questions for a college paper

[Sleepster]

Laurend, I've merged your other thread with this one, and put it in the main forum where more people will be able to see it.

[bwexler]

Thanks for replying to my post!
For anyone who wants to help out, my paper is due next Wednesday, so if you want to answer some questions it would be great if you could reply to them by the weekend

In my report I talk about there being 3 types of sleep apnea: obstructive, central, and mixed--which is a combination of the two.
1. So first I'll ask, what type of sleep apnea do you suffer from?
Complex or what you refer to as mixed.

2. How long have you had sleep apnea?
I was diagnosed 3 years ago. I am sure I had it before that but was unaware.

I've found that symptoms of sleep apnea often go unnoticed by the person who has it because they don't realize what they're doing while they're asleep.
3. What symptoms did you have that lead you to find out you have sleep apnea?
I was diagnosed with atrial fibrillation first. The same doctor suggested that sleep apnea goes hand in hand with afib and tested me to confirm.

I've also found that in order to be diagnosed with sleep apnea, you have to have a sleep study done.
4. Have you had a sleep study done? If so, what was that like, how long did it last, where was it done? Anything you can tell me about that experience.
My first sleep study was done in a lab in Las Vegas. It is an overnight study. It typically starts at 9 or 10 PM until 5 or 6 AM.
The labs have several rooms set up like a typical bedroom plus some equipment, EEG, EKG, remotely monitored PAP machine, pulse oximeter and infra red video camera. They attach wires to your body from the top of your head down to your legs. Put the oximeter on your finger and straps around your chest and PAP mask on your face.
Once your wired they tuck you in bed turn out the light and go to the control room. From the control room they can watch each of the patients and monitor all of our vital signs while the adjust the PAP machine to determine weather we have apnea, what type, and what settings will be required.
There is general agreement that no one gets much sleep and one night can not provide an accurate picture of your condition.
My second sleep study was 2 weeks ago when my diagnosis was updated from Obstructive to complex apnea. The experience was much the same.

5. What do you do to treat your sleep apnea? Do you use a CPAP mask?
Treatment require a Continuous Positive Airway Pressure machine (CPAP) with a hose and a mask. The CPAP machine does all the work, the mask simply connects it to your airway.
There are several basic types of PAP machines, Fixed pressure, Auto adjusting, Bilevel, and Servo Ventilator. I just switched from an auto to a SV. I will let those with more expertise expound on the differences.

6. If you use a CPAP, how do you like it? Did you have a hard time adjusting to it when you first started using it?
It is a love hate relationship. I love to breathe, it helps me breathe, so I love it. It is like a crab attached to your face with a hose connecting it to your machine. It can be uncomfortable, especially when it wants you to adjust your breathing at a different rate than you want.
I've read that there is a surgery called a tracheotomy, that can help fix sleep apnea problems.

6. Have you had that surgery? Would you ever consider having it?
NO! NO!

Thanks!
Lauren

[jgjones1972]

In my report I talk about there being 3 types of sleep apnea: obstructive, central, and mixed--which is a combination of the two.
1. So first I'll ask, what type of sleep apnea do you suffer from?

Obstructive

2. How long have you had sleep apnea?

I was diagnosed about 1 year and 2 months ago; but, I'm fairly certain I have had it for about 20 years or more...the symptoms were much less pronounced back then and got worse as I got older...OSA was not suspected as a cause for them back then. Since these symptoms have immediately cleared up with the successful treatment of my Obstructive Sleep Apnea (things like Depression, GIRD, Hypertension, Edema, etc.) I assume OSA was the cause and I must have started developing OSA back when I started developing these symptoms.

I've found that symptoms of sleep apnea often go unnoticed by the person who has it because they don't realize what they're doing while they're asleep.
3. What symptoms did you have that lead you to find out you have sleep apnea?

I suspected I might have sleep apnea for several years; but didn't take action to get treatment because I had no idea that it might be responsible for many of the conditions I had. I knew I snored very loudly and was told that I sometimes stopped breathing and then woke up gasping for air, so I figured I had OSA; but thought it was likely only causing some daytime sleepiness and little else. I didn't seek a diagnosis and treatment for OSA until that daytime sleepiness progressed into Narcoleptic events.

I've also found that in order to be diagnosed with sleep apnea, you have to have a sleep study done.
4. Have you had a sleep study done? If so, what was that like, how long did it last, where was it done? Anything you can tell me about that experience.

I had a Home Sleep Study...simple, quick, easy and much cheaper than a full-blown in-lab Sleep Study. Get a package in the mail, watch a video that shows how to put it on, wear it one night (at least four hours of sleep), pack it back up and ship it back - results in just a couple days.

