Possible sleep apnea? (perhaps some mild TMI)

So I went to the doctor today, mostly so I could get my Rx of Nasonex for my allergies renewed. Turns out I have an ear infection (that would explain the mild soreness in my left ear…) and when the Dr. looked at my throat she said that my tonsils were enlarged and asked if I had trouble sleeping or if I had excessive sleepiness during the day. I said well sometimes when I have my period I feel tired and drained but that seems normal.

We also discussed my migraine headaches, which I also sometimes get while I am on my period and sometimes just randomly, and my elevated BP - it was 136/75, but it was most likely a result of having to listen to screaming tots in the waiting room while I waited nearly 45 minutes for my appointment. But I was expecting the long wait as that is pretty much the standard here in Vegas.

She said based on my info and current health status (headaches, BP, enlarged tonsils etc…) that I may possibly have sleep apnea.

I have looked at the online information regarding sleep apnea and I don’t really have any of the symptoms. I am confused, though, regarding why she would think that I have sleep apnea. If it is a matter of puffy tonsils clogging up my throat- couldn’t I just get my tonsils removed? Could my tonsils just be puffy from having allergies and an ear infection? (Or is that asking for advice?)

I have a follow up appointment in 2 weeks, what kind of questions should I ask before I am shuffled of for expensive sleep testing at a center that my insurance may not cover and I probably wouldn’t have time to do anyway? Or should I just ask to have my tonsils removed (that the insurance does pay for)?

I was diagnosed with obstructive sleep apnea (OSA) several months ago following a sleep study. For years I had struggled with a lack of energy which I attributed first to depression and then to hypothyroid (which I learned later can be itself caused by OSA, as can high blood pressure). Now I’m on CPAP (the breathing assistance machine) and I finally am starting to improve and feel somewhat rested after three weeks of sleeping eleven hours a day.

From what I’ve read on the Internet (I’ve found sleepapnea.org to be the best resource) headaches are a fairly common symptom of OSA. I strongly recommend that you push your insurer to pony up for the sleep study; good sleep is necessary for any worthwhile quality of life.

As for treatment, CPAP is the first-line option. There are a number of different surgeries that are performed (all the way up to a tracheostomy :eek: ) but success rates are in the coin-flip range at best. Anyway, good luck with it.

While I don’t see a lot in your OP to indicate sleep apnea, your doctor may have more to indicate it – are you by chance overweight? I had absolutely no symptoms of sleep apnea before I was diagnosed, other than fatigue (with my chronic pernicious anemia and my hypothyroidism, who would think sleep apnea, right?) but I had what was considered “extremely severe” as in “life-threatening” sleep apnea. I also would have bouts of hypopnia during sleep – not a good combination. It doesn’t hurt to get tested, but it is a great thing to get treated.

As for your migraines – I also used to suffer from the occasional migraine that would come either right before or just after my period had started. It was hormonal. My doctor put me on prozac for it, and it helped – except that prozac makes me very, very, very high so I had to take it at night. Losing all of my excess weight has seemed to relieve the migraines completely. I have had one since losing all my weight, and it was really weird in and of itself, so we are hoping it was just a fluke. You might want to start tracking the migraines and if they always come with your period, get on something to prevent them.

Do you sleep with a partner? My best diagnosis was my wife looking at me and saying, “You stop breathing at night.”

Without her, even knowing I’ve got it, I debate if I’m fighting it some nights. (I sleep with a CPAP but allergens, colds, etc. can make it less effective.)

Headaches are a good indicator for me as well as a sore throat from snoring like a sleepy banshee all night.

Just my 2¢:

I had a sleep disorder in which I would wake up *gasping for breath, so I guess that would technically qualify as sleep apnea. However, it looked as though it was the result of acid reflux. Solution (for me, anyway): I just eat earlier in the evening, several hours before going to bed. Usually when it hit me, it was when I had eaten within an hour or two before bedtime.

*In fact, the first time it ever happened, I actually ran outside my apartment in my underwear. That way, if I was choking to death, at least someone would find my body before it became a smelly soup.

