference between the central and the obstructive. I read those a lot but they don't say what they are. But it seems like she needs a CPAP.

Is there a type of CPAP that does both? Because I don't know which one she has.

[CTyankee]

She needs a sleep study to start with. Most big hospitals now have sleep labs. This is something you can't self prescribe.

[Cuda]

If you have insurance or can otherwise afford it I would ask her to do the sleep study. I was crushed as I had to cover it all myself but still the best money I could have spent. OSA can easily cause depression, anxiety, muscle cramps, insomnia and on and on. Get her checked out, it can be fatal.

[Pugsy]

My problem is that I don't know the difference between the central and the obstructive. I read those a lot but they don't say what they are. But it seems like she needs a CPAP.

Is there a type of CPAP that does both? Because I don't know which one she has.

Hi Jon,
I will try to keep it simple so bear in mind there is more to what can be said. I am just giving the overview.

Obstructive apneas are caused by the collapse of the tissues in the airway. These can be either full or partial collapse of the airway. Full meaning essentially no air can move..partial means the collapse doesn't block the airway entirely but maybe partially so the air moves but not well enough. Obviously when no air moves.. Oxygen levels can fall they don't always but they can and do sometimes a lot.

Central apneas... The body does not perform the effort to forcefully inhale and exhale. Any number of reasons which I won't go into right now. So the body doesn't breathe.. no air is moving but the airway is open. Remember if no air moves..for whatever reason.. oxygen levels can fall. If you sit back and hold your breath for 15 seconds.. that technically is a central apnea but you are causing it. No air moves for 15 seconds and the airway is open.

An occasional short lived episode with no air movement..whatever the cause.. is not particularly stressful to the body and oxygen levels won't drop much.
Now if you have many more episodes of no air movement...that are much longer and more closely together..then we have a problem because the stress is hard on the body and our oxygen levels might drop significantly.

Do you ever witness your wife stopping breathing during the night? Gasping? Choking? Snoring?
While these are some pretty good signs that a person has a problem it takes a sleep study to tell for sure.
It takes a sleep study to tell the difference between centrals and obstructives.

Do you all have insurance that will cover these costs? It is not cheap. It is the best way to know for sure.
There are some alternatives to try if there is no money for sleep study but I won't get started on those right now.

The best course of action is to express your concerns to your regular family doctor and let him make the referral for a sleep study.

Most people have plain ordinary obstructive sleep apnea. Effectively dealt with by a cpap machine of some model.
Not a huge undertaking in most instances other than getting used to all the stuff.

For people who have either a lot of centrals with their obstructives or mainly have all centrals there is another type of machine that is very special and takes special instructions for use. Use of this type of machine should definitely be under a doctors care. No self treatment when it comes to large number of centrals requiring that machine. Also this type of machine is hugely more expensive than cpap or apap.

Hope I have answered your questions sufficiently. There is more to it but I tried to just cover the high points to get you started. Welcome to the forum. How does your wife feel about this possibility? My husband ragged my butt for over 2 years about it and he plainly saw me stopping breathing during the night. I wouldn't listen till I was ready.

[mars]

Hi

Sleep apnea, both obstructive and central, cause a loss of oxygen in the blood, called desaturation. This can be measured with an oximeter, and can be a useful first step if a sleep study is not immediately available.

http://www.sleep-apnea-guide.com/portab ... meter.html

another useful link is at

http://www.amperordirect.com/pc/r-perso ... apnea.html

cheers

Mars

[JonnyH]

Thanks everyone. Some really good stuff here and thank you Pugsy. I have read a bit about the apnea but I didn't know that it causes the airway to collapse. I think I was getting the two mixed up at first. We have insurance but it is not a very good one and they really don't pay for much. We don't have a family doctor but my insurance will cover different things if we have to call an ambulance. I will see about getting a sleep study if I can but if it's not an emergency then I will probably have to pay for it all. How much does it cost?

My wife snores like a chainsaw and that is why I stumbled across apnea and CPAP on the internet. But what is APAP? I have never heard that.

[Pugsy]

But what is APAP? I have never heard that.

oops.. It is a cpap machine that offers a range of pressures instead of one straight pressure (which we call cpap machines) My machine is APAP an auto adjusting pressure machine. I can use it to start out with at 10 cm of pressure and if for some reason I have some really stubborn airway collapses..I might need 16 cm of pressure and my machine will adjust itself and give me more pressure.

Straight cpap machine will only give one set pressure. It won't go up or down. Mine will.

So my machine is technically an auto cpap... we call it APAP for short. It is for treating plain obstructive sleep apnea.
I don't have any history of centrals to warrant me using the high dollar machines. I might have an occasional central or what my machine calls clear airway event but nothing abnormal. We all have them from time to time. Even people without the official OSA diagnosis.

