Do you have to actually be seen not breathing to have apnea?

[toogerbug]

Hi,

I'm wondering about apnea both for my husband and myself. Him beause of his size (6, 256 lbs, 18" neck, snoring) and me because of sinus problems & likely inlarged adnoids (sp?). I'm a normal sized woman, small actually with a small neck. Both of us snore. He is worse than me (I think?).

Anyway, my first question is-if one of us observes the other one sleeping, do we actually have to see the other one stop breathing for 10+ seconds between inhales for us to lean toward thinking one or both of us needs apnea testing? I guess what I'm asking, is can it be there even if an untrained observer (feeling the ohter person's respirations by placing a hand on chest/back during sleep) can't see any stopping of breathing beyond 3-5 seconds? (I only did 20 min with my hubby watching him so far, then I fell asleep, he hasn't watched me yet.) Or is it somehting that is only measurable?

I was thinking about getting one of those sleep strips for each of us to see if we should have a study.

Both of us are constantly tired and have been for years and years. I'm 33, he's 55. So it's doubtful it's a new problem affecting either one of us. Not that I want to have apnea, but I would be thrilled to find an (somewhat solvable) answer beyond likely Fibromyalgia for me and stress induced fatigue for him.

Huby has had his tonsils removed, what that mean he could or could not still have apnea? He does snore. I have to make him roll on his side. His snoring usually gets somewhat better then, but not completely.

I'm running out of room, so I'll continue as an answer to this post... Please read on...

[toogerbug]

Continued from above...

For me I began having fatigue in my teens around the time I developed migraines, vertigo and sinus problems/allergies. I have trouble remembering a time when I've ever felt truly refreshed (a few times on vacation, but only briefly). If I let myself, I could easily sleep 12-14 hours a night. If I get less than 9-10 I feel totally worn out. I don't fall asleep inappropriately (hubby has while watching TV, I get very drowsy sometimes).

Sometimes when I'm falling asleep I feel like I'm not getting enough air. I do have asthma, but it is well under control. I'm mostly a mouth breather (*drooler*). I sleep on my side, I can't sleep on my back, due to vertigo. I do find that sometimes (not always, maybe 30-60% of the time varying, if I lay on my right side I get a headache sometimes within minutes. (That's also the side of my nose that acts weird when I use a netti pot, like it's blocked.

I have tons of morning headaches and headaches that occasionally get worse when I lie down. I tend to have a lot of headaches in general and always have for years and years. (About the time I started getting tired about 20 years ago as a teen). I also wake up with a dry mouth and have acid reflux (which may not be related, since I have it during the day too.)

I found a youtube video (NOT of me!!!) that sounded similar to my snoring according to hubby. Does this look/sound like sleep apnea based on the snoring?

I can't post a link but search for MNJOE on youtube and it's the third video down showing a lovely Asian (?) woman sleeping. Hub

[Pugsy]

There are other signs and symptoms besides snoring and visually documenting episodes of shallow or stopped breathing. Fatigue, elevated BP, GERD, morning headaches, dry mouth and need for naps are a just a few. Take the Epworth sleepiness test, see how you rate. Do one for yourself and have your husband rate you also. Then do the same for him. When I went to the sleep specialist part of the paper work was for me to complete it and for my husband to also complete it base on what how he felt I was reacting. Enlarged tonsils might inhibit the flow a air some but the absence of tonsils doesn't mean you have less of a chance just by them being gone. My tonsils have shrunk up to absolutely nothing and I still met criteria for severe sleep apnea.

Good luck and here is the link for the little sleepiness test.

http://en.wikipedia.org/wiki/Epworth_Sleepiness_Scale

[LavenderMist]

From the symptoms you are describing, it sounds like a sleep study would be prudent. At the very least, you could ask the Dr. to prescribe an overnight pulse ox to measure your o2 sats during the night. Have you discussed these concerns with your doctor? If not, that would be my first step.

[Pugsy]

I just now saw your second post. My sister has half the symptoms you are presenting and I am on her case constantly to at least talk to her doctor about it. Sleep apnea hits old and young, skinny and fat, always healthy to always sickly. It doesn't discriminate. Put the old stereotype of typical sleep apnea patient out of your mind. We are no longer just fat men with huge necks. We come in all shapes and sizes and males don't have a monopoly.
Keep us posted on what happens. I am new to this forum but there are some wonderful caring people here to try to help in any way they can.
Brenda

[Toogerbug]

Thanks!

