Can you have sleep apnea during the day?

[zonk]

This question from sleep disorder - 04/25/2012
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Question:

I have just been diagnosed with a sleep apnea hypopnea. However I have not yet seen the doctor for a follow up. I am trying to get an understanding before I see him this week. My reports said that I had 38 hypopneas in 1 hour of the sleep study (I did not have a complete study due to the disturbances in the environment) with a mean duration of 22.9 seconds and maximum of 38.5. I understand that this is shallow breathing. I wonder if I experience this throughout the day because I always feel like I am holding my breath and have to remind myself to breath. I take deep breaths and sigh often. If it is possible that sleep apnea does exist in daytime, what could be the causes? Friends have asked me if it could be anxiety, but I do not feel that it is. I love my job and have a wonderful family. I am definitely fast-moving and have high energy. I was wondering if it could be neurological. Thank you.
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1st answer: Syed Nabi MD wrote

It is best you get treated for your sleep apnea. Brain is a funny thing with complex physiology during day and it changes during sleep. You may be surprised that your daytime breathing improvesl as your sleep apnea improves with CPAP. Sleep apnea happens only during sleep and not while awake, but i have seen some people reported breathing better during day as well. It is one of those things you will have to try CPAP to know how it goes.
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2nd answer: J. Douglas Hudson, MD, DABSM wrote

Yes, you can have sleep apnea in the daytime if you are napping. I assume, however, you mean can you experience apnea while awake, not asleep, in the daytime. Yes, you can. This is usually Central Apnea caused by a malfunctioning of the brain respiratory center and/or a malfunction of the normal oxygen and carbon dioxide interchange which tells us to breath or exhale. Sometimes it is not necessarily secondary to any abnormality of the brain or other organ system which affect the oxygen ratios (heart disease, for example). But, it can be present in normal individuals who go to high altitude areas like Colorado or deep sea divers who become accustomed to holding their breath for long periods. If you have an Apnea/Hypopnea index of 38 per hour you need to be treated, preferably with CPAP therapy (continuous positive airway pressure) or Bi-level PAP. You should also be checked out to see if you have any abnormality of your lungs.
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3rd answer: Richard J. Schumann Jr., MD wrote

By definition the sleep apnea events occur during sleep and are confined to that state of consciousness. Sleep apnea is a cessation of breathing that lead to low oxygen and raised carbon dioxide which toxic to the heart and vasculature. Treatment with CPAP or an oral appliance if only mild to moderate in severity should continue if it hasn't begun already. If you have shortness of breath, an irregular daytime breathing pattern or breath holding spells then referral to a pulmonologist or possibly a neurologist may be of benefit to you.
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[trish6hundred]

Hi zonk, this post is interesting. If I'm gonna take a nap during the day, I ALWAYS use my machine. I used to try like heck to get my mom to use her machine while she took naps but I never could get her to do that.

[archangle]

A few comments.

1) As one of the doctors implies, if you're sleeping or napping during the day, it's the same as sleeping at night. I don't think that's what we're talking about.

2) Normal healthy breathing patterns during the day may look like apnea to a CPAP machine. There's different "software" in your body for breathing while asleep. For instance, we may stop breathing for a while when we're thinking deeply while awake. You'll start breathing again before it does you any harm. If you're asleep, this breathing pattern would not happen unless you have some sort of unhealthy problem.

The point is that a CPAP machine may show apneas if you're awake and it doesn't usually mean anything.

Your normal PSG sleep test will ignore any breathing problems while awake when grading sleep apnea. Part of the reason they put EEG electrodes on you is to tell if you're asleep.

3) If you have breathing problems while awake, the cause, diagnosis, and treatment is usually different from the treatment of what is called "sleep apnea."

4) I presume if you have breathing problems while awake, there's a good chance they will continue during the night.

5) I wonder if people with central sleep apnea tend to stop breathing the same way while awake as they do while asleep?

[mjbearit]

While I would not label them as Apneas, I think the answer is yes. Okay, the explanation. I have 2 issues that kinda bug me and I have no intention of going through the system so don't even go there! If I am laying down or reclining doing something like watching television or reading my airway will begin to collapse on a regular basis as I relax (yes, I am wide awake). And it is very annoying as it basically causes the same symptoms as OSA in sleep, but since you are awake, you react quickly and change position or something. The other issue is that from time to time when I am involved in something I just "forget" to breathe. Eventually I realize I am O2 starved and start sucking in air. Since I am awake, I am aware of these issues when they occur and as soon as they come to my attention I am able to fix the problem, or at least change positions or breathe or whatever. It is not sleep apnea in the classic sense because I am not asleep, but it is the same mechanical problems. I don't feel that they are dangerous because since I am awake when they occur I doubt my O2Sat levels drop more than a percent or 2 at most. So the answer is yes, and no...from my perspective.

[Schnauzers 5]

I think if I have sleep apnea, I have it 24/7 whenever I doze off or go to sleep. I also think being overweight is a very serious problem and I still struggle to get the weight and body fat off. Heck, I don't eat much fat and no dairy or animal protein. You would think I'd be thinner now. Nope, only lost 10lbs and some was water retention.

[concerned1]

I have had a similar problem for quite a while but thought maybe I was just imagining it. Lately though the problem of unconsciously not breathing (it is NOT holding my breath but literally feels like i 'forget' to breathe) seems to be worse. I am quite alarmed by this and am not sure what to do. If it is either neurological or pulminary in nature what can be done? I must say though that I am relieved and concerned that I am not the only one experiencing this (I thought I was nuts!). My final question is whether or not this type of issue is becoming much more prominent lately and if any studies have been done on what Apnea sufferers are self describing as 'daytime apnea' issues?

[MAPnea]

I've often felt that I have to consciously remember to breathe at various times during the day. Now that I've read this post, I think I'll wear my (recording) pulse oximeter during the day for a few days and see if my O2 levels drop. I live at 5,700', so maybe that is part of the "feeling" I need to "remember" to breathe. That, and the fact that I'm getting older.... and older.

[justMongo]

I had somewhat sub normal saturated oxygen level all the time at about 88%.
That has improved to about 94% after 4 years on CPAP.
I asked my doc about it -- he said, "people who have sleep apnea for a long time often lose some central ventilation drive."

You might also look up Pickwickian syndrome. Named for an Oliver Twist character, it refers to hypoventilation in obese persons.

Another thing to consider with OSA -- it may cause the collapse of some of the lung avioli. This condition is called Atelectasia.

Note that Atelectasia can be caused by too high a percentage of oxygen in a cpap flow augmented with oxygen.
The O2 is pulled into the blood reducing the gas volume; and my collapse avioli.
So, for those on oxygen in conjunction with CPAP, your physician likely told you not to turn the flow rate up too high.

[concerned1]

What is central ventilation drive?

[justMongo]

What is central ventilation drive?

In medulla of the brain, sometimes referred to as the old brain, where our basic life support functions are controlled is the central respiratory drive. It's a closed loop system that uses inputs from various autonomic nervous system receptors to regulate breathing.

pH and CO2 are primary substances that are detected and used to regulate breathing.

You might wish to read the article in Wikipedia under, "Control of respiration."