I am a nervous wreck

My apap was broken on 4/20/2020, My diagnosis was UARS since my first sleep study in 2004. I have been given 2 at home sleep studies and have been told I don't have OSA, the doctor has recommended I don't drive when drowsy, lose weight and exercise. I did not sleep deeply at both studies due to crazy roommates (same ones that broke my apap).

I have barely functioned all these years, suffering severe exhaustion. I quit an internship because I was falling asleep dozens of times a day, missing out on obtaining a bachelor's degree. I acted an idiot at my part time job, just unable to function and also falling asleep. Fell asleep one afternoon while driving home from work. I have good sleep hygiene, rarely have caffeine after 12 noon. Go to sleep and awaken the same times. Allow 10 hours a night to sleep but the exhaustion still hits every day.

I'm set to get the results of my in clinic test in 2 days and I can hardly stand the anxiety. The last home study I had 10 apneas and 4 hyponeas, only 2.3. What do you have to get to get a machine? Previously they used the RDI score since my brain has lots of arousals. Do they still do that?

Thanks for reading!

My personal take. I am not a medical professional.

nawchem wrote: ↑

Tue May 07, 2024 5:36 pm

doctor has recommended . . . exercise

It is true that many find intense physical exercise early in the day can do wonders for overnight sleep and overall health and feelings of well-being.

nawchem wrote: ↑

Tue May 07, 2024 5:36 pm

severe exhaustion.

This can have many causes beyond how you breathe when asleep.

nawchem wrote: ↑

Tue May 07, 2024 5:36 pm

crazy roommates

I would recommend sane ones.

Anxiety and arousals can show up in breathing even when breathing itself is not actually the root cause. In such cases, treating the breathing may be treating (hiding) a symptom rather than addressing a well-defined syndrome.

Addressing the root causes of the anxiety and arousals, if possible, can often be more productive in the long term than focusing solely on sleep-breathing data. But if PAP is used, setting it up for maximum subjective comfort that helps with keeping you as relaxed as possible during sleep (instead of focusing on the numbers reported) may have some benefits for you, even though that use of PAP would be considered by some as off-label for what the therapy is designed primarily to treat.

I wish you all the best for getting the best sleep possible and for addressing causes for stress and anxiety in your life as effectively as possible.

nawchem wrote: ↑

Tue May 07, 2024 5:36 pm

What do you have to get to get a machine?

Sleep apnea.

Have they ruled out other causes of your daytime sleepiness, such as narcolepsy?

Have you looked at factors like your diet which may contribute to daytime sleepiness? Diets heavy in carbs can set you on a blood sugar roller coaster. If you have a surge of energy after eating then get predictably sleepy after a certain interval, and if you need to eat frequently "for energy" to keep from being so sleepy, that's something to pay attention to, and it's not something doctors will typically consider, despite how common it is.

How do you manage your anxiety? Have you ever tried relaxation exercises, meditation, yoga to manage anxiety? Have you sought medical treatment or counseling for anxiety management?

Thank you for your replies!!

It helps just to be heard. My previous studies (3) said I have no stage 4 sleep, delayed rem and little stage 3 as my brain arousals occur approx every 2 min in the last 3 hours of sleep. I had to purchase my own cpap previously but medicare recognized upper airway respiratory syndrome in 2008 and began paying for everything. i have had a total of 3 sleeping car accidents all when I was without a cpap.

I have chronic plantar fasciitis, nerve damage to my feet. I walk 40 min in the morning and do bike, stretching and weight lifting 5 days a week. It has taken 7 months since my injuries to work up this and I move at a snails pace when I walk. I started gabapentin recently for sleep and nerve pain.

I have moderate hypoglycemia. I guess it is an age problem that I have to eat regular meals lately every 4-5 hours. My carbs are about 100 day, too high but working on that.

Lazarus I love your take on my roommate situation. I'm on waiting lists all over San Diego, trying to get affordable housing.

I listen to Get Sleepy to sleep which is a great site, breathing exercises and stories.

I work with a therapist, I don't have an anxiety diagnosis, my whole life has been on hold waiting for this cpap, too tired to go out, too tired to talk with friends, too tired to perform at a decent job etc.

I'll know tomorrow if I get the machine.

Thank you, feel better talking this out!

Well, my AHI is 8 and I'm getting a new cpap machine.