I looked at the Epworth Sleepiness scale. I rate about a 6 (less than the 10 for sleep problems). I don't fall asleep inappropriately, I'm just TIRED ALL THE TIME!!! I can get my get up and go when I really have to, most of the time, but then I crash.

I'd say hubby would rate at an 11. I'll print this out and show it to him. Maybe it will convince him to get help.

[Pugsy]

There's more to sleep apnea than just sleepiness. That was just one test.
Try this one. This is the one that my sister failed miserably. It actually has questions for other sleep disorders besides sleep apnea.

http://www.sleepnet.com/sleeptest.html? ... late+Score

[kteague]

Sometimes the casual observer can detect extended periods of not breathing. In some, sleep apnea worsens during REM sleep, which we generally get more of later in the night. And for some it worsens when sleeping on their back. To get a better picture, ideally the observer would be watching the sleeper during REM while supine. Even then, observation is a grossly inexact science, so I wouldn't count on it. You've named enough symptoms for both of you to merit talking to your doctor about it. If you two having been seeing doctors with all these symptoms, I'm surprised sleep apnea hasn't been suggested to you as a possibility.

Hope you let us know how this progresses. Best wishes.

Kathy

P.S. LavenderMist, when I saw your post I had to check the date to see if this was an old thread. Don't know where you've been the last several months, but I hope you were out living life to the fullest. Good to see you around.

[toogerbug]

WOW! Thanks!

That was an eye opener! Things I've never even thought of before. I'm super restless (always have been, I used to kick like a mule in my sleep), I wonder if my vivid dreams & nightmares and sleep startled "jumping" are part of it. I have insomnia even though I'm exhausted, my mind just won't quit. I'm taking Melatonin which helps some.

My score on the test (hubby's was the same) (even with different answers).

You show symptoms of sleep apnea, a potentially serious sleep disorder. People with sleep apnea quit breathing repeatedly, often hundreds of times during their nights sleep.


You show symptoms of insomnia, which is defined as a persistent inability to fall asleep or stay asleep.


You show symptoms of narcolepsy, a life-long disorder characterized by uncontrollable sleep attacks during normal waking hours. (THAT ONE SURPRISED ME!!! WOW!!!)


You show symptoms of gastroesophageal reflux, a disorder caused by acid "backing up" into the esophagus during sleep.


You show symptoms of periodic limb movement disorder, a disorder resulting in uncontrollable leg or arm movements during

[Pugsy]

Both of the sleep tests that I sent links for are just simple screening tests. To get you started thinking and realizing that there are many factors are involved.
On the Epworth test I scored a 15 and my husband thoughts on me rated at 12.
I have read where people with low Epworth scores end up having a diagnosis of sleep apnea so a low score doesn't mean that you don't have sleep apnea.

These screening tests are really just designed to get you to realize that many seemingly unrelated physical symptoms can point to various sleep disorder problems. Talk to your doctor about each and every problem as if it were a complete package. Then the package takes on a whole different look.

Time to consider pushing for a sleep study. It will document not only if sleep apnea is present but limb movements and other awakening factors. Good luck on your journey but please get started on it now. Don't put it off.
Brenda

[BeanMeScot]

You don't have to stop breathing to have apnea. During my sleep study, I only stopped breathing a couple of times. Mine manifests as Hypopnea rather than Apnea. Hypopnea is a reduction of air rather than a stopping of breathing. I was surprised at first to be diagnosed with Apnea because I don't have most of the classic symptoms. I was only tired sometimes and that only started in the prior year when I started going to work at 7:30am instead of 8:30am. That extra hour made a big difference in my fatigue. I was never told that I stopped breathing and I never woke up struggling to breath. I snored very heavily though and that was enough to reduce the amount of O2 I was getting past the level that was appropriate.

You and your husband have enough symptoms that you should be tested. Insomnia can actually be a result of apnea as well as fatigue. Your brain knows it will struggle all night to get enough O2 but if it doesn't allow you to go to sleep, that won't happen!

Symptoms that haven't been mentioned so far are Night Sweats where you wake up in a pool of sweat for no good reason. Another is urinating during the night. A normal, healthy person should be able to sleep all night without getting up to pee. The more times you pee, the worse your apnea is. I would get up usually 1 time a night and my apnea wasn't severe. After a few months on CPAP, I almost never get up to pee during the night and my urine is very concentrated in the morning. It wasn't for many years.

[kteague]

Hi. I replied again in this thread late last night but my computer crashed and lost it. I'll try to remember a few things.

On Insomnia. I really believe mine started with a natural instinct to avoid a miserable and even dangerous situtation - sleep. After a while these patterns become habitual, and can take some time and effort to retrain the brain to sleep.

