Aces High Bulletin Board
General Forums => The O' Club => Topic started by: daddog on May 28, 2007, 11:08:56 AM
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This is not a forum I frequent, but I thought it would be worth while to post about this condition if by the off chance it serves as a warning to someone else with this problem.
Not long ago I was diagnosed with severe sleep apnea. This is a condition where the soft tissue in the back of the throat closes off your airway when your sleeping and your brain fails to correct the problem. Those that know me might say ‘That is not all your brain is failing to do.’ :D From what I have read over 12 million American’s have it so it is not uncommon by any means. Sleep apnea can cause high blood pressure, memory problems, weight gain, impotency, and headaches. It is most common for males, over the age of 40 and over weight. I am male and over 40, but at least I am not over weight. My guess is a lot who play Aces High are all three of those.
I would guess for me personally this condition started about 20 years ago. I wonder, correlation? :D It was such a gradual process I never realized I had it. Much like the frog you put in pan of cold water and then you turn on the heat. For years I have always been tired when I get up. I have always been nodding off to sleep while driving to work. I have always fought staying awake in the afternoon. Always tired. I just figured that was life with four children and a busy teaching schedule. I have always been a morning person and I get up 4 AM. Out the door by 4:30 and off to the gym. I would work out, shower and change and try to be at work by around 7 AM or so. Get home between 5 or 6 and would usually stay up till 9 or 10. A couple years ago my wife mentioned she had seen me stop breathing during the night. We knew what sleep apnea was and talked about it, but like so many things in life it was put on the back burner. I did not have time to go to the doc’s and see if that was what I had. Time went on and she had noticed it a few other times. Also sometimes I would wake up breathing hard and in a sweat as if I had been working out. Although I have had this condition for years it was just the past couple years it really became apparent.
I finally went in and had what they call a sleep study. You are wired from head to toe and they monitor your sleep. Needless to say my results were surprising I had hypnea which is a form of sleep apnea. Hypnea means that for a period of time (less than a minute) you receive 50% or less of the oxygen required. Another interesting fact from my sleep study was my REM, (Rapid Eye Movement) stage of sleep. That is to say I did not have any REM sleep. REM is your dream state of sleep and is required for a healthy night sleep. I can remember having dreams as a young man, but over the past 10 years it became rare for me to wake up and recall any dreams I had. In more recent years I might remember one or two dreams in a month. For those of you in the medical field my:
- Respiratory Arousal Index was 59.3 an hour
- Average duration of hypopnea was 15.2 seconds
- REM was only 9% in 269 minutes. In that time I had 200 hypopneas.
After being diagnosed with this condition I bought one of those CPAP (Continuous Positive Airway Pressure) machines. When I go to sleep I place a small mask over my nose that has a flex hose connected to the CPAP machine and I shut my mouth. It acts like a small (and very quiet I might add) compressor. This slight pressure keeps the airways open. I was concerned about keeping my wife awake at night, but it really is very quiet and only took her a few days to get used to it. It took me a few days to get used to it also, but once I did it has really made a difference. No doubt I am not as tired as I was, but what has really been the most significant change is my dreams. It is as if someone had opened up a whole new world at night. When I wake up in the morning my head is flooded with the dreams I had from the night before. It really is amazing to go from a reality without dreams to a reality with dreams. I had forgot how vivid and real dreams could be. Not that I put any kind of weight in dreams or am into dream interpretation, but the simple fact that it is fundamental to have dreams for your health and well being.
It has been about 6 weeks now since I started using CPAP machine and the results are positive in my book. I figured it would be worth while to post this since maybe, just maybe, it will help someone else who struggles with being tired all the time and might have sleep apnea and not know it.
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Your story reads very similar to mine. I was waking 71 times an hour.
Been on a CPAP about 2 years.
And yeah, I started to dream again after starting CPAP, hadn't noticed or thought about fact that I hadn't been dreaming.
I take the CPAP with me when I travel. Makes quite a differance, and haven't woken up with a heart beat going so hard and fast that I could barely breath since.
Plus, my wife doesn't complain about me snoring anymore and I can sleep on my back again.
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that is amazing, Daddog. good thing you finally checked it out. its a pretty big bang for your buck as far as treatments go, going from rem sleep deprivation to restfull sleep. i'm going to suggest it to my brother. thanks for the info
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I believe I have this as well. I'm going to have a Sleep Study done as well.
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Originally posted by Masherbrum
I believe I have this as well. I'm going to have a Sleep Study done as well.
A good tipoff is if you are married, does your wife noticing you jerking at night? Like a whole body shake? Often, when someone has sleep apnea, they will stop breathing, and restart with a jerk, but not be aware of it.
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Mash, you need a prescription to by a CPAP. according to the CPAP website, you can buy a "test tape" from them, tape it to your upper lip and it will record your breathing pattern while you sleep. then you send the tape or strip or whatever its called back to them, and they will send you a prescription for a CPAP if your test is within their parameters. it sounds like it might be cheaper than a sleep study.
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Yep,
Same thing here, I was diagnosed with severe sleep apnea about 6 months ago. in total if I remember right in a 7 hour period I stopped breathing 83 times, Using the CPAP now with a full mask (covers Nose & Mouth) with a humidifier...