I have had sleep apnea all my life even when I was completely fit and skinny as a rail. To make a long story short, I went through a sleep study and it determined that I had moderate sleep apnea which was causing health problems including high blood pressure. I opted for radical surgery which included having my tonsils and adenoids removed, a deviated septum corrected, and a uvuloplasty. That is pretty serious surgery for an adult with a strict bed rest time of 2 weeks and an anticipated wait loss of 15 - 20 pounds for a male because you basically can’t eat anything real for almost a week. It doesn’t sound like you would need all of that but just having your tonsils out as an adult is a major surgery and will require significant time away from work or whatever else you need to do. It isn’t nearly as simple as it is with the kiddies.

The surgery didn’t work for me completely but it did help and I don’t regret having it. I grudgingly have a CPAP machine now and it works quite well as long as I don’t subconsciously rip it off in the night. I would have a sleep study if you can. They aren’t fun but that is the only way to be sure of what is really going on.

I attended an RN seminar last night on sleep apnea and dental appliances vs. surgery/ CPAP. The maxofacial surgeon who taught it uses many diagnostic tools to determine how much air flow/ how constricted your airway is. Not just overweight/ older people have sleep apnea.

I just had Nasonex prescribed for me for my own possible sleep apnea (symptoms - I wake myself up in the night with my own snoring - also, when the doctor came to call me from the waiting room I was nearly asleep!). So possibly part of your doctor’s thinking is that if you have mild symptoms of sleep apnea while on a medication that can treat that very thing that makes it all the more likely that you’d have it in the absence of any medication.

Or, possibly, the word “Nasonex” just got her thinking in a particular way…

My doctor said that apnea does a lot of damage to the heart and lungs. My husband would have had no idea that he had it if I hadn’t insisted that something was wrong with his breathing. The test showed that he was waking up an average of every two minutes during the night. He just didn’t remember it.

This is his third night on the machine. It surely is quiet around here.

If you’re directed to a sleep study, I posted about my experiences getting one in this thread.

I was found to have mild sleep apnea, almost all when I was sleeping on my back. The treatment was to sleep in a T-shirt with a tennis ball in a pocket that I sewed into the back, so whenever I rolled onto my back, I would roll back. After a few months of sleeping in the T-shirt, I stopped sleeping on my back, and seem to be fine.

I’ve always had insomnia, but even when I get what should be a good night’s sleep (8 hours, getting up once to let dogs out), I still wake up exhausted. I’m literally more tired when I wake up then when I went to bed, with grainy, burning eyes. I go through the day yawning. I’ve been thinking about asking for a sleep study. Does it sound like I need one? I hate medical testing.


What a bizarre policy for an insurance company. I’ve had half a dozen or more sleep studies and they’ve all been covered. I can’t imagine that a sleep study is more expensive (or more risky) than surgery.

I don’t know about you, but before I let someone take a knife to my throat, I want to know what’s going on – do I have apnoea? Is it obstructive or CNS? Will surgery be likely to help or would it be better just to use a CPAP machine?

I have OSA and used to wake up literally gasping for air, sometimes 30 times a night. It was horrible. Anyways, I’m obese and was looking into the Gastric Bypass Surgery for weight loss. I had all the tests done and even did two sleep studies. During the night, I stopped breathing 426 times in a 5 hour period ! Now I use a CPAP machine and sleep like a baby. It has a full facial mask and blows air rather forcefully down my throat all night.

I feel so much better, though. It’s DEFINITELY worth getting a sleep study done, because you can have no symptoms at all and still stop breathing at night while snoozing.

Get it done. It’s worth it.

I was just diagnosed with it. I did two nights of sleep studies and I go to pick up my CPAP machine tomorrow morning.

Thanks for the responses and sharing your experiences with sleep apnea.

I am overweight, but not so much so that I cant breathe. I am also have a decent level of cardiovascular health and my BP goes up when I am nervous or stressed. I bought one of those automatic home BP monitors; it’s in the normal acceptable range when I take it at home.

