Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
NotNotLaosho
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Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by NotNotLaosho » Sun May 08, 2022 5:06 pm

Hi everyone.

Can sleep apnea manifest itself mainly via cognitive symptoms (poorer memory, inability to reason, poor concentration...) and without fatigue ? I am tired but it is quite recent whereas my cognitive problems have been going on for more than a year and a half now. Below is the complete story in summary and my symptoms.

My father has sleep apnea. I'm a man, I'm fat. I wake up sometimes (once every 3 or 4 months) feeling like I'm choking/drowning, I might have high blood pressure (but it might be a consequence of my diet) since everything began. I did a STOPBANG test found on the net and I got a 5/8 (the method is not rigorous, I know, but since it's only a score, I guess it's not that unreliable).

It all started around October 2020. At the time I had been on 50mg daily of Sertraline (an SSRI) for about ten months to treat OCD. I felt like I had lost 50 IQ points, just like that, for no reason, I felt dumber than a few months before. I told my psychiatrist about it and he said it was probably a side effect of the antidepressant. It was annoying, but I didn't worry about it any more than that until I went completely off the meds in January 2022. These symptoms never went away and seem to indicate sleep apnea, I have an appointment with a doctor before I do a sleep study around the fifteenth of May.

Snoring: I snore loudly according to those around me.

Interrupted breathing in my sleep: According to someone close to me, this has already happened. Also, I sometimes wake up feeling like I'm drowning.

Cognitive Problems: I have always understood everything fairly quickly, in fact I don't remember ever having trouble understanding anything. Now everything takes me forever to figure out when I do, even things I used to know I understood (I can't recognize the pattern of a simple cross product anymore). I used to be able to concentrate well, this is not the case anymore, reading a simple newspaper article can be complicated sometimes. I used to love to read philosophy books, I can't do it anymore (including books I've already read where I got something out of them). I basically feel like I've lost 50 IQ points. I feel dumb.

Memory problems: I have often been suspected of being hypermnesic (no idea if this is the case, knowing this would be useless). I have always had a very good memory, almost a photographic memory at times, this is no longer the case at all.

Dry mouth in the morning: It's been happening less in the last few days but it was quite regular in the last few months.

I guess it seems pretty obvious that it's sleep apnea, but here goes... I'm not tired. All this makes me doubt and I don't know where to turn (my appointments with my doctor and then my sleep study will take place in about 10 days). So I wonder if it is possible to have sleep apnea without fatigue hence my question at the beginning of the post.

I hope I didn't make a mistake in translation, English is not my native language. I apologize if there are any mistakes in the text.

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Deborah K.
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by Deborah K. » Sun May 08, 2022 5:52 pm

It sounds like you probably do have apnea. Get the sleep study done, then you'll know for sure. I didn't notice any fatigue either, but I learned that I have severe apnea. I would never have guessed that. Try not to worry and hang in there until your sleep study. :)

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zonker
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by zonker » Sun May 08, 2022 6:07 pm

NotNotLaosho wrote:
Sun May 08, 2022 5:06 pm
Hi everyone.
welcome!
I hope I didn't make a mistake in translation, English is not my native language. I apologize if there are any mistakes in the text.
your english is very good. i'm sure i couldn't speak your language as well.

yes, it sounds like sleep apnea. you will know for sure when you've seen the doctor. please come back and let us know how it goes. we can help you get the best results when you start your treatment.

good luck!
life is good, with a circle of friends.

