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[Symptoms] Newbie help - snoring or apnea
#1
Hello All,
I’ve come across this forum several times over the past year, but today is the first time I’ve posted as I am getting close to the end of my tether and do not know where to turn for advice.
 
For the past 2.5 years I’ve been under treatment of Sertraline for Anxiety primarily (with links to low mood / depression). I have also done “Mood improvement” courses. I have felt for the past 12-18 months that my Anxiousness and low mood have far reduced, but I am struggling daily with tiredness and fatigue. This tiredness prevents me from functioning properly and as a result I am only capable of doing 20-30% of the work I normally do, and being self employed, there is no boss to thrash the whip, and no sickpay; so as a consequence my finances have been massively overstretched – which then makes me a bit anxious – bit of a vicious circle. Coping, just financially.
 
I’m mid 30’s, male, 5’11”, 100kg (approx. 220lb), BMI 32. I was around 190lb (85kg) prior to this treatment. I am aware I need to lose weight, and eat very carefully, but struggle to get the motivation and energy needed to do exercise to burn calories to lose weight.
 
I’ve been in regular contact with my GP, who unfortunately has been changing annually, so do not tend to get continued care from 1 person. I’ve had blood tests for Thyroid, Liver, Diabetes done over the past 6 months, and all were ok. Then GP wasn’t really interested in sorting the tiredness/fatigue.
 
Due to a recurrent neck issue – Torticollis, I invested c.£2500 into a new bed and mattress, which has helped the neck issue and regular Chiropractic adjustments help to keep me straight. Due to this, I find it most comfortable to sleep on my back.
The result of this is that I snore badly. I snore every night, regardless of time I sleep, or amount alcohol drunk. I’ve tried sleeping on my side and front – the side leaves me with a sore neck, whilst I struggle to breath easily when on my front.
I’ve used a “SnoreLab” app on my phone, which regularly registers my snoring as “Loud” or “Epic”. I pick up on this device regular snorting and gasping.
I have also purchased a Pulse Oximeter, and have over the past 4 weeks tried to use this as much as possible.
 
Over the past month, the outcome was that my average O2 levels throughout the night were:
  • Basal SpO2 level of 94-94.5% average throughout the night
  • Average low for “events” is 91-92%.
  • Lowest low’s were usually around 88-89%, with a couple of 83/84%’s. There were also a couple of unusual ones at 60%, so I have discounted those as unreliable.
  • The above also corresponded with spikes in Heartrate.
  • Now, the unusual thing is that I only have around 10 events each night – whereas I read that its common to have 10 per hour.
  • At least 40-50% of the night is spent with O2 levels below 95%.
 
On the Epworth score I tend to be around 13-15 points depending on the day. I’ve never fallen asleep, and would definitely not do it whilst driving. I find I can daydream when sat at my desk, and do anything other than concentrate on work. Morning headaches and poor short-term memory also occur.
 
Following these results, I spoke with my GP who reluctantly agreed to refer me to a Sleep Clinic, which I believe could be a 6 month wait.
I’m reluctant to go Private, as 1, I cannot afford it, and 2, if I only have 10 events per night, I don’t think that I’d fall under the OSA diagnosis.
I am wondering though if my Basal Sp02 level of 94-94.5% is the reason for the fatigue – low oxygen in general during the night?? My daytime reading is usually around 97-98%.
 
Other background info, as a child I had my Adonoids removed when having Grommits fitted. I used to have a frequent bought of Tonsilitus, but touch wood, I’ve not had that for at least 4-5 years. Had Asthma as a Child, but have been “grown out of” for 20+ years.
 
I have tried the following snoring aids:
  • Nose strips.
  • Nose dilators – both cylindrical and wishbone shaped.
  • Finger pressure rings.
  • Mouth guards.
  • Tongue retainers.
  • Low pillows and high pillows.
  • Sleeping on front – still feel rubbish next day.
  • Sleeping on side – not as bad, but then torticollis neck issue kicks in.
 
I am wondering if I should pursue the NHS Sleep Clinic, try a private Sleep Test for speed (bit worried as I do not have many events), or stop focusing on Apnea and look for another cause??
 
Any help or suggestions would be most appreciated.
Thank you for reading.
 
 attachment shows usual nightly readout


Attached Files Thumbnail(s)
   
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#2
I'd get a NHS sleep test and depending on the waitlist, whether I'd consider private. There are desaturations, although not as severe as mine. You don't need high desaturations to cause arousal from sleep. There are other things that affect sleep quality too, PLMD is one. A sleep study will give the full picture.
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#3
A quick fix for sleeping on your side and resolving some of the obstruction is to purchase and use an inexpensive soft foam cervical collar. We often find this can keep the airway open, even for some of our members on CPAP. During sleep many tend to tuck their chin towards their chest occluding the airway. This is extremely common, and the soft collar fixes that, even better than a premium bed. Most local pharmacies, discount stores and Amazon sell them.

