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Obstructive apnea while awake
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Sleepster Offline
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Post: #11
RE: Obstructive apnea while awake
(01-26-2014 10:56 AM)victor hegemony Wrote:  On the other hand, since there are more than one reason for Obstructive Apnea, it is possible that exercise would not help the obstructive apnea caused by failure of the CNS to respond to stimulus.

The only way to find out is to try it!

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01-26-2014 11:10 AM
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Post: #12
RE: Obstructive apnea while awake
(01-26-2014 10:56 AM)victor hegemony Wrote:  Which makes me realize I should have given credit to the Singing for Snorers site for mentioning Huang's research.
Exercise does have research to back it up. If muscles aren't toned and that causes the apnea, then toning the muscles would stop the apnea. I wonder if the physical habits of exercise could still work while asleep or directly help CNS failure to respond to stimulus. Physical patterning has a direct neurological effect, maybe the CNS would develop ("kindling" ?) pathways that worked. Like teaching it what to do.
On the other hand, since there are more than one reason for Obstructive Apnea, the most obvious being when a person's tongue is simply disproportionately large for the passageway as mentioned by Eviltim above as opposed to muscles which have lost their tone; it is possible that exercise would not help the obstructive apnea caused by failure of the CNS to respond to stimulus.

It's also known that people with big necks are prone to sleep apnea and possibly obstructions when awake like me. If you have over a 17 inch neck circumference your chances of sleep apnea are very high. Which is what I was told by my doctor as well as researched it.

That's why people like Shaq, Reggie White, Jamarcus Russel are known to have apnea, they are elite athletes in top physical shape, but still have apnea because the mechanics (moving parts in our body) are just slightly off and there is no way to control those muscles when sleeping.

Steroidal sprays helps when I am awake, I do notice a huge difference (before I was diagnosed with OSA) in just gaining 15 pounds made my passage way seem more sensitive to obstruction. Things like jogging get the entire air passages moving and the blood pumping and I still notice I sleep better when I have jogged over 30 minutes in the day. Which I am trying to do everyday now.
01-26-2014 11:14 AM
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herbm Offline

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Post: #13
RE: Obstructive apnea while awake
I an not sure of the term, but wish that there was a clear expression for his (not a medical professional either so take that into consideration reading the following):

When my Afib was bad and untreated because my doc kept missing it, my symptoms were SIMILAR (but different) from yours. When I lay down and relaxed my breathing would stop UNLESS I made a conscious effort to keep it going.

If it is due to lying down, then it is properly termed (probably) "Orthopnea".

Orthopnea or orthopnoea (Greek from ortho, straight + pnoia, breath) is shortness of breath (dyspnea) which occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair. It is the opposite of platypnea. It is commonly seen as a late manifestation of heart failure, resulting from fluid redistribution into the central circulation, causing an increase in pulmonary capillary pressure. It is also seen in cases of abdominal obesity or pulmonary disease. (Wikipedia)

Any disturbance of breathing that doesn't have another name is (likely) some form of dyspnea.

You however, have the problem when standing, so this is also (technically) NOT "Orthopnea" where the word itself indicates the position.

You have it when RELAXING and I haven't been able to find that specific term. This is important because when described to (several) doctors they just don't seem to understand or even HEAR IT (if they can't find it in their vocabulary, many doctors can't treat it.)

My dyspnea, was most obvious on lying down at first, but then it became more obviously related to RELAXING which is closer to what you described, though never standing up for me.

I would sit in a chair instead of lying in bed since this improved the situation and made it less likely that I would fully relax; this would ameliorate the symptoms and at least I could doze off lightly and get through the night (a couple of bad nights, 3 or 4 times before the doc figured out that an EKG and a cardiologist might be useful.)

Perhaps there is a term for "relaxing dyspnea" but if you have not done so already I would have an EKG (*I* would, because those symptoms meant my arythmia and cardiomyopathy were about as bad as they ever got before treatment.)

Turned out my ejection fraction (port of blood pumped out of the ventricle) was down to less than half of normal (>25% instead of about 55% which is normal) and I had Atrial Fibrillation which meant that my right atrium was not pushing blood into the ventricle.

Also since this was not due to ischemia or any other physical cause, for me the solution was fairly easy:

One pill to fix the arythmia (Pacerone aka Amiodarone) and one to "heal the hear" (Correg/Carvedilol); some blood pressure med changes helped a little also.

Note: Amiodarone is an anti-arythmics, said to be 'among the most toxic drugs used in medicine' but for me there was never one recognizable side effect; all it did was fix the arythmia within about 2 days of starting therapy. The cardiologist tapered me off of it over a few months (almost a year) and the arythmia came back a few months later so she put me on it again (smaller dose) and the arythmia vanished again after a couple of days.

Enough about me -- point is that dyspnea on relaxing is NOT something docs tend to HEAR -- they don't have a good word for it so they don't LEARN about it in med school nor do any of their diagnoses have it as a symtom nor meds have it as a mentioned for treatment.

People have trouble reasoning about things for which they do not have words. Docs are no exception.

