Tag Archives: BiPAP

To Sleep, Perchance To Dream

08 Monday Jan 2018

Posted by in Aging, Generational, Health, Lessons of Life, Science, Technology

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Lack of oxygen does bad things to a brain. A lack of quality sleep is almost as bad. Dreaming is a part of quality sleep, but for many years my quality of sleep was being compromised by my obstructive sleep apnea.

When I would try to sleep I would lay down. I would relax. I would drift off to sleep…and then my tongue and soft palate would relax and prevent me from breathing. It’s called obstructive sleep apnea.

My body would react and wake me up just enough to breathe again. I ignored this problem for decades even as it continued to worsen. The result was a constant state of bone-weary fatigue, waking up feeling like I needed a nap, and an inability to focus. I also stopped dreaming.

Finally, my daughter convinced me that I needed to do a sleep study, and I asked my doctor, who then referred me. After the study, I learned that I have severe obstructive apnea (the airway blockage when my muscles relaxed,) central apnea (a failure to breathe automatically,) and hypopnea (underbreathing, or not breathing adequately.) Because of the severity of my problem, I was prescribed the use of a BiPAP machine at night to keep my airway open.

Now, I sleep. Really sleep. And I dream again. Some are odd, quirky dreams…okay almost all dreams are odd and quirky, but it was a surprise to discover what it was like to dream again.

I cannot stress enough how critical it is for a person to ask for a sleep study if they snore, or have been observed to stop breathing while sleeping. People with sleep apnea are; 1) starving their brain of oxygen, and 2) torturing themselves with sleep deprivation that puts them in a state of constant exhaustion. Apneas and hypopneas are an attack on a person’s physical and mental states.

Sleep is vital to our ability to effectively function when we are awake. Dreaming is vital to effective sleep.

Are You Not Breathing When You Sleep?

30 Saturday Dec 2017

Posted by in About Reno, Aging, exercise, Generational, Health, Lessons of Life, Science, Technology

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Hooked up for my sleep study

One of the scariest situations I have encountered is to learn that my brain sometimes forgets to trigger my breathing while I’m sleeping. It is called Central Sleep Apnea and it is different from Obstructive Sleep Apnea that typically is related to snoring.

Central apnea is a ‘systems disorder’ in that the nervous system fails to trigger the breathing reflex. Obstructive apnea is a ‘mechanical disorder’ caused by blockage of the respiratory airways as the soft palate and the tongue relax and collapse into the airway reducing or stopping the airflow. Obstructive apnea is usually associated with snoring. Central apnea is not.

In my case, I have both obstructive and central apnea. Both affect my oxygen saturation in my blood when I sleep, and both can disrupt the quality of my sleep cycles. My central apnea may be a result of my 2012 Wallenberg’s Stroke (AKA:  Wallenberg’s Syndrome.) This is a stroke affecting the medulla, or brainstem that controls automatic body functions such as breathing.

Obstructive sleep apnea is relatively common; however, central apnea is not as common. In addition, obstructive apnea is effectively treated by using a CPAP or BiPAP machine during sleep to force pressure into the airway. Central apnea can be improved by this treatment; however, neither a CPAP, nor a BiPAP machine are designed to recognize a lack of breathing; therefore, a patient with central apnea may still have an issue with low oxygen saturation because the carbon dioxide is not being expelled from the lungs.

Unfortunately, some pulmonary medical professionals involved in diagnosing and treating sleeping disorders focus on obstructive apnea because it is more common, and it is effectively treated with a machine. Central apnea may have fewer events per night than obstructive apnea and when a medical professional observes that most of the apneas are resolved with a CPAP or BiPAP machine, it could be easy for them to view the remaining central apnea events as insignificant.

However, if a patient has central apnea, his brain may still be starving for oxygen even if the obstructive apnea events are completely resolved. The only way to determine this is for the physician to do a follow-up oximetry study to determine if the oxygen saturation of the bloodstream is at normal levels after treatment of the obstructive apnea has begun.

Both obstructive and central apneas can lead to serious health issues including excessive insomnia, fatigue, weight gain, headaches, nighttime chest pain, difficulty in concentrating, and mood changes.