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an older friend of mine had this for years and didn't know it. had to take caffeine pills to get through the day.
if you are getting enough sleep, and still very tired or falling asleep during the day, you should definitely get tested.
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Originally posted by Dago
A good tipoff is if you are married, does your wife noticing you jerking at night? Like a whole body shake? Often, when someone has sleep apnea, they will stop breathing, and restart with a jerk, but not be aware of it.
My wife says I'll "stop breathing, for sometimes 30 seconds and then restart". I guess I wiggle one leg from time to time too. Problem with me is that I sleep like a rock. She's an insomniac. I feel bad for her, she's put up with this for so long. But I just feel it's time like daddog, to move this to the front burner.
I rarely recall dreams anymore. I rarely feel "energized", even though I push 400-700lbs at a time at work. I've lost 32 pounds so far because of my job. But it seems like no matter how long I can sleep, it will "never be enough". I wake up dragging arse.
She's pretty much convinced I have apnea, which is why I'm going to do something about this. I'll be 34 on June 9th, and have been married almost 9 years. It is hereditary, my brother had a sleep test, and was diagnosed with it, but hasn't done anything. Polyps run in the family (grandpa died of Colon Cancer and I almost lost my mother in 1990 to polyps) and I'm the only sibling to have a colonoscopy.
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Originally posted by Masherbrum
My wife says I'll "stop breathing, for sometimes 30 seconds and then restart". I guess I wiggle one leg from time to time too. Problem with me is that I sleep like a rock. She's an insomniac.
I rarely recall dreams anymore. I rarely feel "energized", even though I push 400-700lbs at a time at work. I've lost 32 pounds so far because of my job. But it seems like no matter how long I can sleep, it will "never be enough". I wake up dragging arse.
All those are very strong symptoms of sleep apnea. You are not sleeping like a rock, you just think you are. Lack of dreams illustrates it.
I would bet money if your symptoms are as described, you have apnea and need treatment.
I swear at least one third of the guys at work have apnea. One of the thinnest guys at work has apnea.
One of the bright bulb moments for me was, one day flying home from the east coast, after being on the CPAP for a while, I realized in the airplane that I wasn't tired. It had been longer than I could remember when I felt like that, no underlying tired feeling, just wide awake. Amazing how you just become used to being tired all the time without realizing it.
Get tested soon, untreated apnea can cause heart problems.
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Is surgery any kind of option for this?
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Originally posted by Dux
Is surgery any kind of option for this?
As I understand it, the medical surgical treatment is to use a lazer to burn and remove some of the flesh from the back of the throat, including the uvuala (sp?).
My understanding is it is a painful recovery, you must learn to swallow in a new manner, and if I remember the doctor correctly, it is only successful in something like 30% of the cases.
CPAP has a much better rate of success but the Cpap method isn't without inconvienience, cleaning, taking it along when traveling, and sleeping with a mask strapped to your face.
If I remember it correctly, there is also a method to implant a series of plastic splints in the throat to hold it open, but it didn't sound like a good way to go, so I went with CPAP.
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I have a lot of sleep problems, unfortunately, not diagnosable. I had a sleep study, and they said I don't have apnea and I don't have RLS... Ambien Wan Kenobi, you're my only hope. :(
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Originally posted by daddog
Sleep apnea can cause high blood pressure, memory problems, weight gain, impotency, and headaches. It is most common for males, over the age of 40 and over weight. I am male and over 40, but at least I am not over weight. My guess is a lot who play Aces High are all three of those.
Hmm high blood pressure, weight gain, headaches. I snore a lot, and loudly :(
Is this the sort of thing one would get: http://www.sleeptech.co.nz/s8asc.pdf ?
Is it worth doing the test, some NZ companies do it for NZ$75 (bout US$60) http://www.trademe.co.nz/Health-beauty/Health-care/Other/auction-101156132.htm?p=12
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Originally posted by Vulcan
Hmm high blood pressure, weight gain, headaches. I snore a lot, and loudly :(
Is this the sort of thing one would get: http://www.sleeptech.co.nz/s8asc.pdf ?
Is it worth doing the test, some NZ companies do it for NZ$75 (bout US$60) http://www.trademe.co.nz/Health-beauty/Health-care/Other/auction-101156132.htm?p=12
Yeah, that is the kind of thing. It is normally supplied by prescription, with proper settings derived from the sleep study. In the USA, I don't know if you can even get one without a prescription. Certainly wouldn't know the proper air pressure setting required, that is something they determine in the sleep study.
I believer here to, a doctor may have to order the test for insurance to cover it, but if you are paying yourself, probably not.
I remember taking my test, the sleep technician was a pretty young girl with a very nice voice. (she talked to me over an intercom setup a bit) :D
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I'm not a real pilot, though I play one on the internet....but I AM Board Certified in Sleep Disorders Medicine, and I'm medical director of our sleep laboratory. I've treated sleep disorders for about 15 years. So here's a viewpoint from the medical establishment side of things.
