Sleep Apnea Symptoms & Questions to ask

Bogof · Post by **Bogof** » Thu Jul 19, 2007 9:16 am

Hi,

We all know the Epworth sleepiness scale which no doubt most of us have relayed to family or friends in a bid to find out whether they too suffer from sleep apnea.

Besides the 'do you snore' and 'do you stop breathing' obvious symptoms and questions, which questions to you ask potential cpap candidates to determine whether they suffer from this disorder?

I'm trying to come up with the definitive apnea questionnaire, hopefully!

DreamStalker · Post by **DreamStalker** » Thu Jul 19, 2007 9:24 am

Bogof wrote:Hi,

We all know the Epworth sleepiness scale which no doubt most of us have relayed to family or friends in a bid to find out whether they too suffer from sleep apnea.

Besides the 'do you snore' and 'do you stop breathing' obvious symptoms and questions, which questions to you ask potential cpap candidates to determine whether they suffer from this disorder?

I'm trying to come up with the definitive apnea questionnaire, hopefully!

I used to have to visit the bathroom several times a night. I also noticed that as the severity of my OSA increased, I started waking up to a pillow full of drool. I often awoke with migrane headaches and overall body aches.

Of course there is the obvious ... being sleepy when driving for more than an hour or two ... falling asleep at work in front of the computer ... being exhausted all of the time no matter how early I went to bed.

Then there is the gradual weight gain and inability to loose weight (although there are some who do not have the weight issue).

Bogof · Post by **Bogof** » Thu Jul 19, 2007 10:19 am

Thanks DreamStalker, that's very helpful.

I'm also wondering (based on some tests I've read about) whether waist to hip ratio and collar size are decent enough indicators to be included in any sort of sleep apnea questionnaire. Any ideas on that?

skjansen · Post by **skjansen** » Thu Jul 19, 2007 10:31 am

My worst symptom beyond the obvious...being extremely tired even after sleeping all night...was ANXIETY. My doc says when he sees a patient with extreme anxiety that appears to have no real reason he always suspects sleep apnea. I went 18 years without getting a diagnosis because I did not snore, was not excessively overweight and did not have a large neck.

One other thing the docs looked for was how large the throat opening is. I have huge tonsils and adenoids and that appears to block my airway at night.

tuna · Post by **tuna** » Thu Jul 19, 2007 10:46 am

Lack of o2 causing waking up in a panic attack! That would happen to me..

Bogof · Post by **Bogof** » Thu Jul 19, 2007 10:50 am

Thanks skjansen, anxiety is another good one.

I wonder whether a method exists to simply measure throat opening size without a doctor's involvement.

As far as oxygen is concerned, that would have to be measured with non-domestic equipment so besides mentioning 'gasping for air' as a symptom, going into o2 detail is probably a bit much for a paper based survey.

Guest · Post by **Guest** » Thu Jul 19, 2007 10:51 am

I don't like the Epworth very well for me. Having GERD is also correlated with sleep disordered breathing.

In my case, I wasn't aware of feeling tired, I didn't snore and I wasn't overweight. But every afternoon I'd start to feel "brain dead." I just couldn't think well after 3 or 4 p.m. When anyone asked me how I was feeling in the afternoon or evening, I'd say "brain dead." To me tired was how I felt when I got no sleep, the "brain dead" thing was ongoing. I have moderate OSA.

I would also have said that I had low energy and was easily exhausted. But for me, tired is not the word I'd have used because tired is not a chronic, but rather an acute state.

Another symptom, in my case, was great difficulty in handling my environment. I could never get organized although I have reasonable organizational skills and worked hard at organizing. It's much easier now and I think I may finally have a house that I'm not ashamed to have people come into.

Memory problems are a big one, too.

sharon1965 · Post by **sharon1965** » Thu Jul 19, 2007 10:53 am

obviously fatigue and daytime sleepiness...but also muscle pain and weakness, not feeling rested no matter how long you've slept, craving sleep, heartburn was a big one for me, along with sudden rapid weight gain unrelated to diet or activity level; snorting and gasping along with the snoring; brain fog, inability to concentrate, memory problems, word retrieval difficulties, irritability, mood swings, low energy, low motivation; waking with heart pounding, gasping for air; nightmares

Guest · Post by **Guest** » Thu Jul 19, 2007 10:57 am

Depression (mild) that occurred if I got only one night of sleep that was 6 hours or less. (No longer happpens).

Hyperfocusing/intense focus. In order to function at all, I have to keep my attention limited to the important thing, the thing at hand. My adrenalin kept me going.

