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Learning, Sharing, and Teaching => Ask a Mustachian => Topic started by: Mega on September 24, 2013, 08:47:39 AM

Title: Sleep Apnea
Post by: Mega on September 24, 2013, 08:47:39 AM
Hello there fellow Mustachians. Have any of you ever been diagnosed with sleep apnea?

I recently (Last Friday) had a sleep study conducted. I fully expect a diagnosis of sleep apnea, given the tech said I stopped breathing while on my back. I did fully wake up three times, so I guess it is bad.

I suspect I have had sleep apnea for many years, as I usually wake up tired in the morning. However, with a small child, I am no longer able to catch up on sleep on weekends.

What has your experience been with sleep apnea? Were you able to cure it, as opposed to just treat it?
Title: Re: Sleep Apnea
Post by: rtrnow on September 24, 2013, 09:01:39 AM
I don't have apnea but my partner does and brother did. Most/many people have sleep apnea from excess weight. That was the case for my brother and a healthier lifestyle cured his. My partner on the other hand seems to have a genetic predisposition to snoring and apnea. He is normal weight and leads a healthy lifestyle. He has been using a cpap for several years and after some getting used to it really likes it. He feels better rested and more alert during the day. I sleep better too without the snoring. There are surgical options but we were told the effectiveness is only 50%. In short, if you're overweight lose some and if not give the cpap a try.
Title: Re: Sleep Apnea
Post by: hybrid on September 24, 2013, 09:15:08 AM
I don't have apnea but my partner does and brother did. Most/many people have sleep apnea from excess weight. That was the case for my brother and a healthier lifestyle cured his. My partner on the other hand seems to have a genetic predisposition to snoring and apnea. He is normal weight and leads a healthy lifestyle. He has been using a cpap for several years and after some getting used to it really likes it. He feels better rested and more alert during the day. I sleep better too without the snoring. There are surgical options but we were told the effectiveness is only 50%. In short, if you're overweight lose some and if not give the cpap a try.

Big +1.  Everyone I've met that has the issue needed to lose a bunch of weight.  My wife (who has always been in good health) gained ten pounds at one point a year ago and developed a snoring issue where for 25 years she had none.  After she lost the weight, no more issues.

Title: Re: Sleep Apnea
Post by: Mega on September 24, 2013, 09:20:09 AM
I don't have apnea but my partner does and brother did. Most/many people have sleep apnea from excess weight. That was the case for my brother and a healthier lifestyle cured his. My partner on the other hand seems to have a genetic predisposition to snoring and apnea. He is normal weight and leads a healthy lifestyle. He has been using a cpap for several years and after some getting used to it really likes it. He feels better rested and more alert during the day. I sleep better too without the snoring. There are surgical options but we were told the effectiveness is only 50%. In short, if you're overweight lose some and if not give the cpap a try.

Big +1.  Everyone I've met that has the issue needed to lose a bunch of weight.  My wife (who has always been in good health) gained ten pounds at one point a year ago and developed a snoring issue where for 25 years she had none.  After she lost the weight, no more issues.

Ok, what should I target for my weight? I am 5 foot 11 inches tall. I usually / used to weigh around 180 lbs, but put on forty once my son was born. I am now down to 200 lbs in the past 3 months. (Thanks MMM!)
Title: Re: Sleep Apnea
Post by: rockstache on September 24, 2013, 09:49:19 AM
My husband had it too, also not a weight issue. He used to use the cpap machine, but he still had trouble and would wake up several times each night. He had surgery and had his tonsils and a few other things removed (all at once), and hasn't had a problem since.
Title: Re: Sleep Apnea
Post by: Mega on September 24, 2013, 10:15:33 AM
My husband had it too, also not a weight issue. He used to use the cpap machine, but he still had trouble and would wake up several times each night. He had surgery and had his tonsils and a few other things removed (all at once), and hasn't had a problem since.

I had my tonsils removed about 7 years ago, because I could barely breath when awake if I was sick. They were like golf balls... Maybe part of them grew back...
Title: Re: Sleep Apnea
Post by: totoro on September 24, 2013, 10:18:17 AM
My best friend has this and is on cpap.  It is weight-related for her - she is going to have gastric bypass.  Your doctor/specialist can tell you what they think the cause is.  If it is weight related then my friend was told that losing weight is a cure.
Title: Re: Sleep Apnea
Post by: Spork on September 24, 2013, 11:10:30 AM

Short answer: yes.  I have it.  It's a family trait.  I wouldn't consider myself overweight. 

I've got fairly strong opinions here... and no real medical training to back them up.  Take this with a grain of salt...

I do think CPAPs work and work well (once you get used to them).  They make you rest better and (again, after you get used to them) are sort of comforting in the way they open up the passages.