First, if it were me, I would want to be absolutely sure the diagnosis were right, and that means a sleep study. Home sleep studies are not reliable enough to be real substitutes, though they can be used to screen -- if they are completely negative, you're in the clear, but if they are positive then you have to get a monitored study to document severity and to get the right treatment level. Although modern CPAP/BiPAP is much less of a problem than it used to be, it still isnt something you want to do if you don't have to . Monitored treatment studies allow the technician to adjust the pressure real time, which is important because too much treatment pressure can be miserably uncomfortable, and too little will allow symptoms -- and damage -- to continue. Also, at our lab we have almost a dessert tray with different styles of masks. Some cover the nose, some the nose and mouth, and some just fit in the nostrils without covering anything. Here's a really popular one right now (http://optilife.respironics.com/Features.asp)
If it were me, I would not trust the internet for diagnosing or treating a problem this serious. The home test with internet prescription is....unwise. The docs writing those scripts cannot have your best interest in mind, since there's no hint of individual attention and care.
Here are some quick screening questions:
1. Do you snore? Snoring is NEVER normal, since its the sound of air flowing through a tube that's too narrow. (Just like the rude sound you get when letting the air out a balloon's mouth.) People who snore also have higher blood pressures, and higher risk of heart attacks, than similar people who don't snore. This makes sense because the stress of working to breathe through a narrow passage gives you higher adrenaline levels all night long -- and those levels may persist through the daytime.
2. Do you feel rested after sleep? Sleep that does not restore you normally is abnormal. Snorers who have nonrestorative sleep after getting enough time in bed are likely to have sleep apnea, or another kind of sleep disorder.
3. Do you have high blood pressure and a neck size larger than 45cm (about 17 inches)? People with high blood pressure and 45cm necks have a 90% chance of having sleep apnea, even before any other testing is done.
4. Have others heard you get quiet/stop breathing, or do you wake up gasping at times? Frequent awakenings without good reason can also be a sign of sleep apnea. I've often seen guys who thought their prostates were making them wake up and pee find out that treating the sleep apnea make the night time urination go away.
5. Are you tired when awake? If you had enough sleep, you should not feel tired, and you should not be drowsy when sitting still with nothing to do. If you struggle to stay awake, something is up.
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Originally posted by Vulcan
Hmm high blood pressure, weight gain, headaches. I snore a lot, and loudly :(
Is this the sort of thing one would get: http://www.sleeptech.co.nz/s8asc.pdf ?
That model is a really good one, because its small and VERY quiet. (It uses a centrifugal system for the pump instead of a valve that opens and shuts as the pump runs.)
There are some machines that auto-sense the obstructions patients have, and adjust the pressure jsut enough to keep the space open. Some of these devices can even produce a "report" that looks just like a sleep study.
The problem with the home diagnostic machines, and the home self adjusting ones, is simple for us simulation pilots to understand: They rely on AI. Just like a human pilot is much smarter, more adaptable, and accurate than the AI from a boxed sim, the software in those machines is going to make mistakes when things aren't exactly the way the program wants them to be.
And mistakes on a sleep study can mean anything from getting an uncomfortably wrong pressure treatment, all the way to being diagnosed with sleep apnea when you don't really have it at all. Too high a pressure can actually make the number of apneas INCREASE instead of making them go away.
A good sleep study from an accredited sleep lab has multiple layers of quality assurance. For example, even though the technicians score the data first, I view every second of a sleep study I interpret -- its not enough to just view the computer printout. We have proficiency testing, comparison scoring between technicians, regular educational conferences, and comprehensive systems to make sure our patients are followed and supported every step of the way. When troubles come up , we work to get them solved so people can keep using the treatment that helps them.
So if it were me, I would want to plug in with a good sleep specialist.
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Simiril, I hope you don't mind me asking a question...
All the time, it takes me 30-45 minutes to fall asleep. Is this abnormal? Or is it just my ADD riddled mind keeping me up?
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Unless it's something that is stress related or I've had too much coffee before bedtime, I think of dark grey battleships on dark blue waters silently cruising to some point unknown extremely relaxing and helps me fall asleep very quickly. Also, for some reason the image of a 109G firing up and taxiing for take off helps me fall asleep as well. And I don't even much care for 109's but it's the only plane that helps me fall asleep.
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1. Do you snore?
Eh....I snore so loud they can hear me in the living room.....with the bedroom door shut....
2. Do you feel rested after sleep?
I can't remember ever waking up and NOT feeling like I could sleep more.
4. Have others heard you get quiet/stop breathing,
My wife says I do sometimes....
If you had enough sleep, you should not feel tired, and you should not be drowsy when sitting still with nothing to do.
If I sit down to watch tv....I'm out cold in minutes
Mebbe I should have a sleep study done....
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Great info Daddog!
I hope I never get it because with my luck the hose would get wrapped around my neck and strangle me!
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Originally posted by Simaril
That model is a really good one, because its small and VERY quiet. (It uses a centrifugal system for the pump instead of a valve that opens and shuts as the pump runs.)
T
I use a REMstar Plus C-Flex CPAP w/ Heated Humidifier, how does that one stack up? Any suggestions for a small travel CPAP?
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Originally posted by lasersailor184
All the time, it takes me 30-45 minutes to fall asleep. Is this abnormal? Or is it just my ADD riddled mind keeping me up?
"Normal" time to fall asleep is 20 minutes or less.
