As those who have been following my blog for a little while know, I have sleep apnea. Recently, I have started getting it under better control by adjusting a few things that don’t need a doctor’s permission. For example, I turned off the humidifier, using just the fan part of the CPAP machine. The first night I did that, I disconnected the humidifier and attached the hose directly to the part that contains the fan.

I kept waking up during the night because the fan had seemed to become very noisy. I could understand why people complain about the noise of CPAP machines. My wife also commented that it was noisier than usual. So the next night, I reattached the humidifier, but did not put any water in it. When I turned the machine on that night, I made sure the humidifier was turned to zero, allowing the air to pass straight through without being moistened.

My apnea/hypopnea index (AHI) was coming down closer to 1 event per hour, but then I had a night where I couldn’t sleep. The next day I saw somewhere that a low dose of melatonin might help with getting to sleep. I was able to pick up some 1.5 mg tablets at Walmart. I took one that night – out like a light, and slept well. Apparently, there were some strong thunderstorms during the night. I vaguely remember hearing something, but turned over and went back to sleep. Obviously, the melatonin worked for me! However, it is not something I want to take every night. It makes me feel too sleepy the next day!

I was interested to know what had happened to my AHI, so first thing in the morning I took the data card from my CPAP machine and read it into my computer (it is a standard card, so there was no difficulty there). The software told me that my AHI was 0.9 – the lowest it has been for several months. Of course, this was only one night, and I have to continue for several more nights before I can claim I have found the fix that helps my machine get my apnea under control. You certainly have to be persistent with these darned machines, but it is still better than the alternatives.

With my apnea under better control, I am feeling like I want a nap less and less during the day, and I am even starting to exercise more. I am starting to look forward to getting on my bicycle again – it has been a while since I did that. When I lived in New Zealand a few years ago I cycled around Lake Taupo – it took me all of a very long day, but the feeling when I finished was absolutely amazing. I wasn’t racing, but I also wasn’t last ! Nothing like that planned for now, but may be tomorrow I will go out and do 15 to 20 miles – just for fun. Here is a pic of Lake Taupo – it looks huge …

Cycling around here took all day ...

I recently saw an article on PubMed that suggested that acupuncture may help improve some of the symptoms of sleep apnea. The study, published in Chinese, suggests that the apnea-hypopnea index (AHI), and the oxygen desaturation index (ODI) were reduced, and oxygen saturation of the blood were both improved after 3 to 5 sessions of acupuncture each week until 30 sessions had been completed. Unfortunately, there were only 30 patients enrolled in this study, so the evidence that acupuncture may be beneficial for sleep apnea is not very strong.

Unfortunately, when I searched PubMed for other studies that looked at acupuncture and apnea, there was only one other study, conducted by the same group, in which 12 patients were actually treated with acupuncture. In this study, the patients were treated once a week for 10 weeks. As in the more recent study, the AHI improved in patients who got acupuncture. There was also a control group who got no treatment – in these patients the AHI deteriorated.

These two studies in people with sleep apnea suggest that it may be worth trying acupuncture to reduce the effect of sleep apnea. However, the number of patients is small, and you need to have at least 10 and up to 30 sessions to show the kind of effects that were seen in these studies. Clearly, more research will be needed before acupuncture can be used to treat sleep apnea. If I was able to find an acupuncturist who could do this, I would want to have another sleep study after the treatment session before I turned off my CPAP machine. Also, I would want to have a follow-up study 6-12 months after the course of acupuncture to make sure that the apnea had not become worse.

Do you or someone you know have sleep apnea? There is a stereotype that says that you have to be overweight, over 40, and a guy. However, the reality is that apnea can affect anyone. The usual symptoms include daytime sleepiness, waking up in the middle of the night gasping for breath or needing to use the bathroom. Snoring is often a sign that people think is associated with sleep apnea, but not everyone with apnea does snore, and not everyone who snores has sleep apnea. The only way to accurately measure apnea is with a painless sleep study. You are wired up with various recording systems, but once you are asleep you don’t notice. The standard indicator of severity of apnea is the apnea-hypopnea index (the AHI that I mentioned above).

The AHI is simply a measure of the number of times each hour that you stop breathing for more than 10-20 seconds (apnea) or have restricted breathing where your airway is not completely obstructed (hypopnea). My AHI was 31 times per hour before I got treated with CPAP. After more than 18 months of wearing a mask every night, it is now 2 times per hour (sometimes less, sometimes more).