I don't think sleep apnea is nearly as dangerous as a sleep doc will tell you it is.  Is it associated with a little bit of risk of death?  Sure.  OH MY GOD YOU STOPPED BREATHING 80 TIMES A MINUTE YOU ARE GOING TO DIE!!!  ... um... no. 

I've never met anyone that didn't get THAT response from the doctor. 

It is also a bit of a racket.  If you hadn't already gotten a sleep study: I would probably have advised you not to.   My doctor took one look at my chart, looked down my nose and throat and said "I can tell you 100% that you have it.  You only need the sleep study in order to be able to file on insurance."

What he DIDN'T tell me: the sleep study + somnambulist reading + doc reading + god only knows what was about $14,000.  (I was actually told it would be about $4000 total... but that was only quoting some of the charges.)  Now... a little math here...  My insurance covers 80%.  My out of pocket was $2000.  A brand new CPAP with no insurance coverage can be had for $800-1500 (depending on bells/whistles).  I could have bought the damn thing outright if he'd have just written me a prescription for it and come out ahead.

And the medical supply companies are pests.  They want to bill you for not a cpap... but for the parts that make up the cpap.  (The parts are billable at a higher rate than the assembled machine.)  And they want to replace every stinking part of the setup at ridiculously short intervals.  "Oh my god, you need a new hose.  Yours is 3 months old!"  (No, mine is 3 years old and still works fine, thank you.)

TL;DR
The first thing I'd do is get a script for the mask that fits (if you can discover that) and the CPAP and run (don't walk) to cpap.com (for example.. there are probably others that are just as good).  Buy all your supplies and whatever you can buy there and ignore the weekly phone calls from the medical supplier that your doctor recommends.

Ranty blog entry about the whole affair: http://sporkintheeye.blogspot.com/2010/03/edit-thinking-about-my-recent-sleep.html
Title: Re: Sleep Apnea
Post by: ASquared on September 24, 2013, 11:15:53 AM
How much do you weigh?  Could a diet/lifestyle overhaul fix your sleep apnea? 
Title: Re: Sleep Apnea
Post by: Mega on September 24, 2013, 11:30:57 AM
Regarding the cost, I live in Ontario, so two sleep studies a year are fully covered by OHIP. And on the insurance front, I married wisely, as my wife is a teacher. I expect somewhere around 100% coverage between her and my insurance.

Looking back at my sleep history with what I know now, I suspect my sleep apnea is not weight related. I used to sleep through my alarm (people could hear it through two concrete walls) when I was at university weighing 30lbs less.

In regards to the dangerousness of the condition, I think it is highly dependent on the severity and your ability to cope with the decrease quality of sleep. I used to be able to cope with the sleepyness before I had a son. As strange as it is, I am actually looking forward to trying a CPAP, so I can have a good night'sa sleep.

It is good to know I am not alone, and that I can try losing weight to see if it helps.

Thank you!
Title: Re: Sleep Apnea
Post by: rufflina on September 24, 2013, 12:09:24 PM
I was diagnosed with mild sleep apnea three and a half years ago. I'm a typical tiny Asian woman (5' 4" and 115 lb), and the cause, like some others here have noted, were my gigantic tonsils (as opposed to weight). Got a tonsillectomy and adenoidectomy and the sleep apnea completely disappeared. A nice side effect was that I no longer snore, which I'm sure my boyfriend appreciates :)
Title: Re: Sleep Apnea
Post by: Spork on September 24, 2013, 01:10:26 PM
In regards to the dangerousness of the condition, I think it is highly dependent on the severity and your ability to cope with the decrease quality of sleep. I used to be able to cope with the sleepyness before I had a son. As strange as it is, I am actually looking forward to trying a CPAP, so I can have a good night'sa sleep.

Don't give up on it.  My first 3 months were miserable.  It turns out the respiratory therapist fitted me with the wrong size mask. 

It can be expensive to try out different sizes/styles... but you may have to.  The full face masks gave me claustrophobia and are (to me) just WRONG WRONG WRONG.
Title: Re: Sleep Apnea
Post by: FuckRx on September 24, 2013, 02:09:07 PM
try weight loss first, cheapest approach, at 5'11" with normal muscle mass you probably should be under 180. fat deposits everywhere, some people get more of it around their tonsils/tongue/neck, that's the weight you are trying to lose. CPAP is a must if you don't want to get all sorts of other health problems down the road (pulmonary hypertension, essential hypertension, narcolepsy and leg cramps etc). once you lose the weight chances are you won't need the CPAP but in the meantime probably use it. if you absolutely cannot tolerate a CPAP (most people get used to it) then there is a mandible device that you can wear. agree with avoiding surgery at all cost.

as for just getting a prescription from your doc to buy a CPAP...convenient for the patient but if there are any complications with that device that kind gesture from that physician will likely be answered by a juicy law suit ...
Title: Re: Sleep Apnea
Post by: Spork on September 24, 2013, 02:19:12 PM

as for just getting a prescription from your doc to buy a CPAP...convenient for the patient but if there are any complications with that device that kind gesture from that physician will likely be answered by a juicy law suit ...