We all have a biologic clock, which synchronizes itself by specific inputs. In order of importance, our brains set the "wake up" time by: Habit (getting up the same time every day); bright light (sunlight is about 20 times more intense than even bright indoor light); eating; and activity.
Some have strong clocks, and can sleep easily no matter what. Those who have less intense signals from their clocks may have trouble getting to sleep or staying asleep. If you're someone with a weaker clock, expect that you may have to coddle it if you want to have regular sleep patterns when you need them.
Rules for better sleep:
Get up at nearly the same time every day. That helps set your clock. Focus on the time you get up because you can force yourself to get out of bed, but you can't force yourself to fall asleep.Even if you just got to sleep an hour earlier, sleeping in may confuse the clock and make it harder to get to sleep other days. Be consistent!
Do not nap, especially when you're fighting insomnia. When you have trouble getting to sleep, remember that being tired is a GOOD thing, not something to get frustrated over. Frustration keeps you awake, because it causes adrenaline and other stress hormones to release -- not good when you're trying to get to sleep.
Do NOT lay in bed awake. Tossing and turning, or reading/TV, teach your body to be awake in bed -- and that's the habit we're trying to break Allow no more than 20 minutes to fall asleep. If you can't fall asleep in that time, get out of the bed and read (or do something boring -- NOT computer games!) until tired enough to try again. Being in bed "resting" also allows your brain to get "micro sleeps", short periods of 30 seconds to a few minutes that DO NOT rest you but DO get you just a little less tired -- so its even harder to get into good sleep. Get out of bed!
Use the bed for only 2 things, one of which is sleep. Don't do work, or watch TV, or whatever -- you want your body to think of "bed" and "sleep" as if they were one word, the same thing.
If you still have trouble breaking the habit of insomnia, you can try sleep restriction therapy. Pick your wake up time, and don't even try to go to bed until 5 hours before that. Follow all the rules above, even if it means you only get a couple hours' sleep that night. Get out of bed at the right time even id you just fell asleep. DO NOT NAP.
Because of the extra fatigue that program produces, most healthy people will find that they get to sleep and stay asleep well the next night, or the night after that at worst.
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Dago --
Thats a good machine too. The CFlex is a brand specific software tweak that allows the machine to slide the pressure around a little to maximize comfort. For some people its just nice, but for others its vital to make CPAP tolerable. If your body really likes or wants the CFlex, then you may have trouble with other brands.
Just like cars, there are a lot of brands, but they all do pretty much the same thing pretty much the same way. And just like cars, the manufacturers scramble to make something that differentiates them from their competition. I wouldn't tell someone to ditch something that's working for them unless there really was a problem they were running in to.
If you were looking for a small machine you cant get one much smaller than the S8 that was linked. Most insurance companies won't pay for a second machine, and these can be very expensive -- especially if purchased cash at a medical supply company. If you were looking to buy a travel machine with REAL money (instead of that funny stuff the insurance company spends for you), I'd look online for a source that seems reputable and has a history. Online prices look to be several hundred dollars less than what I see from home care companies. If you can use that info to squeeze a better price locally, that's great (but don't hold your breath).
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I had a Sleep Study done in mid April. I got the results 3 weeks later.
My problems with fatigue have been on going for close to a year. Id sleep 8-9 hours and feel dead tired waking up. I blamed it on having allergy issues last summer...but come fall and winter, i was still feeling groggy all day. Oddly enough, as the day went on, I felt better.
I also had a lot of aches and pains which Id blamed on the statin/cholesterol lowering medicine Im on. But I also had an old bed that was way overdue to be replaced. Once I bought a new bed with a pillow top mattress, almost all the achey pain went away.
So, part of the problem was a good bed.
The Sleep Study showed that it took me almost 2 hours to fall asleep. I work up repeatedly. I have a hard time staying asleep. Thankfully, no sleep apnea and minimal snoring. Their diagnosis was my going from 3rd shift to second shift hours broke my sleep cycle. For the past few weeks, I've been doing the Sleep Hygeine thing. Go to bed at a specific time everyday for 2 weeks. I used Advil PM the first week and as the second week rolled along, I've used it less.
Basically, I'm teaching my body to sleep again.
For the past three weeks, Ive only had one or two nights of insomnia.
The rut I was in for a long time was this: bedtime at midnight (since I get home from work around 1030)...then Id wake up at 2am, 3am, 4am, etc etc. With the Advil PM, I sleep thru the night. And its not nearly as problematic as the prescription sleep meds.
Its amazing how something as simple as Sleep can be taken for granted!
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Originally posted by Dux
Is surgery any kind of option for this?
Lumping patients together, the overall success rate for surgery is 50% or less. For soem patients, whose throats collapse from the sides as well as front to back, the success rate is so bad that surgeons won't even touch them. Laser surgery is a bit less effective than the gold standard surgery, the UPPP (Uvulo-palato-pharyngoplasty). The nylon palate stiffener inserts (the "Pillar procedure") is much easier to get done, but is no more effective than standard surgery, and can only be used for the simplest patients. Since they're cherry picking the easy ones, that success rate isn't all that hot.
Of course, if you'r elucky enough to be one of the patients whose surgery works, the success rate is 100% -- for you. But even then its not a lifelong guarantee, since time or weight gain can make the problem come back again.