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Miss Emerita
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by Miss Emerita » Sun May 08, 2022 6:19 pm

Most certainly possible. My biggest symptoms were feeling stupid, irritable, and gloomy—not feeling a need to sleep during the day.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

Janknitz
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by Janknitz » Sun May 08, 2022 6:27 pm

Sleep apnea can absolutely manifest primarily as cognitive symptoms. But you are having MORE than just cognitive symptoms.
My father has sleep apnea. I'm a man, I'm fat. I wake up sometimes (once every 3 or 4 months) feeling like I'm choking/drowning, I might have high blood pressure (but it might be a consequence of my diet) since everything began.
Waking up feeling like you are choking/drowning sounds like gastroesophageal reflux, but it doesn't take you off the "possible apnea" list because when your airway obstructs, your struggle to breathe can cause a pressure gradient that pulls stomach contents up into the esophagus. High Blood pressure CAN be a symptom of sleep apnea (you are sleeping all night bathed in stress hormones. Obesity can also be a symptom of sleep apnea, because lack of sleep causes abnormal levels of insulin and ghrelin which regulate appetite. AND, obesity can in turn cause sleep apnea by pressure on the airway when you sleep.

So yes, you need to be tested, and treated if it turns out you do have apnea.
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Julie
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by Julie » Sun May 08, 2022 6:41 pm

That was such a good reply Janknitz! Really comprehensive.
Last edited by Julie on Mon May 09, 2022 6:41 pm, edited 1 time in total.

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Miss Emerita
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by Miss Emerita » Sun May 08, 2022 8:16 pm

Julie wrote:
Sun May 08, 2022 6:41 pm
That was such a good reply Miss E! Really comprehensive.
Thanks, Julie. I was just admiring Janknitz’s post.
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lazarus
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by lazarus » Mon May 09, 2022 9:42 am

Miss Emerita wrote:
Sun May 08, 2022 6:19 pm
feeling stupid, irritable, and gloomy
So now I'm wondering whether my own OSA is as well-treated as I thought.
Can sleep apnea manifest itself mainly . . .
I tend to answer "yes" no matter what follows those words. Bad sleep and bad breathing can make just about anything worse.

I thought I should post something distracting in order to balance out those good posts from Jan and Miss E.
"As long as we are fortunate enough to be breathing, we will breathe in, breathe through, breathe deep, breathe out. And I'm a doctor now, so I know how breathing works."--Taylor Swift after her honorary “Doctor of Fine Arts” degree from NYU.

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zonker
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by zonker » Mon May 09, 2022 10:24 am

lazarus wrote:
Mon May 09, 2022 9:42 am
Miss Emerita wrote:
Sun May 08, 2022 6:19 pm
feeling stupid, irritable, and gloomy
So now I'm wondering whether my own OSA is as well-treated as I thought.
Image
life is good, with a circle of friends.

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Miss Emerita
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by Miss Emerita » Mon May 09, 2022 11:37 am

zonker wrote:
Mon May 09, 2022 10:24 am
lazarus wrote:
Mon May 09, 2022 9:42 am
Miss Emerita wrote:
Sun May 08, 2022 6:19 pm
feeling stupid, irritable, and gloomy
So now I'm wondering whether my own OSA is as well-treated as I thought.
Image
In the immortal words sung by the Shirelles:

Mama said there'll be days like this
There'll be days like this, my mama said
(Mama said, mama said)
Mama said there'll be days like this
There'll be days like this, my mama said
don't you worry
(Mama said, mama said, hey, hey) don't you worry, now
(Mama said, mama said, hey, hey)
(Mama said, mama said, hey, hey) mama said there'll be days like this
(Mama said, mama said, hey, hey) there'll be days like this, my mama said
(Mama said, mama said, hey, hey) mama said there'll be days like this
(Mama said, mama said, hey, hey) there'll be days like this, my mama said
(Mama said, mama said, hey, hey) don't you worry
Oscar software is available at https://www.sleepfiles.com/OSCAR/

Janknitz
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by Janknitz » Mon May 09, 2022 12:42 pm

Miss Emerita wrote:
Sun May 08, 2022 8:16 pm
Julie wrote:
Sun May 08, 2022 6:41 pm
That was such a good reply Miss E! Really comprehensive.
Thanks, Julie. I was just admiring Janknitz’s post.
I admire all of you intrepid posters who help people out!
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

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zonker
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by zonker » Mon May 09, 2022 1:07 pm

this meeting of the mutual admiration society will now come to order.
life is good, with a circle of friends.

