Sleep apnea and "Irritable Bowel Syndrome"

[DrowsyDan]

I'm 57 years old, exercise most days, and am quit fit. Among other things, my BMI is about 22. I was diagnosed with OSA 5 years ago. The study was flawed, in that although it clearly showed disordered breathing & low pulse ox in the initial test, the numb-nuts running the test (search "Numb Nuts" in the Seattle yellow pages, 1st listing is "Virgina Mason Sleep Center") hosed the follow up study done with CPAP, and only got data for the LAST 45 minutes of that night's test. While there is no doubt I have sleep disordered breathing, I am not convinced my apnea is obstructive. Never the less, I ABSOLUTELY used the CPAP EVERY NIGHT as they prescribed for about 2 years, with NO change (ZERO) in any of my symptoms (day time sleepiness, mental fog, aches and pains, just generally feeling like CRAP every second I'm awake). In addition to the symptoms typically associated with OSA, symptoms which I've had since I was in my early 20's (had I known how life was going to proceed, I would have jumped off a bridge THEN), and which I had at least developed the ability to live with, beginning in 2008, I started having symptoms that are generally referred to with the wastebasket diagnosis "Irritable Bowel Syndrome". Gas, bloating, nausea, multiple loose/urgent bowel movements each day. This dysfunction has cost me my marriage (What??? You can't travel at the drop of a hat & go out to fancy restaurants anymore??? BYE BYE!!!), my house, most of my savings, and my career aspirations, and has utterly destroyed my quality of life. Despite trying to live a good life & take care of my body for the past 40 years, I just feel terrible all day, every day, and have for decades. Not a single 24 hours passes without my weighing the +/- of blowing my brains out at least once. The gut thing is absolutely THE LAST STRAW. I have contacted another sleep center in the city I now live in (Olympia, WA), and will likely do another sleep study. I'm wondering if anyone here has had any variety of stomach upset in the context of their sleep apnea, and if treatment helped. There does seem to be some study data suggesting a connection in some patients. Also, if anyone has been diagnosed with CENTRAL sleep apnea, I'd love to hear your experiences with diagnosis, any effective treatment, etc.

Thanks for letting me vent, and for considering my question.

Dan

[Julie]

Sounds like you've had just a peachy time! Not a great start but good for you for trying (but don't quit yet!). I have not heard of IBS in connection with OSA or Cpap, but someone else may have. As far as your having not felt any better on Cpap yet, it's quite possible you've been less than fully treated up until now... you may well need your pressure setting to be higher (so many MDs don't really get it or ever suggest changes) but if you're concerned about centrals, that could be a problem (not necessarily, but 'could'). Many people do have some as they're falling asleep and just before wakening, but that's not abnormal... it's when you have a lot throughout the night that there could be a problem. However, can you please tell us what your machine is - fullest name(s) and model #, what mask you use and anything else you think might matter, like what meds are you taking, how much caffeine and when, hrs slept, etc etc. Once we have a better idea we'll try to help. Btw, any particular reason you're on plain Cpap vs Apap? And have you ever used software (like Sleepyhead) to track overnight progress?

[Wulfman...]

I'm 57 years old, exercise most days, and am quit fit. Among other things, my BMI is about 22. I was diagnosed with OSA 5 years ago. The study was flawed, in that although it clearly showed disordered breathing & low pulse ox in the initial test, the numb-nuts running the test (search "Numb Nuts" in the Seattle yellow pages, 1st listing is "Virgina Mason Sleep Center") hosed the follow up study done with CPAP, and only got data for the LAST 45 minutes of that night's test. While there is no doubt I have sleep disordered breathing, I am not convinced my apnea is obstructive. Never the less, I ABSOLUTELY used the CPAP EVERY NIGHT as they prescribed for about 2 years, with NO change (ZERO) in any of my symptoms (day time sleepiness, mental fog, aches and pains, just generally feeling like CRAP every second I'm awake). In addition to the symptoms typically associated with OSA, symptoms which I've had since I was in my early 20's (had I known how life was going to proceed, I would have jumped off a bridge THEN), and which I had at least developed the ability to live with, beginning in 2008, I started having symptoms that are generally referred to with the wastebasket diagnosis "Irritable Bowel Syndrome". Gas, bloating, nausea, multiple loose/urgent bowel movements each day. This dysfunction has cost me my marriage (What??? You can't travel at the drop of a hat & go out to fancy restaurants anymore??? BYE BYE!!!), my house, most of my savings, and my career aspirations, and has utterly destroyed my quality of life. Despite trying to live a good life & take care of my body for the past 40 years, I just feel terrible all day, every day, and have for decades. Not a single 24 hours passes without my weighing the +/- of blowing my brains out at least once. The gut thing is absolutely THE LAST STRAW. I have contacted another sleep center in the city I now live in (Olympia, WA), and will likely do another sleep study. I'm wondering if anyone here has had any variety of stomach upset in the context of their sleep apnea, and if treatment helped. There does seem to be some study data suggesting a connection in some patients. Also, if anyone has been diagnosed with CENTRAL sleep apnea, I'd love to hear your experiences with diagnosis, any effective treatment, etc.

Thanks for letting me vent, and for considering my question.

Dan

Did you monitor your therapy with software?
Did you ever think that your bowel issues may have been "aerophagia" (ingesting air in your stomach)?
It also may indicate that you have a weak LES or borderline GERD.
Did you ever experiment with what you were eating?
Taking any medications? Maybe a possible link there.

Lots of users BLAME their CPAP therapy for many of their biological issues when the possibilities lie elsewhere.


Den

.

[LSAT]

There are specific tests that can determine IBS, Colitis. I have had OSA for 8 years and was diagnosed with IBS this year. I don't believe there is any relationship. Your symptoms sound like Colitis to me...ask your doctor for a Calprotectin Stool Test.