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Originally posted by Simaril
Dago --
Thats a good machine too. The CFlex is a brand specific software tweak that allows the machine to slide the pressure around a little to maximize comfort. For some people its just nice, but for others its vital to make CPAP tolerable. If your body really likes or wants the CFlex, then you may have trouble with other brands.
Just like cars, there are a lot of brands, but they all do pretty much the same thing pretty much the same way. And just like cars, the manufacturers scramble to make something that differentiates them from their competition. I wouldn't tell someone to ditch something that's working for them unless there really was a problem they were running in to.
If you were looking for a small machine you cant get one much smaller than the S8 that was linked. Most insurance companies won't pay for a second machine, and these can be very expensive -- especially if purchased cash at a medical supply company. If you were looking to buy a travel machine with REAL money (instead of that funny stuff the insurance company spends for you), I'd look online for a source that seems reputable and has a history. Online prices look to be several hundred dollars less than what I see from home care companies. If you can use that info to squeeze a better price locally, that's great (but don't hold your breath).
I never use the C-flex, tried it at first, but the tech who set up the machine set the time frame too long, so I quickly learned to do without it. No problems at all, never use Cflex now.
Will probably break down and buy my own travel CPAP, tired of dragging a large unit in it's own container. Just wondered if you knew any better than the others.
Thanks for the answer.
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Originally posted by Simaril
"Normal" time to fall asleep is 20 minutes or less.
We all have a biologic clock, which synchronizes itself by specific inputs. In order of importance, our brains set the "wake up" time by: Habit (getting up the same time every day); bright light (sunlight is about 20 times more intense than even bright indoor light); eating; and activity.
Some have strong clocks, and can sleep easily no matter what. Those who have less intense signals from their clocks may have trouble getting to sleep or staying asleep. If you're someone with a weaker clock, expect that you may have to coddle it if you want to have regular sleep patterns when you need them.
Rules for better sleep:
Get up at nearly the same time every day. That helps set your clock. Focus on the time you get up because you can force yourself to get out of bed, but you can't force yourself to fall asleep.Even if you just got to sleep an hour earlier, sleeping in may confuse the clock and make it harder to get to sleep other days. Be consistent!
Do not nap, especially when you're fighting insomnia. When you have trouble getting to sleep, remember that being tired is a GOOD thing, not something to get frustrated over. Frustration keeps you awake, because it causes adrenaline and other stress hormones to release -- not good when you're trying to get to sleep.
Do NOT lay in bed awake. Tossing and turning, or reading/TV, teach your body to be awake in bed -- and that's the habit we're trying to break Allow no more than 20 minutes to fall asleep. If you can't fall asleep in that time, get out of the bed and read (or do something boring -- NOT computer games!) until tired enough to try again. Being in bed "resting" also allows your brain to get "micro sleeps", short periods of 30 seconds to a few minutes that DO NOT rest you but DO get you just a little less tired -- so its even harder to get into good sleep. Get out of bed!
Use the bed for only 2 things, one of which is sleep. Don't do work, or watch TV, or whatever -- you want your body to think of "bed" and "sleep" as if they were one word, the same thing.
If you still have trouble breaking the habit of insomnia, you can try sleep restriction therapy. Pick your wake up time, and don't even try to go to bed until 5 hours before that. Follow all the rules above, even if it means you only get a couple hours' sleep that night. Get out of bed at the right time even id you just fell asleep. DO NOT NAP.
Because of the extra fatigue that program produces, most healthy people will find that they get to sleep and stay asleep well the next night, or the night after that at worst.
Thanks! I'll try it out.
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Originally posted by Simaril
Use the bed for only 2 things, one of which is sleep.
Couldn't resist this one...
What's the OTHER thing?
:D
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Originally posted by Simaril
I'm not a real pilot, though I play one on the internet....but I AM Board Certified in Sleep Disorders Medicine, and I'm medical director of our sleep laboratory. I've treated sleep disorders for about 15 years. So here's a viewpoint from the medical establishment side of things.
First, if it were me, I would want to be absolutely sure the diagnosis were right, and that means a sleep study. Home sleep studies are not reliable enough to be real substitutes, though they can be used to screen -- if they are completely negative, you're in the clear, but if they are positive then you have to get a monitored study to document severity and to get the right treatment level. Although modern CPAP/BiPAP is much less of a problem than it used to be, it still isnt something you want to do if you don't have to . Monitored treatment studies allow the technician to adjust the pressure real time, which is important because too much treatment pressure can be miserably uncomfortable, and too little will allow symptoms -- and damage -- to continue. Also, at our lab we have almost a dessert tray with different styles of masks. Some cover the nose, some the nose and mouth, and some just fit in the nostrils without covering anything. Here's a really popular one right now (http://optilife.respironics.com/Features.asp)
If it were me, I would not trust the internet for diagnosing or treating a problem this serious. The home test with internet prescription is....unwise. The docs writing those scripts cannot have your best interest in mind, since there's no hint of individual attention and care.
Here are some quick screening questions:
1. Do you snore? Snoring is NEVER normal, since its the sound of air flowing through a tube that's too narrow. (Just like the rude sound you get when letting the air out a balloon's mouth.) People who snore also have higher blood pressures, and higher risk of heart attacks, than similar people who don't snore. This makes sense because the stress of working to breathe through a narrow passage gives you higher adrenaline levels all night long -- and those levels may persist through the daytime.
