25/6/2010

Sleep Apnea 6: Resolution!

Filed under: — Bravus @ 10:06 am

I don’t have a headache today! I keep feeling for it, like checking a loose tooth with my tongue, but my scone remains resolutely painfree.

I used my (rented) machine at home for the first time last night. It did take some getting used to, but it’s definitely worthwhile, ‘cos I feel much better today, and imagine I’ll keep getting better.

Me in my mask

Went to the doctor yesterday morning, and found out why I still had a headache after the sleep study. In the course of the night they cranked the pressure up from 4 to 9 (cm of water is the pressure unit, so not a lot), but it didn’t stop the events: there were still about 30 in the final hour.

That meant that I went home with an APAP – Adaptive Positive Airway Pressure – machine, instead of the constant pressure CPAP machine. It’s the one that’s a bit smarter, and adjusts the pressure to the resistance it feels. It also records what it does, so I can go back to the doctor at the end of the month and he can see what pressure it was using most often.

The problem is, the APAP costs about twice as much as the CPAP… and twice as much as health funds will pay for. We’d be up for over a grand out of pocket if I needed that machine. So the hope is that the machine will tell us what pressure works, and I’ll try a CPAP for the second month and see if it gets the job done.

We’ll see – but today, I don’t have a headache!

23/6/2010

Sleep Apnea 5: Titration

Filed under: — Bravus @ 5:31 pm

That’s me, wired up for my second sleep study, which happened last night. I was also wearing a mask all night – pity it’s not in the photo, but you can see its red traces above and beside my nose.

This was the ‘titre’ study: basically, I was fitted for the… I was going to say ‘most comfortable’, but ‘least uncomfortable’ masks yesterday, then went and was connected up to a CPAP machine last night. The technician (Mary again) basically watched the monitors and slowly turned up the pressure, from its starting level of 4. When it reached 7 she noted that the apnea events had stopped, so she stopped increasing the pressure there, and that’s my prescribed setting.

Still woke up with a bit of a headache this morning, but that may have been a side effect of the early apneas, as well as the discomforts of using the mask for the first time.

Without being too indelicate, I usually have to visit the en suite bathroom 3-4 times in a typical night. I assumed that was just due to drinking a lot of water during the day, but apparently the body ramps down kidney function overnight… but with apnea you keep waking and it doesn’t get the cues to do so. With the machine on last night there were only two visits… so that’s an unexpected bonus.

Back to see the doctor tomorrow to, I think, actually pick up my mask and machine to take home. Then we’ll get started with it in earnest and see how I feel.

10/6/2010

Sleep Apnea 4: Diagnosis

Filed under: — Bravus @ 5:00 pm

Visited the doctor this afternoon, who kinda told me what I already knew: yep, I have sleep apnea. Severe sleep apnea. The scale starts at zero events per hour, the ‘severe’ part starts at 30 and I’m averaging about 46. (And yes, there’s a bizarre sort of bragging going on here: If I’m gonna have a condition, I’m gonna have it hardcore!)

So, it’s back to the sleep clinic some time soon. Same study, same wires and such, but with a mask and a Continuous Positive Airway Pressure (CPAP) machine on. Basically, someone sits outside the room, watching the monitors, and keeps turning up the pressure a notch at a time until I stop stopping breathing… And then I’ll know what pressure I need to keep my own little (no doubt expensive) bedside machine on…

It’s all a hassle, but it’s a relief to have a diagnosis – and given that untreated sleep apnea can lead to heart attack, stroke and all manner of other nasties, and that treating it will get rid of my daily headaches and make me feel more awake and alive… good to be on the path to a solution.