There has already been a sleep study... Can't see how that could happen.  This just avoids the middle man that services the device and adds a juicy upcharge.  And by "services the device" I mean "does nothing."
Title: Re: Sleep Apnea
Post by: Mega on November 02, 2013, 02:38:57 PM
So, just wanted to provide you with an update, and another request for advice.

I was diagnosed with moderate (15) sleep apnea overall, but severe (39) sleep apnea when sleeping on my back (my O2 saturation dropped to 77).

I had a follow up sleep study to test the CPAP machine. I only tried the nose covering mask. How have people found the nose vs the mouth and nose masks? What if you have a cold? Can you get both a nose and nose + mouth mask?

Are you able to adjust the settings on your CPAP on your own?

Title: Re: Sleep Apnea
Post by: footenote on November 02, 2013, 03:07:40 PM
My husband probably had sleep apnea (although he was never tested for it).

Major weight loss over the past 18 months plus an ambitious workout regimen and he doesn't even snore. He also found a millet pillow very helpful btw.
Title: Re: Sleep Apnea
Post by: Etihwdivadnai on November 02, 2013, 03:25:28 PM
I was diagnosed with (obstructive) sleep apnoea back in the late 90's.

But I am certain that I have suffered with it since at least my early teens because it is primarily down to a very narrow airway.

My O2 saturation drops to as low as 65% and the sleep-stop-breathing-snore-nearly-wake-up cycle is approximately every 3 minutes through out the night.

The apnoea is now treated very successfully using CPAP machine.

The sleep-clinic reckons that only about 50% of patients cope long-term with CPAP. But my partner says that if I had to choose between them and the CPAP machine, then the CPAP machine would win. So it is definitely worth persevering with if you can.

I use a nose-only mask an I just had to learn not to breathe through my mouth while asleep.

When I get a cold, it can be pretty tough to sleep properly.
(And nowadays I cannot cope with the resultant sleep-deprivation as easily).

But I use an in-line humidifier into which a few drops of methol + eucalyptus oil helps with the cold.

Sleep-clinic usually does not allow CPAP users to adjust their CPAP machine settings because if they do, they find that patients often tend to keep adjusting the pressure setting up until it hits the maximum.

But they do allow *me* to self-adjust and I will increase the pressure (from 13 psi) up by about 14 psi to 14.5 psi for the duration of the cold symptoms.

As previously mentioned, there are several forums dedicated to the world of CPAP
Title: Re: Sleep Apnea
Post by: m8547 on November 02, 2013, 05:46:54 PM
A really cheap option would be to try a pillow with more neck support to hold your airway open. I don't (think I) have sleep apnea, but I use a pillow like this
http://www.amazon.com/Malouf-Memory-Molded-Contour-Pillow/dp/B0038FWRXC/
and it helps me breathe better and sleep better when I'm sleeping on my back. In CPR they teach you that pushing the jaw and tilting the head back will open the airway. http://www.blscprtraining.com/a2.jpg A pillow with neck support will have a similar effect.
Title: Re: Sleep Apnea
Post by: abhe8 on November 02, 2013, 06:23:13 PM
osa can be pretty nasty. its not the quick stops in breathing that cause people to die, its the increased incidence of MVA (due to daytime fatigue) and the heart disease that forms over time from the increased resistance in the lungs during all those short stops in breathing.

from a financial pov, i'd start by ways to cure OSA: weight loss and/or surgery to remove tonsils/adenoids/etc.

op, if you developed it after gaining weight, odds are in your favor it will resolve when you lose the weight.

but in the mean time, i'd learn to use the CPAP. (and continue to use it if you can't cure the OSA).
Title: Re: Sleep Apnea
Post by: frugaldrummer on November 02, 2013, 09:06:11 PM
Cheap low tech way to keep you from sleeping on your back:

Put a tennis ball in a tube sock, and safety pin to the upper back of a sleep tee shirt.  When you roll on your back, you roll onto the ball, which is uncomfortable, so your sleeping self rolls back onto your side.
Title: Re: Sleep Apnea
Post by: N on November 03, 2013, 01:30:11 AM
I have severe sleep apnea. Using CPAP probably literally saved my life. I was beginning to think I had narcolepsy, because I would often fall asleep against my will or every intention, just if I sat down in the afternoon. I was afraid that I would fall asleep at stop lights because I was so tired and tempted to close my eyes while waiting.