Your blood work did not include free testosterone which can be a root cause of most of the problems you described.

You probably need CPAP therapy. Keep an eye out for used machines you can obtain and tryout, probably less expensive and quicker than going thorough the medical system. You certainly want to stay in the queue for proper diagnosis and treatment.
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#4
thank you both for the replies.
i've just chased my NHS referral. I saw the doc 4 weeks back when she said she'd be making the referral. Needless to say, its not yet been done, and will be sent this week. Sad
Expect it'll be another couple of weeks before i hear, and then a few months before i get to see the Sleep Clinic/Consultant.

i'll have a look at the soft foam collars, and will also keep a lookout for a used CPAP machine. I was a bit nervous of getting one off gumtree until i'd had a second opinion from people who had experienced the issue. 

The screenshot i uploaded was an average night, but they can drop lower, although i don't seem to have dozens of drops on one night - less than 10 at most.
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#5
I agree with Sleeprider.  Diagnostically, you have many signs of sleep apnea.  Anxiety and depression is a common symptom.  Mine was greatly reduced since I started CPAP.  

"I’ve never fallen asleep, and would definitely not do it whilst driving. I find I can daydream when sat at my desk, and do anything other than concentrate on work. Morning headaches and poor short-term memory also occur." sounds exactly like the "before" picture of me.

I would not stress over the weight loss.  From your history, it sounds likely to me that your problems are more anatomical than weight related.  Losing weight may lessen it, but my guess is that you will still find CPAP helpful.  Most people find it difficult or impossible to lose weight before addressing their sleep apnea both for reasons of exhaustion and altered hormonal (I think that is right) states.  You need to fix your sleep first.

Given the state you are in, and the wait times, I think that finding a used machine is a good idea.  You are not going to hurt yourself by using one.  You want one that is both Auto(matic) and data capable so that we can help you fine-tune your therapy.  Here is a good list to get you started: http://www.apneaboard.com/wiki/index.php...ne_Choices
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#6
Thank you chill for the reply. Really appreciate it, especially knowing that I'm not imagining the symptoms. 
I've just checked the cpap machines you referred to, and I have stupidly ordered a second hand resmed escape II s8 model ☹️.
It's due to be despatched tomorrow, so I might be able to cancel it, as I have just located a resmed s9 autoset. It's twice the price, but if people think it's worth it, I'll try and switch to that.
Feeling so knackered for ages, that as soon as I got a couple of replies back with the cpap recommendation I jumped in feet first, without reading the recommendations as I'm so keen to get it resolved.
Thanks in advance.
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#7
Hi sleepybones,
WELCOME! to the forum.!
Oh I hope you can cancel the order for the escape and get the S9AutoSet. The Escape is a brick, not data-capable. The S9AutoSet is data-capable and a good machine.
Hang in there for other suggestions and good luck to you as you start your CPAP journey.
trish6hundred
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#8
(04-26-2017, 05:35 AM)sleepybones Wrote: Hello All,
I’ve come across this forum several times over the past year, but today is the first time I’ve posted as I am getting close to the end of my tether and do not know where to turn for advice.
 
For the past 2.5 years I’ve been under treatment of Sertraline for Anxiety primarily (with links to low mood / depression). I have also done “Mood improvement” courses. I have felt for the past 12-18 months that my Anxiousness and low mood have far reduced, but I am struggling daily with tiredness and fatigue. This tiredness prevents me from functioning properly and as a result I am only capable of doing 20-30% of the work I normally do, and being self employed, there is no boss to thrash the whip, and no sickpay; so as a consequence my finances have been massively overstretched – which then makes me a bit anxious – bit of a vicious circle. Coping, just financially.
 
I’m mid 30’s, male, 5’11”, 100kg (approx. 220lb), BMI 32. I was around 190lb (85kg) prior to this treatment. I am aware I need to lose weight, and eat very carefully, but struggle to get the motivation and energy needed to do exercise to burn calories to lose weight.
 
I’ve been in regular contact with my GP, who unfortunately has been changing annually, so do not tend to get continued care from 1 person. I’ve had blood tests for Thyroid, Liver, Diabetes done over the past 6 months, and all were ok. Then GP wasn’t really interested in sorting the tiredness/fatigue.
 