[story1267]

There is a connection between sleep apnea and bowel symptoms.

I recommend this podcast. http://doctorstevenpark.com/category/podcast-2 "Sleep Apnea and Gastrointestinal Problems" Podcast # 25.

My sympathies on your struggles.

[ChicagoGranny]

DrowsyDan

I don't see anywhere that you state what your current AHI or leak level is. If you are not tracking your CPAP therapy with Sleepyhead software, you should start doing that before taking any other step. It's possible that your CPAP therapy has not been effective for the last five years. Good luck.

[Sylvia54]

the wastebasket diagnosis "Irritable Bowel Syndrome". Gas, bloating, nausea, multiple loose/urgent bowel movements each day.

Hi Dan, I was diagnosed with breathing disorder/sleep apnea last April, predominantly while asleep on my back. My main complaint was restless sleep and chronic insomnia but there were other strange symptoms that went with it. Soon after the short, abnormal sleep cycles started in 2012, my stool started turning off color with strong abnormal odor, slushy stool, intermittent diarrhea with no explanation. Sometimes gas was part of it too (very embarrassing), no nausea but sometimes urgency, first thing in the morning and once in a while, even during the night. It was like my system was in this hyper arrousal mode (heart palpitations) with my intestines out of whack. Over 3 yrs ago, a digestive doctor ordered colonoscopy (I'm over 50), endoscopy, CT scan and then blood test for celiac disease. Turned up nothing except gastritis which explained intermittent burning pain in my upper stomach and loss of appetite. Was told by one doctor that it may be IBS caused by anxiety. May have been correct for the gastritis (stress and worry about insomnia, etc.) but for the abnormal bowel problems, I didn't agree. During that time I was doing my own research and saw where there is indeed a connection between sleep quality and the gut (something to do with serotonin which helps make melatonin).
My MD at the time dismissed it, blew it off as speculative.

Anyway, during the past 6 wks, after switching from fixed to variable pressure on cpap (variable 8-12 cm), this symptoms among other symptoms have almost gone away. And just recently I came across an internet article on digestive health titled; "Is your gut health affecting your sleep?" by Julie Revenant, published Aug 15, 2016, FoxNews.com. Dr. Michael J. Breus, PhD, a clinical sleep specialist in Los Angeles, is quoted in the article.

The article states that;
"Health conditions can affect gut health too. Research is also being done on how other factors can affect the gut and in turn, sleep. In fact, obstructive sleep apnea, which affects more than 18 million adults in the U.S. could alter the microbes in the gut, the European Respiratory Journal found."

So I hope you get some answers soon.
Hope the sun is out up there in Olympia, Wa. (I'm originally from Kitsap county).

[Julie]

Sylvia, I'd be interested to know what you saw re serotonin and the 'gut'. Serotonin's a brain chemical that regulates mood, but in your note it sounds as though it's in the stomach, and relates to melatonin, again unrelated to my knowledge to either serotonin or gut issues... very confusing, then again anything on Fox is suspect for me, never mind a PhD student expounding on gastroenterology.

[Sylvia54]

Sylvia, I'd be interested to know what you saw re serotonin and the 'gut'. Serotonin's a brain chemical that regulates mood, but in your note it sounds as though it's in the stomach, and relates to melatonin, again unrelated to my knowledge to either serotonin or gut issues... very confusing, then again anything on Fox is suspect for me, never mind a PhD student expounding on gastroenterology.

No Julie, Dr. Michael Brues is not a Phd student, he is a clinical sleep specialist who holds a Phd and works in a sleep clinic in Los Angeles. I have seen many of his internet articles on sleep and interviews on YouTube.

The article says; "In fact, 90% of serotonin, the building block for the sleep hormone melatonin, is located in the gut" (intestines, not the stomach). If you don't like Fox News (they are just merely reporting it), then there's a Huffington Post article titled; "Unlocking the Sleep-Gut Connection", dated 1/13/2016, written by the same doctor but reported by "The Huffington Post". Sorry, I don't know how to provide you the links but I can view the articles myself by searching the title. Others on here have mentioned Dr. Steven Parks, ENT website articles on the same topic. He writes about a strong connection between IBS and sleep breathing disorders. OSA is mentioned in both articles.

[Hang Fire]

Serotonin's a brain chemical that regulates mood, but in your note it sounds as though it's in the stomach

lol 90% of the human body's serotonin is located in the gastrointestinal track. It's very easy to find this science with an internet browser.

Your knowledge is very shallow and often misinformed.

[Chevie]

Your knowledge is very shallow and often misinformed.

... and she scatters it all over this forum, all day, every day.

[Julie]

And yours is worse - it's the GI tract, not track, you ignoramus.

[Cereal Killer]

track

igoramus

Dueling typos.

[Janknitz]

It's hard to tell if your IBS issues are related to sleep issues, but I agree that the FIRST question is whether or not your therapy is even effective. Learn how to download and use Sleepyhead software, as that will tell the story if your therapy has not been working for you (looking for low leaks, good AHI control, good breathing patterns).

If the therapy looks OK on Sleepyhead, the sleep lab may still reveal other issues, so that's a good next step. Glad you have that in progress. If it doesn't look good on Sleepyhead or in the lab, then dialing that in is going to be the next step.

If optimized treatment doesn't help the IBS symptoms, then you need to look elsewhere. There's a lot of information on gut microbiome and it's contribution to overall health, and many people seeing positive changes to IBS by altering their diets and using probiotics and prebiotics. This does not have to be a life sentence of misery.

[mal59]

I didn't bother to read through the rambling post. Please be concise and leave out the editorial.