My former RDI was 15.3 so they think my apnea has improved.

Looking for a new sleep doctor to purchase machine and set it up.

nawchem wrote: ↑

Thu May 09, 2024 4:16 pm

Well, my AHI is 8 and I'm getting a new cpap machine.

My former RDI was 15.3 so they think my apnea has improved.

Looking for a new sleep doctor to purchase machine and set it up.

Congrats on getting a machine! Be sure to come back here for help with settings and such.

I have moderate hypoglycemia. I guess it is an age problem that I have to eat regular meals lately every 4-5 hours. My carbs are about 100 day, too high but working on that

Hypoglycemia is a pretty clear sign of insulin resistance, and needing to eat regularly "every 4-5 hours" is a sign that you are on the blood sugar roller coaster. This MIGHT explain some of the sleepiness. It's worth checking out. Standard tests for diabetes won't really show anything at this point, but you can try an experiment:

First, eat regularly, and write down how often you feel sleepy between lunch and dinner, how often you need a snack.

Now, just for a week or so, change your lunches only. Eat protein (meat, chicken, fish, seafood, eggs, tofu, cheese) and some green, non-starchy veggies. Avoid any breading, dressing or dips that contain sugar and starches. No bread, pasta, crackers or chips. A hearty salad with protein and lots of veggies, a salad dressing like olive oil and vinegar or blue cheese or ranch (check ingredients!), some eggs and veggies, some tuna salad with a side of avocado, chicken breast or thigh with some veggies, etc. Don't skimp on amounts, mayo, butter, oils are OK, eat to satiety. No fruit or sugary beverages. In other words, very low carb, just for this one meal a day. See how often you feel sleepy in the afternoon after eating that way daily for 4 -5 days. If it is different, that's a clue. If you notice no difference, no harm, no foul.

This may not be your issue, but it's easy enough to find out, one way or the other.

Janknitz wrote: ↑

Fri May 10, 2024 1:23 pm

I have moderate hypoglycemia. I guess it is an age problem that I have to eat regular meals lately every 4-5 hours. My carbs are about 100 day, too high but working on that

Hypoglycemia is a pretty clear sign of insulin resistance...

Wut?

Maybe not exactly how I would have worded things because of the relative rarity and variety of "causes"--and yet, counter-intuitively, for some, because of a sort of resultant reactionary timing dysfunction . . .

Researchers have not yet fully identified the specific causes of reactive hypoglycemia. However, the condition stems from having too much insulin in the bloodstream at the wrong time. Possible causes include: having prediabetes, which can make it hard for the pancreas to produce the right amount of insulin.--https://www.medicalnewstoday.com/articl ... mia#causes

Yeah but in insulin resistance your glucose is normal or high. If one is hypoglycemic then they aren't insulin resistant. AAMOF they would be insulin super un-resistant.

Maybe this mechanism would be more the relevant one for the OP, but it's far beyond my depth.

Excess stress sets off your fight-or-flight response: Your adrenals secrete catecholamines, hormones (including epinephrine and norepinephrine) that raise your blood sugar so your muscles have the required energy to combat an attacker or flee as quickly as possible. That’s useful when you’re confronted by a physical threat, but when the only offender is anxiety, your bloodstream gets flooded with glucose and there’s no way to quickly use that energy. To compensate, your pancreas may over-produce insulin so blood sugar rapidly falls and you end up hypoglycemic.--https://www.levelshealth.com/blog/hypoglycemia-causes

lazarus wrote: ↑

Fri May 10, 2024 5:42 pm

Maybe this mechanism would be more the relevant one for the OP...

Yeah, probably not.

FoF only lasts as long as the threat is present +45 minutes or so.

If the OP is constantly in a life-threatening threat every/all day, probably needs to move out of that neighborhood.

The first question I would ask is how the OP came up with "moderate hypoglycemia". On the spot glucose testing (hey because of my hobbies I've got a monitor. They're cheap).

Thank you Janknitz. Is it okay if I change breakfast? I'm thinking potato chips isn't such a great idea anymore, I usually have pistachio nuts in the morning too, cause i'm a big salt craver. That is when the worst hypoglycemia hits me.

If I tried to have potato chips for breakfast and my PCP found out about it, I'm pretty sure she'd show up at my door with a SWAT team before I was finished chewing the first one.