You could do as Mars suggested and buy an overnight Pulse Oximeter that will record oxygen levels through the night.
About $100 will get you a nice one.
The only problem with using it as a purely screening tool for sleep apnea is that not everyone who has sleep apnea will have significant levels of oxygen drops (desats).
In other words if you use it and you find huge drops in Oxygen levels it probably indicates sleep apnea
BUT
If there are no significant drops in the Oxygen levels it does NOT mean no sleep apnea. People can have sleep apnea and not show significant drops in oxygen.. so at best you have a "maybe".

[archangle]

Listen to your wife while she sleeps. Especially when she's snoring. Does she stop breathing entirely for a while? Often, you will stop breathing, hold it for a while, struggle, and then "explosively" snore once you force enough pressure. Or snore, get more and more obstructed, then stop breathing mid-snore. Time how long she stops breathing.

[JonnyH]

Hmm, well you have all given me a lot to think about. I am going to call up my insurance tommorow and see if there is a place around here that does sleep studies. I was looking at the oximeter tester but it seems a bit pricy. If they say she does have the apnea then should we get a CPAP or an APAP? Which one is better?

[Pugsy]

Hmm, well you have all given me a lot to think about. I am going to call up my insurance tommorow and see if there is a place around here that does sleep studies. I was looking at the oximeter tester but it seems a bit pricy. If they say she does have the apnea then should we get a CPAP or an APAP? Which one is better?

The APAP .. like mine will also work in straight CPAP mode. So it is like I have 2 machines.
Not every one needs APAP or does well with variations in pressure (can disturb sleep) so cpap probably is better choice.

But one never knows if one might want to try variable pressures for some reason. So APAP is better in the sense you have the 2 options and not just one with a straight cpap machine.

If you are going to want to maybe try this all on your own (self diagnose and self treat) then get a machine like mine.
It will make the work easier. But that discussion is for a later time. Ideal course of action is a sleep study if at all possible because so much more is measured than just airways..

[MidnightOwl]

Now I've read that the apnea actually CAUSES depression.

Apnea CAN cause depression but most depression is NOT caused by apnea. Lots of things can cause someone to be tired and apnea is not necessarily the first thing you should assume. Do you have any other reason to suspect apnea?

This is good advice:

Listen to your wife while she sleeps. Especially when she's snoring. Does she stop breathing entirely for a while? Often, you will stop breathing, hold it for a while, struggle, and then "explosively" snore once you force enough pressure. Or snore, get more and more obstructed, then stop breathing mid-snore. Time how long she stops breathing.

If she does this she likely does have it.

[Sheriff Buford]

Jonny: I didn't see you speak about how your wife feels about the possible treatment. I admire your dedication to her. My wife is similar, but I don't think she has the depression. I have begged, bribed, argued, pleaded, threaten, ignored, had other family and doctor talk to her... with no luck.

Sheriff

[Lizistired]

Hmm, well you have all given me a lot to think about. I am going to call up my insurance tommorow and see if there is a place around here that does sleep studies. I was looking at the oximeter tester but it seems a bit pricy. If they say she does have the apnea then should we get a CPAP or an APAP? Which one is better?

Not sure what you mean by pricey, mine cost me $112. Worth every penny. The hospital charged medicare $300+ for my dad to use theirs for one night. Then the results, which we couldn't get for a week, were inconclusive.

[ThirdOutOfFive]

You don't have to completely stop breathing and then gasp or snore explosively to have apnea. I was told that I had just a gentle, constant snore; I was told I have apnea based on the number of arousals per hour. Both I and my husband were surprised, since he said I never stopped breathing. Still, I hope your wife will agree to have a sleep study, if only to prove that she does not have apnea. That was my reason for going in. . . .

Good luck.

[WalkingZombie]

I am newly diagnosed with SOSA. I am still very shocked that mine is severe. I would have bet money that I did not have apnea. My only symptom was my lack of energy. I never seemed to be able to get enough sleep. I would nap any time I had the chance. I don't snore. My hubby has never heard me stop breathing or gasp for breath. I was shocked when my doctor even suggested a sleep study. I thought the people at the sleep clinic would laugh me out of the place.
Since I was diagnosed a little over a week ago, I joined this group and have read alot. I realize that my memory loss and lack of concentration can also by caused by my apnea. But, like I said, I had none of the typical signs that people look for. I think I could be a poster child for someone who doesn't have many symptoms, yet was proven to have SEVERE OSA through the sleep study.
I wish you the best of luck in getting your wife diagnosed.