2. Do you feel rested after sleep? Sleep that does not restore you normally is abnormal. Snorers who have nonrestorative sleep after getting enough time in bed are likely to have sleep apnea, or another kind of sleep disorder.
3. Do you have high blood pressure and a neck size larger than 45cm (about 17 inches)? People with high blood pressure and 45cm necks have a 90% chance of having sleep apnea, even before any other testing is done.
4. Have others heard you get quiet/stop breathing, or do you wake up gasping at times? Frequent awakenings without good reason can also be a sign of sleep apnea. I've often seen guys who thought their prostates were making them wake up and pee find out that treating the sleep apnea make the night time urination go away.
5. Are you tired when awake? If you had enough sleep, you should not feel tired, and you should not be drowsy when sitting still with nothing to do. If you struggle to stay awake, something is up.
I'm glad this thread started. I've been considering going to have the sleep test. My wife tells me I quit breathing often than gasp for breath. Guess I better make the appointment. I've even woken myself up gasping for breath.:confused:
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Originally posted by scottydawg
Couldn't resist this one...
What's the OTHER thing?
:D
Scotty, it may be time to ask your mom about getting The Talk.....:lol
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I had my wife read this thread. She said....*it sounds like you*, I asked her which part, she said all of it, even the gasping for breath....ugh. I have an appointment to see a doctor Monday morning.
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On the plus side, Elfie --
one of the things I really like about Sleep Medicine is that people get SO much better, that it makes such a big difference in their quality of life. It's not about fixing some number, its about helping people feel better.
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Interesting how a bunch of late-night flying folks can develop this apnea thing!
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I am really glad I started this thread. Sounds like some positive movements due to it. Thanks for posting more information and thank Simaril for also posting and answering questions.
Get it done guys. Get in and have that sleep study! You will be so glad you did.
Here is the unit I use. Very small and quiet. I am quite pleased with it.
http://www.thecpapshop.com/product_page_detail.asp?ProductID=340&ProductCatID=22&Search=
ResMed
Thankfully my insurance covers everything 100%.
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Interesting thread. Must be miserable to not get proper sleep & all that results from it.
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Did you know your squaddie was a Sleep Study Director?
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Thankfully my insurance covers everything 100%.
I'll have to make a co-payment to see the doctor. We have an HMO for health insurance, anything they send you outside the HMO for is paid 100% iirc so the sleep study shouldn't cost us anything. I am hoping that if I need a CPAP that it will be covered also.
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Originally posted by LePaul
Did you know your squaddie was a Sleep Study Director?
I do now.
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Originally posted by Dago
I never use the C-flex, tried it at first, but the tech who set up the machine set the time frame too long, so I quickly learned to do without it. No problems at all, never use Cflex now.
Will probably break down and buy my own travel CPAP, tired of dragging a large unit in it's own container. Just wondered if you knew any better than the others.
Thanks for the answer.
Dago,
I travel a lot and I use the following:
http://www.thecpapshop.com/product_page_detail.asp?ProductID=416&ProductCatID=8&Search=
Works very well and it's very light 2@3 lbs, you will need to get a letter from your doctor stating you need to have it with you as it's not advised to have it in checked luggage, it seam's they are a "hot item"
Cheers
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I have to say this is the first O'Club thread I've read in a year and a half that hasn't declined into a flamewar AND is interesting at the same time. KUDOS!
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Lot of informative reading on this post!
I am 22, not over weight, I dont dream much (if ever hardly), and I snore softly (almost like a deep breathing). I never EVER feel like I got a good night sleep!!! I slept 8 hours last night, my eye lids are about 40lbs, and I am yawning right now at 11:30. I never thought to much about it as my medical knowledge is less than stellar. After reading this I am going to visit someone and see whats going on. I literaly cant remember the last time I woke up refreshed and ready to go (even with 10 hours sleep).
Thanks Daddog for starting this and all the great posts!
CFYA
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CFYA--
If you're not feeling rested after adequate sleep, then something isn't right. Can't always be sure just what's doing it right off, but it makes sense to follow whatever clues are there.
Since you snore -- even lightly -- you have at least some mild degree of sleep breathing abnormality. Even if you have no apnea problem now, this means that you NEED to be careful about your weight for the rest of your life, because you are at risk for sleep apnea.
Some people get sleep disturbance with even minor degrees of airway narrowing. This Upper Airway Resistance Syndrome acts like sleep apnea and is treated the same way, except that since the degree of narrowing isnt as severe there is better (but not perfect) response to surgical treatment (like getting the sinuses fixed, etc.)
In your age range, and without being overweight, it's also good to think about general medical causes of fatigue. These commonly include anemia, depression, thyroid problems, electrolyte or hormone problems, and so on.
There are also non-apnea sleep disorders to consider. Lack of adequate sleep time is the most common cause of fatigue in the western world. And yes, almost everyone needs 7-8 hours sleep for full recharge. Although some people have body clocks that hide the fatigue almost completely, tests of functional alertness show they make more mistakes and have more injuries than those who get enough sleep. Likewise, shift work can mess up the natural body clock and leave people feeling permanently jet lagged.