5. What do you do to treat your sleep apnea? Do you use a CPAP mask?

Auto CPAP with Full Face Mask

6. If you use a CPAP, how do you like it? Did you have a hard time adjusting to it when you first started using it?

I love it - I took to it like a duck takes to water...keep in mind though, by the time I got my CPAP I was in such bad shape and so desperate for a good night's sleep I could have slept with a bag full of rattlesnakes over my head.

I've read that there is a surgery called a tracheotomy, that can help fix sleep apnea problems.
6. Have you had that surgery? Would you ever consider having it?

No. I would not consider having a tracheotomy - though I would have considered it if CPAP did not exist.


Good luck with your paper!

[DeepBreathing]

Hi Lauren

Here are my answers - Hope they help.

1. Mixed - both central and obstructive

2. I don't know, as I was only diagnosed in the past few months. However my beloved has been complaining about my snoring for a couple of years.

3. I've had a lot of symptoms which I put down to other things. I'm a chronic insomniac, so when events such as dozing behind the wheel occurred I put that down to lack of sleep rather than suspecting apnea. I always woke up with a headache every morning, which I put down to another condition. However I was referred to a cardiologist because of heart arrhythmia, and she suggested I may have apnea which was causing or contributing to the arrhythmia.

4. Yes, I had a polysomnogram. It took place in the sleep clinic at a private hospital here in Perth. I arrived mid-evening, and went through a battery of tests (blood pressure, ECG, lung capacity etc), then was wired up for the sleep test. I counted 17 different electrodes and sensors attached to my body - head, face, chest, abdomen, legs. The room was like a standard hospital room with the exception of a console for all the electrodes, a CPAP machine, and a CCTV camera. I slept reasonably well and got breakfast in bed (unaccustomed luxury).

After the test the doctor showed me the results ("very severe" apnea, with both obstructive and central events). They issued ma a CPAP machine and mask there and then, and booked a follow-up appointment for a week's time. I was in two minds about getting the machine straight away - I felt that they may have been taking advantage of me in a vulnerable situation. However, on reading how long it typically takes for American users to get sorted I'm glad that I got started immediately.

5. I use a PAP machine. I got a ResMed S9 Auto on a month's rental which included four appointments with the therapist. After the four weeks I still wasn't getting a huge improvement so they changed it to a Philips Respironics Bipap - this has been much better. I use a full face mask - now on my 4th or 5th - it took a while to find one I was comfortable with.

6. At first I had trouble with the mask leaking and high pressures causing a drowning sensation. With adjustments to the pressure and a a series of different masks I have now reached the point where I'm comfortable with both the mask and machine. However I still take it off in my sleep quite often.

7. No - I've never had surgery for my apnea. I think you'd be pretty desperate to go for a tracheotomy, though there are other surgical procedure available. From what I've read, surgery is very painful and has mixed results.

There you go - I hope that's been of some help
Regards
Paul

[Tez62]

Lauren, welcome from Australia

1. What type of sleep apnea do you suffer from?
Complex or Mixed

2. How long have you had sleep apnea?
Have been diagnosed for 2.5 years, but have had it my whole life 51 years

3. What symptoms did you have that lead you to find out you have sleep apnea?
Was diagnosed with depression, symptoms - tiredness, aches and pain through out my body, I used to only sleep 1-2 hours per night, foggy head, memory loss.

4. Have you had a sleep study done? If so, what was that like, how long did it last, where was it done? Anything you can tell me about that experience.
Pretty much everyone has to have a sleep study to be diagnosed either in a hospital / clinic or by a home sleep study. You have around 20 wires attached to different parts of your body to monitor you and are filmed and monitored during your sleep study.

5. What do you do to treat your sleep apnea? Do you use a CPAP mask?
CPAP is the gold star treatment for sleep apnea and really the only effective treatment at the moment.

6. If you use a CPAP, how do you like it? Did you have a hard time adjusting to it when you first started using it?
I love my CPAP, it saved my life and keeps me alive, a lot of people have difficulty adjusting to mainly the mask and the idea that they will have to be connected to a machine every night of their life.

7. Have you had that surgery? Would you ever consider having it?
NO WAY, have heard surgery is very painful and has a very small success rate.
Losing weight can help reduce the serverity of sleep apnea but again have not heard of many people where it has cured them.

Good luck and would love to hear your results when you get them.