In the afternoon or evening I would talk a blue streak, but it wasn't good conversation. I think I talked to keep myself awake. I would later feel embarrassed knowing I wasn't a good conversationalist. If I stopped to listen I'd lose my train of thought totally. I think my brain was trying to dream while I was awake sometimes, too. Kind of bizarre. I was very REM deprived.

Captain_Midnight · Post by **Captain_Midnight** » Sat Jul 21, 2007 12:38 pm

Hi Bog - -

Back in February I started a project to develop a compendium of symptoms for OSA. My objective is to put them into a stand-alone website that could be a useful reference for both docs and prospective patients.

Of course, the biggest issue is that many symptoms have only a rare (or even disputed) association with OSA. No worries, I'm going to list them all initially with the qualification that some symptoms are not, as yet, connected to OSA with a high degree of certainty within the scientific and medical community.

To see my prototype list, go to the following link to my post at the ASAA site.

http://www.apneasupport.org/viewtopic.p ... highlight=

Comments and suggestions welcome.

Oh, one important note. Although I'm "Woofman" at the ASAA site, I'm not the same poster as the venerable "Wulf man" hereabouts. (Coincidence, not a copy. What are the odds?)

Regards all -- Cat Midnight.

Bogof · Post by **Bogof** » Mon Jul 23, 2007 1:35 pm

Thanks Rosemary, Sharon and Captain Midnight!

Thanks to your help, relentless Googling, learning about javascript and many long nights, I can now reveal the Online Sleep Apnea Screening Test.

Three tests combined into one survey: Epworth, Berlin and additional questions, mainly those you guys suggested. Thanks a lot for your contribution!

I'm hoping (possibly with some improvements after user feedback) this will be a nice, convenient, useful, easy-to-use, one-stop "Do I have Sleep Apnea?" site. From lurking the many forums, that seems to be one of the most frequently asked questions so I hope the standard reply will become a link to this questionnaire Feel free to put it in your bulletin board signatures, that would be awesome exposure! The more people we can get diagnosed and teated, the more happy friends we will make.

Thanks again for your input and I welcome continued feedback!

SleepGuy · Post by **SleepGuy** » Mon Jul 23, 2007 1:43 pm

Don't overlook the "Berlin Questionnaire."

It consists of ten very simple questions used to evaluate risk factors for sleep apnea, such as snoring behavior, waketime sleepiness or fatigue, and obesity or hypertension. The Berlin Questionnaire has been proven to have strong predictive value. For patients scoring as being at "high risk" based on the questionnaire, its positive predictive value is 89% (89% of those people will test as having sleep apnea in a sleep lab).

Here's a link:

http://www.pur-sleep.com/uploads/Berlin ... nnaire.pdf

Bogof · Post by **Bogof** » Mon Jul 23, 2007 1:45 pm

SleepGuy wrote:Don't overlook the "Berlin Questionnaire."

Thanks! But it's already in there Good suggestion though!

SleepGuy · Post by **SleepGuy** » Mon Jul 23, 2007 1:56 pm

Bogof wrote:
SleepGuy wrote:Don't overlook the "Berlin Questionnaire."
Thanks! But it's already in there Good suggestion though!

guess I should have read it all the way through. Then you're definitely on the right track.

I think getting the word out is extremely important.

I don't know what the stats look like in the UK but they can't be too different than the US. For years the studies showed about 20 million Americans with OSA. Now the most recent survey--a very good one from 2005--shows that 25% of all Americans over 18 are at high risk for OSA (one third of all men and one fifth of all women). Another study that extended into Europe, using the Berlin Questionnaire I might add, showed that ONE THIRD of ALL patients over 18 who see a primary care doctor are at high risk. In this study all they did was have patients over 18 fill out the BQ as part of the normal office intake procedure.

Based on the 2000 US Census, that means that 50 million Americans are at high risk for OSA. Sadly, only a relatively small fraction of them have any idea about the condition.

Bogof · Post by **Bogof** » Mon Jul 23, 2007 2:06 pm

Things are similar here. I recently blogged about how there are around 750,000 OSAHS sufferers in the UK, of which just 180,000 have been diagnosed and just 20,000 are on CPAP, leaving the rest untreated or with inferior solutions.

Those number will only rise, mainly with obesity on the increase and funding for sleep disorder treatments being slashed.

What's scariest though is how many people discard their sleep issues as not so important. I'm hoping this site will help in that regard, especially with the Tell a Friend feature.

Sleep Apnea Symptoms & Questions to ask

Sleep Apnea Symptoms & Questions to ask

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Symptoms compendium