RE: Daytime Apnea?
I mostly am looking for others (if there are any) with some similar symptoms in the hope that: 1) If any exist, then maybe the medical establishment has seen something like this before, and 2) Maybe that someone could provide a lead that I could investigate via the internet (I am fairly proficient at internet research). I don’t want anyone to depart from any forum’s rules or the norms of common sense in attempting to diagnose me. Just looking for “directions” for me to look into.
I find it helpful to answer/add information to a post such as yours by embedding my responding text into the original. Please bear with me as I do this with yours. My text will be preceded and followed with four asterisks (****) and be in ALL CAPS for easy differentiation.
Well, your description of the night time side of things is mostly Central apnoea (that is when the brain isn't sending the breathing signal - OSA or Obstructive (classic) Sleep Apnoea is when something is blocking the breathing tube). The question is, if this is happening during the day, why? You mention zoning out - is there a risk of high function narcolepsy or catalepsy that could trigger a CA event? **** I HAVE NEVER RESEARCHED THESE – WILL DO SO TOMORROW. BUT FOR CLARIFICATION THE ZONING OUT FEELS MORE OF THE KIND OF TEMPORARY MENTAL STATE ONE HAS WHEN TIRED OR CONCENTRATING ON SOMETHING ELSE. I'VE ALWAYS HAD A VERY ONE-TRACK MIND AND I CALL IT 'ZONED OUT' WHEN I'M CONCENTRATING HARD OR ELSE LETTING MY MIND REST. OTHER THOUGHTS ARE THEN BLOCKED FROM MY ATTENTION**** These need to be cleared up with a neurologist. Since you stopped smoking a fair while back, the risk of emphysema is actually rather mild, but, again, a chest thump and maybe an x-ray would rule it out altogether or confirm it. ****I STILL DO GO TO MY DOCTOR, BUT ON AN AS-NEEDED BASIS – NO CHECKUPS/ETC. THE THUMP AND STETHOSCOPE LISTENING HAVE BEEN DONE AT LEAST YEARLY WITH NEGATIVE RESULTS SO FAR, BUT NOT THE CHEST X-RAY**** I rather wish you had mentioned all this history at the outset. It would have avoided blind alleys of speculation. ****SOMETIMES SPECULATION LEADS IN A NEW DIRECTION – HELPS ME THINK OUT OF THE BOX**** At best we can set out a few different scenarios for you to examine, see if any fit the symptoms. ****EXACTLY WHAT I DESIRE!****
In addition the above, which follows the logical scenario you set out, a few other thoughts. Are you a nose or a mouth breather? ****NOSE**** If the former, is there a possibility of some nasal obstruction or collapse of the nasal walls, restricting O2 intake? ****MY UNDERSTANDING OF ALL THE TESTS AND DIAGNOSTICS RESULTS WHILE I STILL HAD INSURANCE (AND MY DOCTOR OFFICE VISITS AND ADDITIONAL TESTS SINCE) IS THAT THERE IS VIRTUALLY NO CONNECTION OF AN OBSTRUCTIVE NATURE. ALL THE WAY FROM THE NOSE/MOUTH TO THE ALVEOLI, EVERYTHING LOOKS GOOD EXCEPT THE MOTOR NERVE SIGNALS TO THE RESPIRATORY MUSCLES. TWO SEPARATE SLEEP SESSION TESTS, THE LAST ONE WITH ADDITIONAL (AND SOMEWHAT EXPERIMENTAL I GATHERED) INSTRUMENTATION TO DETECT ANY NEGATIVE PRESSURE IN MY TRACHEA WHICH WOULD INDICATE AN ATTEMPT TO INHALE WITH AIRWAY BLOCKAGE, WERE NEGATIVE. THERE WERE EVEN TWO ACOUSTIC SENSORS (BASICALLY TINY MICROPHONES) TAPED TO MY THROAT AND STERNUM TO DETECT ANY GURGLING OR TISSUE FLAPPING OR OTHER POSSIBLE INDICATIONS OF AN OBSTRUCTION. THAT TESTING DETAIL IS PARTLY WHY I WAS SO SURPRISED WITH THE EVALUATING PHYSICIANS’ ONE-DIMENSIONAL RECOMMENDATIONS. I CAN ONLY GUESS MY SPECIFIC SYMPTOMS ARE “ATYPICAL”**** This is a far more common problem that one would think ( I have it, which is why I must wear nasal pillows with my CPAP). Also polyps or a deviated septum? ****NO KNOWLEDGE, WILL RESEARCH****