[skyler]

Thanks for replying to my post!
For anyone who wants to help out, my paper is due next Wednesday, so if you want to answer some questions it would be great if you could reply to them by the weekend
Thanks!
Lauren

Good luck with your paper.
I was diagnosed in April of 2008 with an overnight sleep study done in a hospital sleep lab. I had gone to my GP because I could not stay awake during the day and was sleeping 12-14 hours a night. I would get up in the morning and promptly fall asleep standing up, eating breakfast, anything. I could not safely drive, though I would load up on Red Bull and 5 Hour Remedy and be somewhat alert for about 30 minutes.
The sleep study was fun. I was very interested in the outcome and anxious to find relief from my sleepiness. It lasted from 10PM- it took an hour to get all wired up so we started at 9PM- and lasted until 6AM the next morning. I slept like the dead and don't remember anything from that night.
I had another sleep study done- a "titration" study where they determine the pressure needed to stop my apnea. I barely qualified for a cpap with an apnea/hypopnea index (AHI) of five, five being the cutoff for diagnosis. Since my sleepiness was so severe I jumped at the chance to use a cpap machine. It was a bit difficult to get used to the mask. I used a full face mask (FFM) as I breathe through my mouth and the mask caused a sore on the bridge of my nose that would not heal. I also struggled with leaks. The machine was no problem. I was desperate to feel better.
It took four years to iron out all the wrinkles with my therapy, but here I am five years later and I have my life back. I would not consider surgery because my cpap therapy is successful and I would not have a tracheostomy for the same reason. If my cpap therapy did not work I would continue other options.

[Peter_C]

Thanks for replying to my post!
For anyone who wants to help out, my paper is due next Wednesday, so if you want to answer some questions it would be great if you could reply to them by the weekend

In my report I talk about there being 3 types of sleep apnea: obstructive, central, and mixed--which is a combination of the two.
1. So first I'll ask, what type of sleep apnea do you suffer from?
Obstructive

2. How long have you had sleep apnea?
About 12 years now

I've found that symptoms of sleep apnea often go unnoticed by the person who has it because they don't realize what they're doing while they're asleep.
3. What symptoms did you have that lead you to find out you have sleep apnea?
My Doctor found my at rest heart rate to not go below 122, after many different tests I was found to have severe OSA.

I've also found that in order to be diagnosed with sleep apnea, you have to have a sleep study done.
4. Have you had a sleep study done? If so, what was that like, how long did it last, where was it done? Anything you can tell me about that experience.
I have had four sleep studies done so far. Each one was done in a 'sleep lab'. Sadly, I never got much sleep, due to all the wires, and other stuff hooked-up. The one suggestion I can offer is to make sure you are very tired when you go, as if you don't sleep, it won't work.

5. What do you do to treat your sleep apnea? Do you use a CPAP mask?
Yes, currently bounce between a nasal mask, and nose pillows, but have a full face mask on order.

6. If you use a CPAP, how do you like it? Did you have a hard time adjusting to it when you first started using it?
I never sleep without my 'dream machine'. I have no problem at this point, but did have a tough week when I first started with it. Mask issues is my biggest issue.

I've read that there is a surgery called a tracheotomy, that can help fix sleep apnea problems.
6. Have you had that surgery? Would you ever consider having it?
No I haven't, and for me it is the last choice. I have had both nose and some throat surgery. Of course, if xPAP failed to work, and this was the only option, then there would be no choice.

Thanks!
Lauren

[Sleepster]

In my report I talk about there being 3 types of sleep apnea: obstructive, central, and mixed--which is a combination of the two.
1. So first I'll ask, what type of sleep apnea do you suffer from?

Obstructive.

2. How long have you had sleep apnea?

No way to know. I was diagnosed with it two years ago. I think I had it for at least 25 years, if not for my whole life.

3. What symptoms did you have that lead you to find out you have sleep apnea?

My wife complained that I was snoring. I was having trouble sleeping and it just kept getting worse so I saw my ENT doctor to find out if there was a possible connection between my snoring and my inability to sleep. He immediately ordered a sleep study and I was diagnosed with moderate obstructive sleep apnea.

4. Have you had a sleep study done? If so, what was that like, how long did it last, where was it done? Anything you can tell me about that experience.

It was overnight in a sleep lab. I slept in a room that was made to look and feel like a nice hotel room with a private bath. Of course there's a technician who hooks up a bunch of sensors to your scalp and other places on your body so you have to go in there with clean hair and no conditioner. The tech talks to you for about an hour while you get hooked up. Then you have to call him every time you need the restroom. And there's a camera fliming you.