Central apnea can also result in death. There have been documented cases (SEE below) of a patient dying in their sleep (Ondine’s Curse) within days or weeks of a Wallenberg’s stroke. The assumed cause is a failure to breathe.

The only way to determine central apnea is for the patient to undergo a sleep study; however, it is important to remember that not all sleep study programs recognize central apnea as a significant issue. If the patient has both obstructive and central apnea, they may assume that treatment of the obstructive apnea issue resolves the problem. It is vital that a follow-up nighttime oximetry test be done to determine if the oxygen saturation is resolved by the use of a CPAP or BiPAP machine.

My apnea issues were undiagnosed for five years after my Wallenberg’s Stroke. Hopefully, the neurological medical community will someday require a sleep study for every Wallenberg’s Syndrome patient as part of the best practices for stroke patients. Post-stroke apneas seem to be overlooked because they don’t present obvious symptoms unless the patient dies.

Links to central apnea related to Wallenberg Syndrome:

Central sleep apnea (Ondine’s curse syndrome) in medullary infarction

Central type of sleep apnea syndrome caused by unilateral lateral medullary infarction

Obstructive sleep apnea after lateral medullary syndrome

Sleep Apnea as a Feature of Bulbar Stroke

Delayed Central Respiratory Function After Wallenberg’s Syndrome

Rapidly progressive fatal respiratory failure (Ondine’s curse) in the lateral medullary syndrome

Ondine’s Curse in a Patient with Unilateral Medullary and Bilateral Cerebellar Infarctions

Death By Snoring

17 Monday Jul 2017

Posted by in Aging, exercise, Generational, Health, Science, Technology

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My sleep study wasn’t all fun and games….in fact…

Not all people who snore have sleep apnea, a stoppage of breathing during sleep, but most, if not all, people who have sleep apnea, snore. The problem is that if a person has sleep apnea, they are likely dying a slow death.

I have snored for most of my adult life, and I’ve known it was bad. What I didn’t understand was that my snoring was a sign of sleep apnea, and it has affected the quality of my life. Left untreated, sleep apnea acts almost like a disease that nibbles away at a person’s health, until the body systems began to fail.

A sleep study, involving sleeping in a lab where I was observed all night, revealed that my breathing stopped 82 times…in one hour. In addition, my oxygen levels dropped below acceptable levels.

What that means is that the following health issues may have been caused by, or exacerbated by my sleep apnea:

Stroke:  Five and a half years ago sleep apnea may have contributed to, or caused my Wallenberg stroke.

Fatigue:  My sleep apnea likely has kept me from obtain quality sleep every night, and led to a near constant state of fatigue.

Overweight:  Most of my life I have been able to eat almost anything and not gain weight; however, in the past twenty years, my weight has soared, and now I am almost sixty pounds over my recommended weight. While aging is a factor, sleep apnea, and the resulting fatigue is likely contributing to the issue.

High Blood Pressure:  Sleep apnea is linked to high blood pressure, and my blood pressure has gone from borderline high to blood pressure that requires treatment with medication.

Brain Atrophy:  After my stroke I had a MRI scan of my brain. The neurosurgeon wrote that I had brain atrophy, but he linked it to normal aging. Now I question the role sleep apnea has played in the shrinkage of my brain.

Depression:  I have had issues with mild depression since my stroke. I believe most of the depression is linked to the frustrations with lingering effects of the stroke. Sleep apnea may be a primary cause of those issues, and/or it has had an effect on my overall sense of wellbeing.

Difficulty Exercising:  I often become light-headed and mildly dizzy when a begin to exercise. Even a simple walk can generate the symptoms. If my brain is starved for oxygen at night, it might be establishing a deficit during the day that leads to a lack of oxygen for exercise.

Concentration:  In the past few years I have written less. It is possible that sleep apnea has made it difficult to concentrate.

It is unclear how much sleep apnea has contributed to my health issues, as aging also contributes to many of the above symptoms; however, it is almost impossible to establish natural aging issues from issues caused by sleep apnea. It may take months for me to feel a difference using a machine to maintain an open airway at night.

Still, starving the brain and body of oxygen every night is going to cause damage over the long term. If left untreated, I won’t die of sleep apnea, but I will die of what sleep apnea does to my brain and body.