Ive probably had it since I was in my 20s, but I thought I just liked to sleep in. I was skinny then, but Im not now. In any case, if you can treat it with cpap, even if you are overweight, you may find you feel so much better after treatment that it becomes easier to lose weight.

I also bought my machine straight from cpap.com, for about 400. I buy my replacment mask cushions on ebay, and it costs me about 60$ a year. I have a nose covering mask, and have also learned to sleep with my mouth shut. It took me only a week or so to get used to it, and now I find it very relaxing and fall asleep almost immediately with it.

I have had a couple of colds, and find sometimes the cpap pressure actually makes it easier to sleep. sometimes I take a decongestant a little before going to bed and then use my neti pot to clear everything out and go to sleep right after (if I have a cold, that is) I also like to use the humidifier, it helps, otherwise I tend to get a little stuffy and dehydrated.

My insurance completely covered my sleep study-it was considered a lab test and my coverage includes that fully. However, they wanted to charge me 2500 for a machine and my deductible was 3500. So that is why I bought one myself for 400. A year later, I happened to need surgery on my leg and met my deductible so I went ahead and got fitted by them for a machine which I didnt have to pay for and I have an extra for back up.

I cannot overstate how much it changed my life. I feel so much better, like a new person. like a magic pill. I felt so terrible those last couple of years and I just could not figure out why. Probably having children who I co-slept with for the last 10 years and breastfed during the night made me get even less sleep or less deep sleep than previously. But even after I got the cpap I still had a nursling in bed with me and I had no issues waking for him and still getting a great night sleep and feeling great the next day.

It may in fact be due to excess weight, maybe not. But if you can start treatment, I advise doing so and not waiting.
Title: Re: Sleep Apnea
Post by: yarrow on November 03, 2013, 09:55:12 PM
I highly recommend http://cpaptalk.com (http://cpaptalk.com) for CPAP advice.

It's not the place to go if you're still deciding whether to use CPAP, as most folks there are already convinced that the answer is yes. (As indeed am I.)  But if you're pretty sure you'll be going with CPAP you'll find good advice on what kind of machine to get, how to negotiate insurance and Durable Medical Equipment to get what you want, and/or good places to go for used machines if you're not going through insurance, and how to live with the damned/blessed things.

I had a pretty rough first year on CPAP, and people on cpaptalk spent lots of time looking at my charts with me.

Quote
Are you able to adjust the settings on your CPAP on your own?

A good how-to resource for this is http://www.apneaboard.com/adjust-cpap-pressure/change-cpap-pressure-settings-adjusting-your-machine-with-a-clinician-setup-manual (http://www.apneaboard.com/adjust-cpap-pressure/change-cpap-pressure-settings-adjusting-your-machine-with-a-clinician-setup-manual).  (There's a huge "Join our Forum!" section at the start -- you need to scroll down to get to the good stuff -- and it is indeed good stuff.  They will email you clinician's manuals for most machine on request.  (I asked for my machine's manual, and gave them a small donation.)
Title: Re: Sleep Apnea
Post by: FunkyStickman on November 04, 2013, 05:43:39 AM
As others have said, #1 cause is weight gain, followed by genetic disposition. I had/have mild apnea, I'm about the same height as you, and weighed 215-ish. I dieted and exercised and got down to 175, and my wife said my snoring and apnea almost completely went away.

Since then, I've put about 10 pounds back on, and it started to come back (though not as bad as it was). So, simply put, try getting down to your ideal weight, and if that doesn't work, look into a CPAP.
Title: Re: Sleep Apnea
Post by: aj_yooper on November 04, 2013, 06:29:59 AM
I have used cpap for 10+ years due to obstructive sleep apnea.  My doctor indicated neck size is predictive of sleep apnea to the extent that weight training on neck muscles should not be done.  If you have sleep apnea, you tend to gain weight as your energy levels go way down.  Losing weight is very helpful as is increasing aerobic and strength physical fitness.  I had surgery on my nose to improve my air flow, but I still have the moderate to severe apnea.  I also use the humidifier with the cpap to avoid nasal dryness. 

Untreated sleep apnea increases risks for accidents and cardiovascular events. 

Congratulations on your diagnosis!
Title: Re: Sleep Apnea
Post by: Mega on November 04, 2013, 09:04:32 AM
Thank you all for your support!!!

I hope to lose weight once my energy levels return with the CPAP. However, I was diagnosed with mixed sleep apnea (obstructive and central), so it will never go away completely.