I saw today that the World Congress on Sleep Apnea is holding it’s tenth congress in Rome. They only meet every 3 years, so don’t look for one next year. The last one was in Seoul, Korea, but that web site is no longer active.

I am not going, as I am not a physician, and do not work in the sleep apnea world – I just live in it as a patient. I was particularly interested in a couple of items on the agenda for discussion on Rodshealth.

1. Philips Respironics is organizing a symposium on CPAP compliance. Participants are going to be hearing about the rationale for using CPAP, with the question of how much is enough being asked. They are also going to hear about interventions that will improve CPAP compliance from a PR person, then something about the role of behavioral interventions in improving CPAP compliance.

   I wonder if they will address what seems to be a frequent mantra of those who work in this area that the straps should be pulled as tight as possible? Getting the patient set up right at the start of their treatment is extremely important for improving adherence to the treatment program (I prefer adherence to compliance because I choose to follow the treatment). 
    

2. In the introduction to the Congress, Dr. Christian Guilleminault notes that sleep disordered breathing is responsible for many health-related problems, especially cardiovascular diseases. There will be no arguments from those who have sleep apnea that inattention, daytime sleepiness, systemic inflammation, and grinding of the teeth are associated with sleep apnea – they were in my case.

   Dr. Guilleminault goes on to note that sleep apnea “is induced or enhanced by obesity leading to fat deposition within the tongue and neck.” As pointed out, which comes first is not easy to identify.

The last point raises a question that I have often seen in the forums – will my sleep apnea be cured if I lose weight? My own opinion is that it all depends on which came first. I am not obese, although I am overweight. As a child I was definitely not overweight – almost the opposite, in fact. Yet I had symptoms that I now recognize as being possibly related to sleep apnea. There is no way to confirm that I had sleep apnea that long (50+ years!), but the possibility of being able to stop using the CPAP through weight loss is intriguing.

This looks like a scientifically very interesting meeting, and I hope I will be able to go through the abstract book over the next few months and highlight some of the interesting studies. Meantime, I will continue to work on my exercise program, my diet, and taking good quality vitamins to support my diet and exercise program.

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 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.

Rodshealth is a blog about my health and things about health that interest me. Hopefully, more about things that interest me than about my health. My health is actually very good, which is a good thing for those wanting to learn about other things.

I have sleep apnea that was diagnosed in September 2009, and is now being treated effectively with plain old continuous positive pressure (CPAP). I never knew that my snoring and tiredness during the day could be anything dangerous. I thought it was because I was not getting enough sleep each night, and because I was stressed because of work. Wrong! Wrong!

I woke up on the bathroom floor one morning after passing out. I was in a pool of blood. Scared the heck out of me. Scared the heck out of my wife. Upset my son having to get up so early to go to the hospital. Upset me having to have 20 stitches in my forehead. Upset the docs, because they couldn’t find a cause for it.

I am not excessively overweight (I would like to lose about another 10-15 pounds). I was exercising every day until a little while before this happening. After several tests including a head and neck MRI and various heart tests  (they found nothing), the only thing only thing they could think of was to have a sleep study. Result was, I now sleep with a machine every night.

Took a bit of getting used to, but I will not sleep without my CPAP machine if I can possibly avoid it.

More on my story of sleep apnea later.