excessive vomiting as a cause of OSA?

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djr1215
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excessive vomiting as a cause of OSA?

Post by djr1215 » Mon Jul 26, 2010 12:47 pm

Can excessive vomiting possibly cause some damage to the soft tissues of the throat to cause OSA?
Here's my story and why I'm asking. I did snore before, and get up and go to the bathroom during the night sometimes (depending on how much and how late I drank my coke). But I rarely had trouble going to sleep or going back to sleep if I got up in the night. I dreamed all the time. If I hit snooze on my radio in the morning I could be back asleep and dreaming again before the 9 minute snooze time was up. I did not have excessive sleepiness or tiredness during the day. I didn't fall asleep reading or watching TV in the evening.
Last July I had a colonoscopy and the CRNA asked if I had sleep apnea and I told him no, not as far as I know - you tell me, you'll be watching me sleep! He told me after I woke up that I did not have any apnea problems during the procedure. Then at the end of December acute pancreatitis put me in the hospital. Several days of no food and severe vomiting. Then the day I left the hospital I ended up right back in with an episode of atrial fibrillation. Based on that episode, the cardiologist prescribed the sleep study (early January) which showed apnea-hypopnea index 23.6, 58.8 during REM sleep, sleep efficiency of 74.7%, sleep latency was long at 34.5 minutes, prolonged sleep latency with increase in wake after sleep onset, 02 saturation low was 72%, hypoxic for 2.9% of the night (snored for 100% of the total sleep time). Because of various issues I did not get CPAP equipment until May. I have not had another episode of atrial fibrillation (though I did have another pancreatitis attack.) Before I started on cpap I also had an endoscopic ultrasound of the pancreas, but I'm assuming that the endoscope would have kept the airway open? They didn't say anything about apnea but they did say I fought them the whole time- I don't remember any of it.
Since December/January I have been tired, wake up even more during the night, fall asleep reading or watching TV (even fell asleep a couple of times at my desk during work). It takes me longer to fall asleep and longer to get back to sleep once I do wake up. CPAP hasn't helped any of this. I did buy a pulse oximeter from Kevin Cooper and I've checked that several times and 02 sats stay up mostly above 95.
So, have I had OSA and was I just lucky during the colonoscopy not to have apnea? (this was actually my 2nd colonoscopy and nothing was mentioned 5 years ago either). Or could something in the pancreatitis process (such as vomiting) cause a new case of OSA?
I've been checked for diabetes, and thyroid and no problems there.
It's not that I want to stop the CPAP, I get that I need it. I just wonder why now?

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elena88
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Re: excessive vomiting as a cause of OSA?

Post by elena88 » Mon Jul 26, 2010 1:12 pm

They place you on your side during a colonscopy, its possible you didnt have any events for the short time you were under..
I also had one two months before I was diagnosed with severe OSA, and also had a stomach biopsy for celiacs, neither doctor mentioned
that I had OSA either.. I was on my side for both procedures too..

I know that your throat can become more swollen, thus smaller in diameter if you have constant bouts of stomach acid going up to your
mouth.. or larnyx.. as I have larynx reflux, (LPR) and that has not helped my osa..

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Big Daddy RRT,RPSGT
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Re: excessive vomiting as a cause of OSA?

Post by Big Daddy RRT,RPSGT » Thu Jul 29, 2010 5:41 am

You might expect that any swelling caused by the vomiting/irritation would resolve overtime.

Has your weight changed during all of your illness? Weight gain can cause OSA although I would expect excessive vomiting to cause weight loss.

Has your sleep position changed? More back time due to abdominal pain?

How long did you wear your CPAP? A few nights, weeks, months? It can take a lot of work to get used to CPAP.

What kind of results is being reported by your System One? Leak rate, AHI? Maybe your not on enough or too much pressure?

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Janknitz
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Re: excessive vomiting as a cause of OSA?

Post by Janknitz » Thu Jul 29, 2010 1:29 pm

Excessive vomiting could cause scar tissue to form in your esophagus, so it could conceivably cause OSA. In addition, the sphincter between your stomach and airway might be stretched out and weakened, causing reflux which can lead to further scarring and aspiration into the lungs. Some people are not aware of this reflux ("silent reflux").

There is a very big correlations between gastroesphageal reflux and OSA. Right not it's a bit of a chicken and egg debate. So if you are having problems like that, it could very well contribute to OSA. And OSA (a narrowed airway)can lead to reflux--because there's a suction effect in a narrowed airway that pulls the stomach contents up the esophagus.
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kteague
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Re: excessive vomiting as a cause of OSA?

Post by kteague » Thu Jul 29, 2010 1:37 pm

I don't know the specifics, but it's my understanding that we are not actually asleep during a scope, just that the medication makes us not remember the time. If that's so, it could explain not seeing apneas.

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