The migraine headaches are nothing new for me, I was diagnosed with them when I was 11 years old… right with the onset of puberty. They were horrific through high school, but as I have gotten older I usually only get a few bad ones per year- not really warranting a daily Rx. When I do, I will take whatever painkillers I can get my hands on to make them go away. I just wanted to see if there were any Rx meds that I might be able to use when I do get one instead of using 10+ Advil (over a period of 4 to 6 hours) to get a migraine to go away.

I just feel, personally, that a sleep apnea diagnoses is sort of jumping to conclusions based on a small set of factors. I will, however, listen to what my doctor has to say about a sleep study during my follow-up for my ear infection.

Right now my allergies are acting up on a ridiculous level. Yay for fall and leaf mold… that’s why I needed to get to a doctor and get my Nasonex refilled. My sinuses are irritated, I have a mild ear infection etc…

As for a sleep study, I have no idea what the insurance will pay for and what it wont since I never really do anything more than the ordinary… GYN visits, the occasional need to get an expired Rx refilled. I get a complete physical through work every year (Industrial Medicine stuff, since I occasionally do work relating to HazMat). I would really prefer never to have t have surgery that requires anesthesia (minor fear of mine)

After reading Billdo’s post :eek: I wouldn’t be able to sleep with all that crap wired up to me. I can’t even sleep with socks on let alone tubes stuffed up my nose. I also don’t sleep on my back, never have, I am a side/front sleeper. Mr. Geek says I only snore a little when I am congested and/or my allergies are bad.

I typically sleep from around midnight to about 6 A.M. on a normal day. Rarely am I tired and when I am it is because I only got 3 or 4 hours of sleep. I usually get about 8 hours of sleep on the weekends.

You don’t have to sleep all night for the study to produce sufficient data. It might not be comfortable, but then it’s a medical test, not a holiday.

<slight hijack>diggleblop – good luck! If you have any questions, please feel free to PM or email me – I had gastric bypass in 2005 and am doing pretty well :)</hijack>

LVgeogeek – one does not have to be so fat that one cannot breathe to have sleep apnea. Sleep apnea can be due to having enlarged tonsils/adenoids/etc, having a very pliable/soft soft palate or even just having a nice, soft tongue – any of those things can obstruct your breathing during sleep when you’re all relaxed. Or you could be like I, and have a situation wherein your body just stops breathing – that had nothing to do with my weight. To be sure, I have what is considered to be “extremely shallow” breathing by most medical professionals, but my O2 concentration is always above 98% – my body has learned to be very efficient with the whole breathing thing because of the occasional “oops, we forgot to breathe for a few seconds” issue :smiley:

The sleep study is very annoying (especially if you like to sleep nekkid, like I and have to have it done in a clinic) most insurance companies do cover sleep studies, because they’d rather cover a sleep study than a heart attack. Trust me, it’s way cheaper! Some insurance companies will even cover the in-home studies – when I was on UHC, they covered it – and that was awesome. The tech came over, hooked me up to all the crap and then left. I was allowed to sleep in my own bed, and the machine recorded everything for them to diagnose later. She came back when I called her in the morning after I’d gotten up and picked up the equipment.

I agree that based on your OP, the doctor may be jumping the gun on this possible diagnosis, but better safe than sorry. Good luck however it turns out.

I don’t want to add to your concern, but I had a hell of a time falling asleep during my study. But, as mentioned, they got enough data during the time I did finally fall out. It seemed like hardly any time to me but was enough.

Interesting about the hypothyroid and sleep apnea. They put me on Synthroid for it but maybe if I use my CPAP consistently that would be enough and I wouldn’t need meds??

YMMV, but if I go even 2 days without my synthroid, I can tell – and my labs show it too. Considering the problems my thyroid have given me over the years, I’d rather just take my meds like a good little patient. I can butt heads with doctor on other less important issues, like whether or not that was a stroke I had a couple of weeks ago.