I had a long conversation with my sister tonight. She’s just been diagnosed with a severe case of sleep apnea. As we discussed it, we discussed a… habit? …trait? …we both share. That is, we both ‘forget’ to breathe on occasion. Not while sleeping, but in broad daylight while wide awake. I sometimes find myself thinking about or focusing on something, and suddenly realize that I’ve stopped breathing. Sometimes it’s for long enough that I feel the need to gulp several deep breaths before I can get back to normal breathing.
I never have difficulty breathing, and it’s not an effort at all to start breathing again once I realize I’ve stopped. It doesn’t happen very often, maybe two or three times a month. And my sister describes exactly the same experience.
Do you ever wake up with a gasp? Do you ever have drowning dreams, or dreams that involve suffocation?
Forgetting to breathe when you’re awake isn’t as bad as when you’re asleep!
You might visit a doctor and try one of those night-time blood-oxygen monitoring machines. Not too expensive. Kinda fun, really: you sleep with a clip on your finger, which records your blood oxygen level throughout the night and prints out a report in the morning.
That’s how my sister was diagnosed. They found that she had more than 100 interruptions to her breathing per hour, and her oxygenation level went down as low as 49% (they told her it should pretty much always be something around 95% or better).
I was Dx’ed with sleep apnea a few years ago. But I have a beef about it:
I’m not doubting that I have apnea. Not for a moment.
But the so-called “sleep lab” diagnosed it without making a semblance of an attempt to look for anything else. The waiting room had posters on the wall about sleep apnea. There were brochures on the coffee table and the reception desk all about apnea. There were freebie ballpoint pens around with tidbits about apnea printed on them. It was all about apnea, apnea, apnea.
Like, you go to a eye doctor and he has posters and brochures about Lasik surgery plastered everywhere. You think maybe he’s a little bit over-primed to find every patient to be in need of Lasik surgery? That’s how I felt there. They weren’t in the business of diagnosing sleep disorders. They were in the business of discovering that you have sleep apnea.
So I got the take-home thingy with the recorder and the wires and the clothespin on the thumb (and maybe there was a mask also? I forget) and I wired myself up that night and tried to sleep. (As I recall, something went very wrong with it and I had to do it all over again another night.) Well, sure enough of course, they found moderately serious apnea.
But I felt sure there must be more to that, which they didn’t find or even look for. It takes me a looooooooong time from when I lay down in the first place until I fall asleep. That isn’t apnea, is it? And I have some trouble with waking up at various times and not being able to get back to sleep. That isn’t apnea either, is it?
But they didn’t even look for, let alone find, anything along all those lines. They were just looking for apnea, apnea, apnea.
ETA: Oh, and I also learned that there’s two kinds of apnea – the more common type, resulting from flabbiness in your upper throat somewhere, and the less common type, resulting from some kind of nerve damage somewhere – whatever part of your CNS tells your lungs to breathe isn’t working right. That kind is said to be less common, but sounds a lot scarier to me. I think it is more serious. I don’t know that they did anything to distinguish one type from the other. They said the data from the recording could distinguish the difference, but I wonder about that.
And, Boyo Jim, what are the apnea doctors having your sister do about it? (And what do you think they will have you do?)
Did they give her a CPAP machine, or any kindred device? If so, have you seen how it works? Do you think you could sleep with a machine like that all over your face?
I got a CPAP machine and used it for several weeks, but I just couldn’t get comfortable with. With the mask, and the plastic hose connected to the machine, you just can’t toss and turn freely, or lie in any position you like.
You pretty much have to lie more-or-less still, and more-or-less on your back. Well, I’ve never in my life been comfortable lying on my back for more than a few minutes at at time (I think it has to do with my twisted up scoliotic spine), and I’m an extremely restless sleeper. (Did I mention just above that it takes me a loooooong time to fall asleep?) I just can’t lie still, or on my back for long. It was very awkward, and I gave it up after a few weeks.
Someday I gotta talk to a sleep doctor again and see if there’s some way to improve on that. I’ve forgotten what it’s like to get a good night’s sleep, it’s been so long, and I’ve also forgotten what it’s like to feel alert and awake during the day. Yawn.