Even orthopnea doesn't seem to be mentioned much in their training.

Investigate an EKG if you haven't had one.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
(This post was last modified: 01-26-2014 07:52 PM by herbm.)
01-26-2014 07:50 PM
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Post: #14
RE: Obstructive apnea while awake
Hi herbm,
WELCOME! to the forum.!

trish6hundred
01-26-2014 09:53 PM
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victor hegemony Offline

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Post: #15
RE: Obstructive apnea while awake
Just had sleep exam and now must re-exam my conditions.
Before and after sleep I tried relaxing on my back and immediately choked. But during the sleep, on my side, there were zero apnea events. Zero. (Which is cool, but confusing and not the current topic.)
So probably the tongue choking while awake is a difficulty unrelated to the apnea is my thinking now.
I didn't plan ahead well enough. I slept on my side the whole night. I should have also slept on my back to see what would happen. But I was so tired, I wasn't thinking about it and I turned on my side.
01-27-2014 01:39 PM
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herbm Offline

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Post: #16
RE: Obstructive apnea while awake
(01-27-2014 01:39 PM)victor hegemony Wrote:  Just had sleep exam and now must re-exam my conditions.
Before and after sleep I tried relaxing on my back and immediately choked. But during the sleep, on my side, there were zero apnea events. Zero. (Which is cool, but confusing and not the current topic.)
So probably the tongue choking while awake is a difficulty unrelated to the apnea is my thinking now.
I didn't plan ahead well enough. I slept on my side the whole night. I should have also slept on my back to see what would happen. But I was so tired, I wasn't thinking about it and I turned on my side.

If you haven't discussed this with your doc and haven't had an EKG then I would encourage you to pursue it with the doc.

This was the main symptom I had and it went untreated for almost a year when my primary doc didn't bother with an EKG.

After a year, he put the EKG on me and 5 minutes later knew that I need to see the cardiologist.

Yours might be nothing, but check with the doc as soon as practical.

Overall, I didn't feel that bad most of the time. And the cardiologist has gotten my heart to 90%+ healthy and expects to get back the remaining function as well.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
01-27-2014 02:47 PM
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victor hegemony Offline

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Post: #17
RE: Obstructive apnea while awake
(01-26-2014 07:50 PM)herbm Wrote:  1)"Orthopnea".
It is commonly seen as a late manifestation of heart failure, resulting from fluid redistribution into the central circulation, causing an increase in pulmonary capillary pressure. (Wikipedia)

2)...when described to (several) doctors they just don't seem to understand or even HEAR IT (if they can't find it in their vocabulary, many doctors can't treat it.)

-- point is that dyspnea on relaxing is NOT something docs tend to HEAR -- they don't have a good word for it so they don't LEARN about it in med school nor do any of their diagnoses have it as a symtom nor meds have it as a mentioned for treatment.

People have trouble reasoning about things for which they do not have words. Docs are no exception.

Even orthopnea doesn't seem to be mentioned much in their training.

3)Investigate an EKG if you haven't had one.
Thanks esp for the Doctors not able to hear!
1) You found out you had a heart attack because of apnea? Wow!
2) Those are true words. Well trained people hear the vocabulary they were trained to hear.
3) Fortunately, my heart seems to be in great shape. EKG less than a year ago. Low BP. 105/60 - I give credit to a completely organic, unpackaged diet. I mean greens, beans and grains in bulk and nothing in a package except olive oil and dairy products (sometimes) and beer. and salt. If I want bread, I bake it. Turns out, I don't want bread so much!
01-29-2014 01:22 AM
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victor hegemony Offline

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Post: #18
RE: Obstructive apnea while awake
Kind've off topic, but weight is an apnea issue -
I was 80 lbs over weight and lost 30 pretty quick by not drinking beer or soda pop (and walking a lot); but the remaining 50 remained until I went organic, unprocessed vegetarian. Processed, packaged vegetarian has sugars and oils our bodies don't want, even the organic kinds. Once I changed the food in my cupboard I lost the 50, over shot by 15 lbs and regained back to the optimum weight.
This is all in retrospect. At the time I wasn't trying to lose weight, everybody and I thought it was fine. Now I feel so much better, I realize why. That was also when I was first told I snored. When I was younger and at optimum weight I remember asking my girlfriend and being told I did not snore.
01-29-2014 02:27 AM
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herbm Offline

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Post: #19
RE: Obstructive apnea while awake
> 1) You found out you had a heart attack because of apnea? Wow!

Nope. I had a form of dyspnea at least somewhat similar to what you described as a symptom to cardiomyopthy, but no heart attack.

The dyspnea was just ignored by the doc for a year, until he finally gave me an EKB and immediately sent me to a cardiologist.

The apnea was caught a year and a half later (this month) by my dentist offering me the chance to buy a "home pulse ox test" (US $160) which I immediately agreed to do since I was suspicious that apnea might be a problem for me.

Get my machine TOMORROW -- Thursday 2014/01/30.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
01-29-2014 01:59 PM
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