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lazarus
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by lazarus » Mon May 09, 2022 4:35 pm

Janknitz wrote:
Mon May 09, 2022 12:42 pm
intrepid posters who help people out!
As much as I liked the answers, I most of all liked the wording of the post of the original poster in this thread. Very well asked and on point. The question alone of this thread is likely to help many who have wondered much the same thing. Well done for people of any and all languages.

I hereby bestow the official Lazarus' Favorite Question of the Week Award (LFQotWA) to the original poster. Thank you, NotNotLaosho, for asking that question exactly the way you did.

Seriously.
Miss Emerita wrote:
Mon May 09, 2022 11:37 am
In the immortal words sung by the Shirelles:
Mama said there'll be days like this
In reply, in the immortal words of John:
Nobody told me there'd be days like these / Strange days indeed / Most peculiar, mama
"As long as we are fortunate enough to be breathing, we will breathe in, breathe through, breathe deep, breathe out. And I'm a doctor now, so I know how breathing works."--Taylor Swift after her honorary “Doctor of Fine Arts” degree from NYU.


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Chris33022
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Re: Can sleep apnea manifest itself mainly via cognitive symptoms and without fatigue ?

Post by Chris33022 » Tue May 10, 2022 3:21 pm

NotNotLaosho, thanks for posting this interesting question! I'm still a newbie and was often wondering the same thing. I'm a 54 year old woman and started CPAP one month ago and was never tired the past few years, during which time I had sleep apnea and would often wake up gasping (turns out I have severe sleep apnea when on my back, as per the sleep study I finally did), but since I started CPAP I've been quite tired (I assume due to how hard I'm finding it to get used to this machine). I have no choice but to mostly sleep on my back, due to a bad hip which I guess I will have to get replaced.

The symptoms I did have before CPAP were brain fog and terrible migraines (often starting during the night, but sometimes during the day) that would usually last for 2 or more days. Since starting CPAP, the only symptom that seems to have really gotten better are the migraines, which is great. I'd much rather be tired than have migraines. One weird thing is that I'd lost a lot of weight these past 2 years without even trying. I'm 5'10" and I'd gotten got down to 140 pounds. I attributed it to not leaving the house during Covid and therefore no longer being faced with the temptation of the pastry shops I'd walk by. And I also attributed it to the fact that I'd noticed a strong correlation between my migraines and certain fats. If I ate olive oil or chocolate or salmon or other high-fat things, even/especially "good fats," I would usually develop a terrible migraine a few hours later. Since starting CPAP, I no longer seem to have this problem, which in a way is unfortunate because it means I no longer have to deprive myself of fats. Perhaps partly as a result of this, I've gained weight since starting CPAP a month ago. I Googled this and was bummed to discover that studied have shown that sleep apnea makes people lose weight and treating it (even by means other than CPAP, such as taking out tonsils in children) makes people gain weight. I'm sure there are plenty of exceptions, such as people who lose weight on CPAP because they have more energy to exercise.

My brain fog doesn't seem to have improved very much yet since I started CPAP, perhaps due to the tiredness caused by CPAP. And in addition, I've written novels my whole life, and the past couple of years I feel that my creative drive has left me, which makes me sad. Not sure why, not sure if it's in any way related to sleep apnea (though as I said I wasn't tired at all).

Oh, one final thing, and I've been tempted to post a thread about this at some point: something very strange has happened to my teeth the past few years. All the enamel has been disappearing. My teeth look dreadful now. I've gone to at least five dentists who said they've never seen anything like it and have no idea what might have caused it. After everything I've read, I'm starting to think it was maybe just dry mouth from being a mouth breather when I sleep. My mouth would get horrendously dry at night, and in fact, it's been comparatively nice and moist since I started CPAP, which I know is contrary to what most people say.

Sorry for this long post. That's it. Good luck.