5. What do you do to treat your sleep apnea? Do you use a CPAP mask?

CPAP with a nasal pillows mask and a chin strap.

6. If you use a CPAP, how do you like it? Did you have a hard time adjusting to it when you first started using it?

The chin strap keeps my mouth closed. I don't notice it otherwise. I had no trouble adjusting to it.

6. Have you had that surgery? Would you ever consider having it?

Tracheotomy is for the cases that can't be treated any other way. It's not recommended for many reasons and doctors won't perform it unless they have to. There are also less invasive surgeries but they have nasty side effects, a long recovery, and poor success rates. Only people who can't or won't tolerate CPAP therapy should even consider the surgery.

CPAP therapy is hard for some of us to adapt to. But once you get past that initial adaptation it's a simple and painless therapy that has tremendous benefits in terms of quality of life and reduced risk of cardiovascular disease.

[sir_sleeps_alot]

1. So first I'll ask, what type of sleep apnea do you suffer from?

I was diagnosed with obstructive sleep apnea, but I had central apneas during my cpap titration. Technically, I think this would mean I have complex sleep apnea, but I'm guessing I'd need to spend more time on cpap to have an official diagnosis (because sometimes people stop having central apneas once they adjust to cpap).

2. How long have you had sleep apnea?

I was told that I had borderline sleep apnea in the early 2000s, but was not offered treatment. I had a sleep study at the beginning of the month and was diagnosed with severe sleep apnea.

I don't stop breathing in my sleep. My diagnosis was made based upon hypopneas. A hypopnea means that you are still trying to breath and getting some air, but not enough. My doc said they are as damaging as apneas because in both cases, you aren't getting enough oxygen.


3. What symptoms did you have that lead you to find out you have sleep apnea?

Difficulty staying awake, difficulty staying asleep, needing excessive sleep, feeling tired, and feeling run down.

I told my doctor I was a hyper-vigilant sleeper--things that most people wouldn't notice wake me up. When I wake up, I'm wide awake--probably because my sleep apnea keeps me from going into deeper stages of sleep-- but thankfully I do not have a problem going back to sleep.

My sleep study showed that I was having 105 arousals each hours. That's..... (tries to do mental math, counts on fingers, get out calculator).....more than once a minute. *frowns* I would not have had such a difficult time figuring that out in the past and I'm not quite old enough to be having age related problems. That's another reason why I had the sleep study--my brain just isn't working as well as it used to.

I do not have the typical symptoms of snoring, stopping breathing, or gasping or choking during sleep.


4. Have you had a sleep study done? If so, what was that like, how long did it last, where was it done? Anything you can tell me about that experience.

My sleep study was an overnight polysomnogram (PSG). It was done at the doctor's office. Interestingly, the exam rooms double as bedrooms for the sleep study. My doctor uses murphy beds--they fold down out of the wall at night and go back up into the wall during the day. Each exam/bedroom has a full sized murphy bed, a television w/ cable, and a private bathroom with a shower.

It took 30 - 45 minutes for the tech to hook me up to all the different sensors. There were several on my scalp to measure brainwaves--this helps the doctor track what stage of sleep I was in. There were sensors near my eyes to track eye movements--I think this has to do with tracking REM sleep. I believe I had some kind of jaw or chin sensor which I think monitored jaw clinching / teeth grinding / sleep talking. I had nasal prongs in my nose to measure how much CO2 I was exhaling plus a temperature sensor in front of my nose and my mouth--this helps determine inhale vs. exhale I believe. There were a couple senors on my legs to measure movement (helps dx restless leg syndrome). There were also elastic straps around my chest and waist to measure breathing effort. Oh! I almost forgot... there was a camera with night vision that was on the wall looking down at the bed and a microphone was clipped on my somewhere to record snoring.

All of these sensors plugged into a box and then the box plugged into their monitoring equipment somehow. They use the box (which had a handy carrying strap) so that they can easy detach you in the middle of the night should you need to use the restroom. Having to unhook each and every sensor would be such a time waster.

I was supposed to have a full night sleep study but my sleep apnea was severe enough that I met certain criteria to have cpap titration. The tech came in about an hour after I'd fallen asleep to put a nasal mask on me. It didn't bother me at all and I actually think I slept better during the cpap titration than I did earlier in the night. I think most people who are first starting out with cpap often have trouble falling to sleep / staying asleep with the mask on.