They kept my sister in the “lab” while they tested her – they didn’t send her home with with some portable testing gear.
She’s just been diagnosed – she has an appointment to get a CPAP mask fitting, and doesn’t have the machine yet. At first they were going to offer her some other thing – some kind of insert to the mouth to keep the breathing passage open. Then they decided her apnea was too severe for the insert, so her only real choice is among some different designs of CPAP machines and masks. She says she doesn’t yet know enough about the gear to make an intelligent decision about those things yet – maybe they’ll provide her with some advice or brochures, or let her take some on a… test drive, so to speak.
I do not have sleep apnea, but I also do the ‘forget to breathe’ thing. Not to the point of needing several breaths, nor do I get OUT of breath, but if I’m sitting at a desk being lazy then, yeah, my bod doesn’t think it needs oxygen, I exhale and…kinda sit there for 5 or ten seconds. Always done this, but never had apnea or snoring. My only problem sleeping is GETTING to sleep, but that’s a brain thing, for me.
The two types are obstructive and central. OSA is more common, especially among us flabby Americans, and the treatment is more straightforward. Occasionally someone will have a mixture of the two. CSA is a little harder to treat because simple CPAP won’t do the job; you have to try to find the underlying cause if possible and address that if possible, and still may need CPAP, BiPAP or something.
If you have a full-on polysomnogram (and a take-home sleep test, where you wired yourself up, is nowhere near as good as a real in-clinic one), it WILL detect other issues such as unusual patterns in the various sleep stages, excessive time to fall asleep, etc. It can detect periods in the various stages of sleep, based on brain-wave patterns. It can also detect unusual limb movements (RLS, myoclonus, issues where your body isn’t paralyzed during REM sleep etc.).
The main thing that they can diagnose, for which they’re essential in the treatment regimen, happens to be apnea. If they diagnose insomnia, REM sleep disorders etc, that’s useful data but there’s fuck-all they can do about that, so I’m not surprised that the posters were targeted at apnea. If you’re diagnosed with apnea, you really have to follow up with another study, at the clinic, where your CPAP setting is titrated. Presumably you’ve done this already.
The other potential issues require followup with a medical person outside the sleep clinic. Whether it’s RLS, insomnia, or whatever, the doctor who ordered the sleep test should be working with you on those. At the very least, a discussion on sleep hygiene, avoidance of insomnia triggers, tips on how to get back to sleep, pharmaceutical help if appropriate, determining whether other health issues are at play, etc. If your doctor hasn’t discussed these with you, MAKE him do so.
Bottom line: while the sleep lab is an essential component, and they will gather data useful to help diagnose / treat other sleep issues, apnea is the only thing they can actually do something about.
Dunno. I too have this, and have all my life that I can recall: there are simply some times where I become aware of breathing, and it’s time for my next breath, and I just don’t feel like bothering. Obviously I do, after a pretty brief time :).
As far as apnea, look for the Epworth Sleepiness Scale and that will give you some hints as to whether your fatigue level is out of line; you can also ask your bed partner (if you have one) for input on whether you snore, gasp, or even simply stop breathing.
As a side note: As far as I can tell, all my life I’ve tended to hold my breath while sleeping. I remember as a kid, dreaming about swimming underwater, needing to breathe, finally breathing - still underwater - and feeling better. As an adult, my husband noticed early on that I’d quit breathing sometimes. Never met the criteria for OSA (the first few sleep studies failed to find it). To me, it seemed more like central apnea, but again the studies didn’t bear that out.
Senegoid: I just noticed that you said you tried the CPAP and gave up on it. Try again. You may need a different mask, different pillows, a “cozy” for the tube, a holder to hold the tube over your head, or whatever - but there’s absolutely no reason you need to sleep on your back (I sure don’t, though I often wind up on my back later in the night). If the CPAP can help you get deeper sleep, you may also find you don’t toss and turn as much. If need be, take a sleeping pill the first few nights on the CPAP (I did). That may help with getting used to it also.