Resltless leg syndrome can affect even teenagers, though its usually obvious when that's the cause of poor sleep. Insomnias, or frequent awakenings, are also pretty obvious.
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Least obvious are the truly rare sleep disorders like narcolepsy. People with narcolepsy have significant symptoms an AVERAGE of 17 YEARS before the diagnosis is made. Partly thats because the majority of docs out there have had very little training in sleep disorders, but its also because patients jsut think its normal to feel the way they do -- theyve never known any differently. On TV, narcolepsy is shown like some kind of sleep seizure, where people can fall asleep in the middle of a sentence, but like many things TV has it wrong. The sleepiness of narcolepsy is more like an incredible pressure to fall asleep, like you've pulled an all nighter and you're in a boring meeting.
What causes narcolepsy is the absence of a critical brain chemical that only shows up in a single small place in the brain. Without that neurotransmitter, the regulation of sleep and wake gets totally messed up...so wake intrudes into sleep time, sleep intrudes into wake time, dreams show up when people are awake, and having the normal paralysis during dreams (that protects our spouses from getting punched when we dream we're fighting) show up when we're awake.
The four primary symptoms of narcolepsy are:[list=1]
- Excessive daytime fatigue with sleep attacks
- Cataplexy -- drop attacks, where varying degrees of paralysis show up in awake people when they get angry or laugh
- Sleep paralysis -- where people can wake up or be about to fall asleep, and find that they simply cannot move even a muscle, no matter how hard they try
- Hypnogognic hallucinations -- where dream like material shows up even though people are awake. For example, I had one patient see and feel their dog on the bed, down to the warmth of the covers and the creases in the blanket, but the dog wasn't there, and they put their hand right through when they tried to pet it. More commonly, people will actually hear something that isnt there, like a phone or a car or a doorbell.
(Don't panic about the last one...most normal people can have this if they get tired enough.)
Sleep apnea and narcolepsy absolutely require a sleep study for diagnosis, and narcolepsy requires a Multiple Sleep Latency Test (four or five nap attempts 2 hours apart, done the day after the sleep study). Final diagnosis of narcolepsy depends on a specific dream pattern during the sleep study and MSLT.
Most doctors don't have a lot of training in sleep disorders, because the area is glossed over in med school and most residency training. If you have a sleep problem, do some research and be prepared, so that if your doctor isnt really strong in sleep stuff you know to see the specialist.
Here's a link to the American Academy of Sleep Medicine: AASM (http://www.aasmnet.org/)
and here's one to help you find a high standard, accredited sleep laboratory: Sleep Labs by state (http://www.sleepcenters.org/)
Lastly, here's a link to a list of Board Certified Sleep Specialists: Board Certified Sleep Specialists (http://www.absm.org/Diplomates/listing.htm)
There are an embarrassing number of Dollar Generating Unit sleep labs, where the main emphasis is maxing out the number of sleep studies they do. There are also many who do sleep medicine with very little training in the less common (IE non-sleep apnea) disorders. Be aware of those factors when you choose where to go.
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Originally posted by scottydawg
I do now.
;)
Being a doc is what I DO, not who I am.
Hadn't come up when we flew or just pal'd around, so I bet most didn't know. It's just my job...and in my opinion, anyone who puts more stock in what they do than they do in who they are inside can't help but get a little messed up.
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My biggest complaint with my sleep is waking up with a sore shoulder. Im 1 month into a newer, softer bed. If I sleep on my back, no problem...but I almost always wind up on my side. If I sleep on my left side, my right arm is sore as hell in the morning. This has gone on for a few weeks. I dont know if its how I drape my arm or what.
Am I going crazy or do other people wake up sore like this?
Maybe I need more time to adjust from a super firm, ancient mattress to this new Serta perfect sleeper w/ pillow top thing?
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Originally posted by DiabloTX
Unless it's something that is stress related or I've had too much coffee before bedtime, I think of dark grey battleships on dark blue waters silently cruising to some point unknown extremely relaxing and helps me fall asleep very quickly. Also, for some reason the image of a 109G firing up and taxiing for take off helps me fall asleep as well. And I don't even much care for 109's but it's the only plane that helps me fall asleep.
The 109 being what It is I could see it puting you to sleep.
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Did you know your squadie was a Sleep Study Director?
LOL Had no idea. Early on I found out Simaril was a physician, but not what his specialty was. Heck for all I knew he was a brain surgeon. :) We are fortunate to have several in our squad that are in the medical field (an OBGYN, Anaesthesiologist, and an Optometrist) How we let dogma in I will never know. ;)
I wake up sore some times, but for me it is due to sleeping in the same position and not moving for an hour or more. I had sore (sometimes really sore) shoulders or neck pain, but that was when I would sleep on my side and stay in the position.
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Well I have had my sleep study done and gotten the results. I have been diagnosed as having severe central sleep apnea. I also have obstructive apeneas and hypopneas.
Yesterday I brought home a CPAP to use for 3 days. This one has software that detects an apnea or hypopnea and then determines the least amount of air pressure required to get me to resume breathing. On Friday I will take this one back, they will dl the infos from it and set the pressure on my permanent CPAP.