On reflux. CPAP treatment has really improved my reflux. If one has OSA, all the struggling as the body tries desperately to breathe can result in extra pressure in the belly resulting in fluids being pushed upward. Sleeping on the left side in a bed with the head of the bed elevated a few inches helps some with reflux. Helped me. Might as well let anatomy and gravity work for you instead of against you.

On narcolepsy. My sleep doctor says any other sleep orders need to be effectively treated before evaluation for narcolepsy. Long term sleep deprivation and/or fractured sleep can cause severe daytime sleepiness, so resolving other issues then clarifies what the residual symptoms are. I for one just want real answers, whatever those answers turn out to be. But I certainly don't want a diagnosis of narcolepsy applied unless it is without a doubt. That diagnosis can come with some baggage, and hey, who needs more baggage in life!

On limb movements. If they are associated with struggling to breathe, resolving the breathing issues should take care of them. One can have OSA and unrelated limb movement disorders such as RLS and PLMD. Both can be diagnosed in a sleep study. When my PLMD, which causes repetitive motions, is at a bad point, it seems my thoughts are very active during sleep, at times being repetitive. There've been times one phrase would repeat in my head hundreds of times a night, like a broken record. Maddening! I described my nights as restless and even a state of agitation. I used to describe it like this - My pursuit of sleep reminds me of the greased pig chase at the county fair, I keep grabbing it but it keeps slipping away! Another characteristic of my sleep back then was the sense of being stuck in a miserable place somewhere between awake and asleep, never quite able to cross over or come back.

On Dreams. In the years before cpap treatment, I noticed a theme to my unpleasant dreams - something or someone was always nearly choking, suffocating or drowning. You might want to journal them for a while and see if a pattern emerges.

Best wishes in you and your hubby getting tested and finding out how to help yourselves feel your personal best.

Kathy

[dsm]

Hi,

I'm wondering about apnea both for my husband and myself. Him beause of his size (6, 256 lbs, 18" neck, snoring) and me because of sinus problems & likely inlarged adnoids (sp?). I'm a normal sized woman, small actually with a small neck. Both of us snore. He is worse than me (I think?).

Anyway, my first question is-if one of us observes the other one sleeping, do we actually have to see the other one stop breathing for 10+ seconds between inhales for us to lean toward thinking one or both of us needs apnea testing? I guess what I'm asking, is can it be there even if an untrained observer (feeling the ohter person's respirations by placing a hand on chest/back during sleep) can't see any stopping of breathing beyond 3-5 seconds? (I only did 20 min with my hubby watching him so far, then I fell asleep, he hasn't watched me yet.) Or is it somehting that is only measurable?

I was thinking about getting one of those sleep strips for each of us to see if we should have a study.

Both of us are constantly tired and have been for years and years. I'm 33, he's 55. So it's doubtful it's a new problem affecting either one of us. Not that I want to have apnea, but I would be thrilled to find an (somewhat solvable) answer beyond likely Fibromyalgia for me and stress induced fatigue for him.

Huby has had his tonsils removed, what that mean he could or could not still have apnea? He does snore. I have to make him roll on his side. His snoring usually gets somewhat better then, but not completely.

I'm running out of room, so I'll continue as an answer to this post... Please read on...

What sent me along to my main sleep study in 2005, was my wife kept complaining that I would just slow & stop breathing & that this disturbed her sleep. I wasn't snoring but just stopped. She would wake, feel my back, often nudge me & say 'breathe'.

Went to an RT who looked at me & said he was sure I would not be classified as having SA, but he was wrong - had an AHI of 40+

Wife now sleeps without any issues as to what I am doing (well, until I swapped machines 3 nights back - With my Resmed machine it is so quiet she hears me breathing, with my Bipap machine she can't pick out my breathing due to the (fairly quiet background noise). But in general terms her sleep is no longer disrupted by what mine is doing.

Good luck.

DSM

[turbosnore]

Just in case - I have severe apnea with AHI over 30 non-supine, and my tonsils were removed when I was a child.
I guess tonsils don't necessarily have nothing to do with sleep apnea.

[dsm]

Just in case - I have severe apnea with AHI over 30 non-supine, and my tonsils were removed when I was a child.
I guess tonsils don't necessarily have nothing to do with sleep apnea.

MY ENT has just told me she wants em out - 'enlarged' and a haven for bugs. Cut them !. But also tells me she has seen grown men cry whilst recovering from a tonsillectomy.

Trouble is I am not a grown man - I am a grown 'great' grandad & that is a whole different ball game

DSM