I have just realized that it has been  9 months since I last posted. Far too long, and I know I will need to post more frequently on Rod’sHealth in the future. A lot has been happening, so here is a brief summary:

I am continuing with the challenges of CPAP treatment – nobody should ever say it is easy! There is so much to learn. I have struggled a bit with insurance companies, DMEs, not to mention masks and machines! I have learned that probably because I have a beard a full face mask does not work for me. I have tried a couple, and end up leaking all around the mask, particularly where it sits on my beard.

I have tried various solutions to the mask question over the last 18 months, and have come to the conclusion that for me, a Silent Nite dental device works well – used in combination with a chin strap and the CPAP machine. More information on that later, but please note you need to find a dentist who is experienced in the treatment of sleep apnea or who can work with your sleep medicine professional. I am neither, so I can’t tell you if it will work for you. Also, I have learned about the importance of regular cleaning of the interface and the humidifier chamber – not doing this regularly has a serious impact on the ability of the machine to keep my AHI under control.

My mother-in-law was diagnosed with advanced cancer last year. She had a surgical procedure, then was put on treatment with hyperthermia. It is still experimental in the US, and requires careful medical supervision. It is being used more frequently in Japan. However, you can read more about it here. As I learn more about it I will post more information here.

I was forced to change my daytime job earlier this year – despite my working very hard (including long hours) my previous company was not doing well. In fact, after I left, they laid off a large number of my former colleagues. It seems like I escaped just in time! My new company has required the dedication of longer hours than I wished for, but I am now well established and able to focus on a few things other than just work!

Just a short post this time. I promise I will post more regularly in the future!

I posted before that I have sleep apnea. Since the diagnosis, I have learned a lot about the disorder – both from reading about it, and from living with it.

My wife tells me that my snoring scared her when we got married (nearly 16 years ago). At that time she knew nothing about sleep apnea, and there were probably not many doctors that knew much about it, either. So she put up with it. I didn’t know that I snored that much, but I did find that I was getting very tired during the day. I thought that was normal for the kind of work I was doing – sedentary, office-type work. I would try and do some exercise, but then I found I was getting even more tired. Weight was becoming a big problem.

There are many effects of sleep apnea – none of them nice. They include  high blood pressure; greater risk of heart attack and stroke; heart rhythm changes; waking up in the night to use the bathroom (I was lucky, only once a night); headaches (including migraine); daytime sleepiness, even after a ‘good’ night’s sleep; memory and concentration problems; weight gain;  possibly seizures; possibly diabetes; gastric reflux disease; sweating during the night; depression; anxiety; pain; impotence; relationship and job issues; and so on. Enough already? The real danger is that some people fall asleep during the day – the person not moving when the traffic signal has changed to green may have sleep apnea. They need sympathy and education, not an angry blast on the horn.

I have been using my CPAP machine for nearly a year now  and have seen a lot of improvement in my health. I don’t snore, and I am no longer needing to nap during the afternoon at work (a very good thing when the boss is around). I still get tired, but I don’t have the ‘brain fog’ that I used to have. I wake up before the alarm some mornings, and I no longer want to sleep late (after 7-8 AM) on a Sunday morning. I do find that I need to go to bed a little after 9:30 PM, but that is because I get up at 5:00 AM on days when I have to go to work.

The CPAP machine is amazing technology. It is just a little fan that blows air through a hose and into my nose through a mask. These masks are often called interfaces because they can cover the whole face (think Darth Vader), just the nose (a little bit like the masks that come down if there is a loss of cabin pressure in a plane), or just sit under the nose so that there is very little contact with your nose (called nasal pillows).

My personal favorite mask is the nasal pillows. They don’t make my nose sore, and are normally very quiet. They do get a bit noisy when they are not adjusted properly and air is leaking out of the sides.

The air pressure is something people get worried about. It is measured in centimeters of water. Why, I don’t know. If they talked about pounds per square inch (in the US, where I live), the numbers would be very small. Nothing that would blow up a balloon. I got used to the pressure I was prescribed very quickly – it was only 8, although I did have to have it increased to 10 after a couple of months because I was still snoring a bit.

So, sleep apnea is a scary thing – the treatment is not.