Due to a recurrent neck issue – Torticollis, I invested c.£2500 into a new bed and mattress, which has helped the neck issue and regular Chiropractic adjustments help to keep me straight. Due to this, I find it most comfortable to sleep on my back.
The result of this is that I snore badly. I snore every night, regardless of time I sleep, or amount alcohol drunk. I’ve tried sleeping on my side and front – the side leaves me with a sore neck, whilst I struggle to breath easily when on my front.
I’ve used a “SnoreLab” app on my phone, which regularly registers my snoring as “Loud” or “Epic”. I pick up on this device regular snorting and gasping.
I have also purchased a Pulse Oximeter, and have over the past 4 weeks tried to use this as much as possible.
 
Over the past month, the outcome was that my average O2 levels throughout the night were:
  • Basal SpO2 level of 94-94.5% average throughout the night
  • Average low for “events” is 91-92%.
  • Lowest low’s were usually around 88-89%, with a couple of 83/84%’s. There were also a couple of unusual ones at 60%, so I have discounted those as unreliable.
  • The above also corresponded with spikes in Heartrate.
  • Now, the unusual thing is that I only have around 10 events each night – whereas I read that its common to have 10 per hour.
  • At least 40-50% of the night is spent with O2 levels below 95%.
 
On the Epworth score I tend to be around 13-15 points depending on the day. I’ve never fallen asleep, and would definitely not do it whilst driving. I find I can daydream when sat at my desk, and do anything other than concentrate on work. Morning headaches and poor short-term memory also occur.
 
Following these results, I spoke with my GP who reluctantly agreed to refer me to a Sleep Clinic, which I believe could be a 6 month wait.
I’m reluctant to go Private, as 1, I cannot afford it, and 2, if I only have 10 events per night, I don’t think that I’d fall under the OSA diagnosis.
I am wondering though if my Basal Sp02 level of 94-94.5% is the reason for the fatigue – low oxygen in general during the night?? My daytime reading is usually around 97-98%.
 
Other background info, as a child I had my Adonoids removed when having Grommits fitted. I used to have a frequent bought of Tonsilitus, but touch wood, I’ve not had that for at least 4-5 years. Had Asthma as a Child, but have been “grown out of” for 20+ years.
 
I have tried the following snoring aids:
  • Nose strips.
  • Nose dilators – both cylindrical and wishbone shaped.
  • Finger pressure rings.
  • Mouth guards.
  • Tongue retainers.
  • Low pillows and high pillows.
  • Sleeping on front – still feel rubbish next day.
  • Sleeping on side – not as bad, but then torticollis neck issue kicks in.
 
I am wondering if I should pursue the NHS Sleep Clinic, try a private Sleep Test for speed (bit worried as I do not have many events), or stop focusing on Apnea and look for another cause??
 
Any help or suggestions would be most appreciated.
Thank you for reading.
 
 attachment shows usual nightly readout


lose weight
all you need to do is eat less than you need to run your body and the weight WILL come off 
you are not eating carefully is you are maintaining that excess level of body mass 

your metabolism will try to slow if you dont do some exercise but you dont have to go gym style athelete
walk a little more will do it.  

give up booze which 
will help the weight loss and sleeping

i would put in for the test and start waiting

what oxymeter reads all night ?
i would like to get one like that

i dont know about uk but i think i 
  need to have more than 5/hr to get help 

how do you know how many events a night you are having ?
i slept pretty good before the tests but they found a lot of stuff that i never suspected was happening 
the oxymeter is only one clue to what is actually happening
you need many others to really know the situatoin 

when 02 goes down the heart goes faster to try to keep getting enough to the brain and other organs
how high did it go ?

there are many things that can disturb sleep even if there is no apnea
and those will make you tired
  my rate went up to 172 at 80% which is way over my alleged max heart rate. 
i always got real tired when they did a stress test on a treadmill and took me up to my alleged max which was far lower
that high heart rate will make you tired 

i would not worry abuot that basal rate 
but those low ones at 60 bother me and i would not call them an error but a problem to be addressed
especially when the heart rate spiked.

with that snoring and low O2 and high heart rate i would be concerned
tiredness proves you have a problem
apnea is likely a  big part of the sleep issues
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#9
"I'm so keen to get it resolved"  Man, that was me 14 months ago.  Desperate like you can't imagine.  Well, actually, you probably can.  Most people can't.  Even if you can't cancel, the S8 is better than nothing.  My S9 died in Spain the day I arrived on vacation last year.  I did a month on an S7!  Way better than nothing at all.  
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#10
The S9 Autoset is a modern auto CPAP with all the features of the current generation machines including data. If you can get it, that will do pretty much everything you could hope for in CPAP therapy.
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