Misdiagnosed with OSA: Pacemaker needed for sleep syncope

This is what happened to me: it may be unusual or it may be more common. But it‘s what happened to me and I’d like to share it: I was misdiagnosed with OSA when I needed a pacemaker.

For years I was tired, snoring, thrashing about in bed and on the point of exhaustion all day, every day. I got sent for a sleep study and was recorded with an AHI of 48 with up to 45 seconds between breaths: I was duly diagnosed with OSA and given CPAP.

I improved markedly on 6.1 cm of pressure and it was assumed I did have OSA: however since I am slim, quite fit and had [almost] no other health problems everyone expressed surprise I could have OSA (everyone except those selling me medical advice and equipment from the OSA industry, that is). I have always had pulse of about 60, which is lower than usual, and a blood pressure at the low end of normal.

When I asked if the fainting spells I was having (and had had since age six with them being less common from about 15 years old to 40, I'm 45 now), could be related, I was met with eye rolling, epilepsy medication and, more helpfully, an insertable loop recorder which monitored my heart 24/7.

The last five episodes I had were all at night: I’d wake in the early hours, feel very nauseous, get up for the bathroom and pass out on the way waking up groggily, still nauseous and sweating profusely.

The last one, about a year ago, was recorded and showed I’d had 10.4 seconds of asystole (flatline, no pulse) which is what knocked me out. I was then given a pacemaker and from the moment I woke up I felt so much better all the time. All the symptoms of OSA disappeared and a new sleep study proved I did not have OSA as I had an AHI of about 2. It works about 10 times a day boosting my pulse when it goes too low (which is set as 40).

A loop recorder capturing an event is the only practical way to diagnose what I have, cardioinhibtory vasovagal syncope which presented in me in the less common form of sleep syncope. It means that the vagus nerve becomes stimulated and causes a range of effects that can include what I’ve described above: OSA-like symptoms and loss of consciousness including overnight and even during sleep.

So, I’d just like suggest that a slow heart and low blood pressure can be associated with the same symptoms as OSA, even in a sleep study, but in cases of syncope the needed treatment may be a pacemaker, not CPAP.

I'm lucky to have Sleep Apnea, I can treat it myself. They put a defib pacemaker in me in 2006., they installed it with defective leads, it never worked period, they didn't correct it, just lied and said it was working. Now the battery is in it's eighth year, they still say it's working fine.

When it's time to change the battery, it's coming out, period. So you were lucky, you didn't have my doctors. Jim