3/6/2010

Sleep Apnea 3: At The Sleep Lab

Filed under: — Bravus @ 8:41 am

I’m massively annoyed with myself. Put my phone on to charge when I got home from work last night so I could take it with me to the Sleep Lab… then forgot to pick it up when I rushed out the door. If I hadn’t done that (heh, I’ll blame the apnea for the forgetfulness!), there’d be a totally awesome photo here of me with a tube in my nose, sensor in front of my mouth, bands around my chest and stomach and 10-12 electrodes stuck to my head and body, trailing wires to a black box on a pink lanyard around my neck! You’ll just have to imagine the picture…

Arrived last night at the hospital, sat around for a while in reception, then Mary, the specialist nurse, who was nice and very efficient, bustled up and took me and the other guy who was also there for a sleep study around to our (separate) rooms. Watched TV for a while, then she wired me up, very quickly and efficiently. (Oh, yeah, she was an Aussie who had spent some time in Canada and picked up something in my accent that told her I was too, which was interesting.) The procedure involves an alcohol swab, a little bit of sandpapery paste, a wipe-off, some conductive paste/glue, an electrode and some tape, in precisely-measured spots on my scalp, face and body. Then there’s a nasal canula with a little tube a cm or so up each nostril and a sensor in front of the mouth, and stretchy bands around chest and stomach to measure breathing.

Lay down, tried to sleep, it was a bit of a struggle in an unfamiliar bed, and I think I probably breathed through my mouth more than usual because it felt like my nose was obstructed. Not the best night’s sleep I’ve ever had, but apparently I slept long enough, and snored loud and long enough, that she was able to record what was needed. I go to the doctor next week to get the results, and will report them here when I do. Woke up with my usual daily headache, so if it’s apnea that’s causing those, they should be able to see it in the data.

Final note: Mary told me when I woke up this morning that I’d been dreaming for some time just before that. I didn’t remember at all, and I have to admit it is slightly odd to have someone else know something you don’t about your brain and body’s workings…

And then I walked down to Coronation Drive and along by the river in the sunshine toward the bus to the uni, and all’s well with the world! Some light drugs for the headache and I should be able to make a decent sized hole in writing this textbook chapter today.

2/6/2010

Sleep Apnea 2: To The Sleep Lab!

Filed under: — Bravus @ 7:17 am

So, got back from Penang, made an appointment with my GP, he referred me to the sleep specialists, and tonight I will be sleeping in a hospital bed, wired up with many sensors. I’ll have to wear pyjamas, which I don’t usually, and won’t have Suzie beside me, so it’s not a purely scientific test of how I sleep (i.e. it could just be that she takes my breath away!) But it should give some sense of whether I stop breathing during the night.

That would explain the almost daily headaches that I’m still getting… and although it sounds bad, the sleep apnea thing is usually pretty easily treatable with a little machine beside the bed. And, as my GP said, many of the other explanations for daily headaches are worse, so I almost hope that this is what it is…

I have an appointment for next Thursday to get the results and discuss them with a specialist, but maybe ‘Sleep Apnea 3’ will be tomorrow when I describe the process and ‘Sleep Apnea 4’ the actual results report… Then there’s obtaining and getting used to the machine, if that’s what happens…

Hope these little diaries are useful and interesting, and who knows, maybe someone else will identify their problem and be on the road to a solution if they google for the symptoms…

16/5/2010

Sleep Apnea 1

Filed under: — Bravus @ 1:30 am

I’ve been waking up with headaches, and walking around with them all day, and taking more panadiene than is strictly good for my liver, for a while now. Wasn’t sure what the problem was, thought it might be allergies, or eye strain, or caffeine withdrawal… then I thought ‘I wonder if it’s sleep apnea?’ Did a little digging, and that’s certainly one of the symptoms.

Sleep apnea is when you stop breathing for a while during the night. It can be associated with snoring but is different. It tends to make one feel tired and a bit vague during the day, not really rested, and headachey… and all those things describe me pretty well lately: just not the usual vim.

I thought of it because I know Dad suffers from it. He’s a bit heavier than me, and it can be associated with weight as well, but I’m a lot like him in all sorts of other ways, so it wouldn’t surprise me if I’ve inherited this.

Fortunately, while not really curable, it’s eminently treatable. When we get back from the Malaysia trip (see above) I’ll get tested (which involves wearing a monitor for a night or a couple of nights to find out whether it’s happening). If it is I’ll need to get a mask and pump ‘constant pressure’ apparatus, and wear a mask over my nose while I sleep that supplies air to keep the airway open and stop the apnea.

It’s expensive, and probably a bit uncomfortable and hard to get used to… but having my energy, mental acuity and headache-freeness back would be very nice indeed.