The worst / scariest part of the sleep study was when I woke up to go to the bathroom. Everything was fine and then all of the sudden, I suddenly couldn't get enough air. I felt like I was suffocating. I pulled the nose mask off and yelled out for the tech (there was an intercom). He came in and I told him what had happened. He said that he turned the pressure down with the hope that I would fall back to sleep. I guess my body really liked that extra air and freaked out when it was gone. It was fine as soon as he turned the pressure back up. I am eagerly awaiting my cpap.



5. What do you do to treat your sleep apnea? Do you use a CPAP mask?


I am still waiting for my insurance to get me a cpap. I'm supposed to use a nasal mask which is a little plastic triange that only covers the nose. There's a hose that comes out of the mask that gets hooked up to the CPAP---kind of elephant trunk looking.

6. If you use a CPAP, how do you like it? Did you have a hard time adjusting to it when you first started using it?

I've only used CPAP once and it was a good experience. I have no idea how it will be once I get my own and start using it at home.


7. Have you had that surgery? Would you ever consider having it?

I think that this question was about tracheostomy. Tracheostomy, I believe, is a surgery of last resort. This is not something that most people even have to consider. I have a hard time seeing any legit doctor say, "well, it's either cpap or trach, your choice." A trach would only be done if all else failed.

There are other surgeries, aimed at widening the airway, that may be an option for some people. I still have a hard time imaging a doctor saying, "up to you, cpap or surgery? I think these are generally reserved for people who cannot tolerate a cpap. These type of surgeries preserve airway function and form (you end up with a normal, but more open airway) whereas a trach creates an entirely new passage of the airway.

If I had tried all available options--cpap, bpap, apap, asv, supplemental O2, oral device, and airway preserving surgeries--and I was still having sleep apnea to the degree I have now, I absolutely would do it. I wouldn't have an option. I'm miserable. If I am not treated, I'm heading towards an early death. If nothing but a trach could save me from that, I'd definitely go for the trach. But chances are, it's never even going to be an option for me.

[DocWils]

Hi again Lauren

1. What type of sleep apnea do you suffer from?

Primarily OSA with very mild CA

2. How long have you had sleep apnea?

At least 15 years, but only firmly diagnosed two years ago.

I've found that symptoms of sleep apnea often go unnoticed by the person who has it because they don't realize what they're doing while they're asleep.

That is very true - often the first indicator of the problem is the sleeping partner being driven from the room due to the volume of the snoring or concerned due to the odd breathing pattern of the patient while sleeping.

3. What symptoms did you have that lead you to find out you have sleep apnea?

I felt tired all the time, fell asleep in the middle of the afternoon, was cranky, irritable, and suffered from hyperacusis, which can happen due to lack of sleep. I also started having heart problems and elevated blood pressure, and had a psychotic break due to lack of sleep. This last bit isn't as dramatic as it sounds, in more or less means I went overboard and did a bit of a nutty on a certain situation, driven by the lack of quality sleep.

I've also found that in order to be diagnosed with sleep apnea, you have to have a sleep study done.

Correct. You cannot receive a CPAP device without an Rx from a doctor. It is a controlled device because of the danger to patient should he use it wrongly or improperly adjusted.

4. Have you had a sleep study done? If so, what was that like, how long did it last, where was it done? Anything you can tell me about that experience.

I was lucky, in that I could insist on having a home study done as first line of diagnosis, rather than an in situ sleep study. For me it meant taking home a portable monitoring system, applying the necessary electrodes, monitors and harnesses, and going to sleep. The next day I could turn it over to the hospital for immediate analysis. Since I had a pretty straightforward case, it was not felt that I needed further study, and a device was prescribed right away.

5. What do you do to treat your sleep apnea? Do you use a CPAP mask?

I use a Automated CPAP device, which regulates pressure as needed, and nasal pillows, which insert into the nose and are very light and easy to wear.

6. If you use a CPAP, how do you like it? Did you have a hard time adjusting to it when you first started using it?

No, I was one of the lucky ones - I took to it the very first night - no real difficulty at all.

I've read that there is a surgery called a tracheotomy, that can help fix sleep apnea problems.
6. Have you had that surgery? Would you ever consider having it?

Lauren, any surgery is a last resort, and choosing to live with a Tracheostomy is a very severe method of dealing with this situation. If you dig around this site, you will find me discussing the pros and cons of this surgery at length, and on the whole, I advise against it unless it is absolutely necessary. As hard as it is to adjust to the mask for some, maintaining the health of the affected region of a Tracheostomy is far harder, and I would caution anyone considering it to fully inform themselves of all the downsides of it, and the downsides are numerous.

Thanks!
Lauren

Good luck, and let us know how your paper turns out - in fact we would welcome if you would post it here, or a link for members to see it.