I didn't find the mask or air pressure annoying at all. My wife said that not only did I not snore at all but I didn't toss and turn all night either. I woke up this morning feeling refreshed and alert. I honestly can't recall the last time that happened.
I also woke up without my nose being congested. I could actually breath through my nose. My CPAP has a humidifier on it and my technician said the humidifier would help with the congestion in my nose as well. I just didn't expect this much help. :)
Thanks for making the original post Daddog. If not for that I might never have gone to the doctor.
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I've been having trouble getting a good night's sleep recently. I assumed it was due to my aching back, but last night (early this morning) I woke up numerous times. I couldn't figure it out until my wife said "If you don't move that Blackberry out of here or turn it off at night I'm smashing it".
I looked at my emails.
I received a spam email almost every hour throughout the night and my phone is set to vibrate. It is enough to wake me up hearing it I suspect, but it must have stopped buzzing before I became aware that it is what woke me up.
It's going off tonight.
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Daddog,
Great post! I think this might be the most helpful thread in AH BBS history.
Simaril,
Thanks for your expertise as well. Although I don’t think this stuff applies to me I find if very interesting and something to watch out for.
I drive home from work with the windows open, even in the winter, to keep from falling asleep. The only place I’m ever really concerned is at a 3 minute traffic light; I put the car in park just to be safe. I’ve done the head bob thing at that light at least a dozen times in the past few years.
I have my own sleep issue: I fold my arms while I sleep and hyper extend my wrists and cut off the circulation to my hands. I wake up regularly because my hands are asleep. I actually mounted my camera on the ceiling and set it to do a time lapse so I could see how I sleep. I think I learned more by having the camera flash wake me up dozens of times; I immediately focused on what I was doing with my hands. I think I have a blood flow issue too because occasionally my feet fall asleep too.
LePaul,
Try sleeping on a carpeted floor once. If you feel better than normal your mattress probably is too soft. We went from a pillow top to the hardest regular mattress the store had; it was a big improvement. IMO, all mattresses feel good when you first lay on them, what counts is how you wake up. You can’t really learn that in a store. I also have the sore shoulder thing at times. I find it helps if I pull a pillow into my chest so that my arm drapes over it. Try hugging a pillow in bed or in your case perhaps R2-D2. :)
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Originally posted by eskimo2
.....snip....
I drive home from work with the windows open, even in the winter, to keep from falling asleep. The only place I’m ever really concerned is at a 3 minute traffic light; I put the car in park just to be safe. I’ve done the head bob thing at that light at least a dozen times in the past few years.
I have my own sleep issue: I fold my arms while I sleep and hyper extend my wrists and cut off the circulation to my hands. I wake up regularly because my hands are asleep. I actually mounted my camera on the ceiling and set it to do a time lapse so I could see how I sleep. I think I learned more by having the camera flash wake me up dozens of times; I immediately focused on what I was doing with my hands. I think I have a blood flow issue too because occasionally my feet fall asleep too.
.....
Eskimo:
When you watched your time lapse, did you see lots of arm and leg movements? We all toss and turn some, but there are people who have a movement disorder of sleep that causes them to jerk, kick, extend, or tighten arms and legs through the night. The movements themselves can cause them to jump to lighter sleep, and can leave them tired from the poor quality sleep. Sometimes this is caused by iron deficiency, but if you've had this chronically its more likely "just the way you are" -- like some people have high cholesterol despite good diet. The problem is called Periodic Limb Movement Disorder; about 20% of people who have PLMD also have Restless Leg Syndrome, which is an uncomfortable feeling when AWAKE but drowsy. (Lots of Requip ads for this lately.) RLS meds tend to work well for PLMD too.
Other things that come to mind are Carpal Tunnel Syndrome, which can be worse during the night when people tend to bend at the wrist. That can cause the hands and forearms to get the tingling numb "falling asleep" feeling that most people blame on circulation. (It's actually much more likely to be from nerve compression, by the way. Circulation problems tend to cause color change, and outright PAIN rather than tingling...and they are much more likely to have symptoms when awake and using the muscles, which demands more blood flow than when you're asleep.)
Even if it isnt carpal tunnel, one way to minimize the unconscious tendency to bend the wrists over in your sleep is to use a carpal tunnel style brace at night. These are simple wrist braces that extend a little onto the palm, so you can't bend the wrist over enough to pinch either the nerve or the artery. They might help you out.
If arms and legs are both involved, I also wonder about any nerve compression at the level of the neck. Neck pain, or electric shock "stingers" when you move a certain way, can be clues about either slipped disks in the neck, or calcium deposits from past trauma or arthritis or whatever. Sometimes these problems show up in the night because we hold the neck in different positions and angles than in the day.
Regardless, take that sleepiness VERY seriously. Most fatal accidents are connected with excessive sleepiness, for the simple reason that drivers who are unconscious can't do ANYTHING to avoid oncoming bad stuff. Even drunks may realize at the last minute, " thats a bridge!!" I've had a mother of 4, without any sleep disorder at all, drift out of lane after an all night drive home from vacation....leaving her husband a widower and her kids motherless. (They were in the car and saw her bleed to death.) If you're as sleepy as the average person with 5 solid hours of sleep, then you're as dangerous as if you were drunk.