Is your posture of the nature that you may be crowding your chest or diaphragm when upright, thus rendering breathing more difficult? ****WHEN I WAS A TEENAGER MY PARENTS WOULD TELL ME TO QUIT SLOUCHING, AND I BEGAN PAYING ATTENTION TO MYSELF IN MIRRORS/WINDOWS AND HAVE HAD GOOD POSTURE SINCE**** Do these breathing difficulties when awake still occur when you are supine? ****YES****. Are they positional? ****NO**** What are specific triggers to events or is there no discernible pattern? ****I AM BY NATURE VERY ANALYTICAL AND HAVE BEEN TRYING TO SPOT A PATTERN OR CAUSE/EFFECT ACTUATOR SINCE MY RESEARCH BEGAN. SO FAR, NOTHING**** Are you on any medications? ****HEY, I’M 60! YOU BET! NOT EXCESSIVE OR UNUSUAL BY MY OBSERVATIONS OF OTHERS MY AGE AND OLDER**** Have you examined your blood sugar and monitored it during the day especially after an event? ****YES, BECAUSE SINCE I DEVELOPED A MILD INSULIN RESISTANCE A COUPLE YEARS AGO AND DOC SAID TO LOSE SOME WEIGHT AND EXERCISE. THAT HAS WORKED WELL AND NOW I ONLY CHECK MY GLUCOSE LEVELS EVERY WEEK OR SO**** The "zoning out" may be due to hypoglycaemia or pre diabetes, for instance. Do you exercise regularly, and if so, does your routine include or cover deep breathing and thoracic work outs? ****ANSWERED THE EXERCISE ABOVE, BUT NO ON THE BREATHING WORKOUTS. WILL RESEARCH THAT****
In order to pin-point the nature and cause of the problem, these are the sort of questions you have to ask yourself (don't tell me! This site is not a diagnostic site, nor may we attempt to diagnose on this site). ****YIKES! I HOPE YOU OR ANYONE ELSE READING THIS UNDERSTANDS I’M JUST SHARING MY INFO IN THE HOPE THAT SOMEONE ELSE WITH MY SYMPTOMS CAN LEARN FROM MY EXPERIENCES AND/OR LEAD ME IN A NEW RESEARCH PATH. I DON’T WANT ANYONE TO OFFER ME HARD DIAGNOSTIC HELP****
Either way, you have to do this through medical channels - it is impossible for me or anyone to tell you what is up over this distance, and although I am one of those white coat guys (actually I never where one, despite it being regulation here), this is a general forum for SA. Nor is it possible to self diagnose or treat this. You need to head to a hospital, probably a polyclinic would be your best bet. Your g.p. can rule out certain problems (emphysema, diabetes, hypoglycaemia, for instance) but neurological disorders are a whole other level of expertise and technology. Try and ask yourself all the above questions, find the pattern and write it all down. Use that to help inform any doctor you see so he can get as thorough a history as he can.
****YOU MENTIONED NEUROLOGICAL DISORDERS, and I currently believe that is the most promising avenue for research. I’ve read many articles/blogs/research papers that tend to point, based on my particular set of symptoms, in that direction. In the process of elimination, all the other causes I’ve explored have one or more conflicting symptom/diagnostic result that probably should eliminate them from consideration. Interestingly, I read a post a few weeks ago from a lady who asked if anyone had her specific set of symptoms which, of the 3 or 4 mentioned, matched mine perfectly. They began after she had a concussion. But the thread was a few years old and had gone dead. One current search focus is on how the oxygen sensors in the aorta, the CO2 sensors in the extremity nerves, and the PH sensors in the brainstem may be working together to create a multi-sensor-correlated closed loop feedback system controlling autonomous respiration. That one looks promising for me to follow because, ironically, during my career there was a project where I had to become competent in the electronic version of such a system for an aircraft navigation system upgrade project I was assigned to. There I learned how correlated sensor systems can behave when one or any subset of the sensors cease sending data or provide false data. If, and that’s a BIG if, there are similarities with the body’s respiratory regulator setup, it might point me somewhere new. Possibly it could take as few as one of those “biological sensors” failing to muck up the works. Sorry for the technospeak, it’s my past life showing through. And THANK YOU for your ideas. I frequently get thinking in circles and different perspectives often help break that cycle.****