I had a consultation with the recommended Respiratory & Sleep specialist today. The data results that were collected over the past month from the CPAP machine were assessed fully and discussed. I do have high range sleep apnoea, so require constant pressure machine use each night for sleeping. I also had a full spirometry, breathing, lung capacity check. All the breathing tests were okay, no respiratory problems. that has to be amazing after being a heavy smoker for such a long time until the end of 1988.
He discussed the differences between auto and constant pressure machines, then gave me a prescription for the CPAP machine, choice is up to me, prefer auto, ResMed, to discuss this with the Healthy Sleep person monitoring me for the next couple of months. I’ll then purchase a suitable CPAP machine and be attached to it each night from there on.
The risks inherent in doing nothing are far too great. I’ve already suffered the effects of memory loss to a degree that became very worrying for me, enough to convince me to do something about it. After a few weeks of use, I seem to have an improvement in the feeling of wellbeing of a morning, although I’m still extremely weak and tired, that’s possibly caused by other health issues. I will have to use a CPAP machine in hospital after the upcoming knee replacement surgery.
A full description of Sleep Apnoea is below.
Sleep apnoea (or sleep apnea in American English) is a sleep disorder characterised by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour. Similarly, each abnormally low breathing event is called a hypopnea. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or “sleep study”.
There are three forms of sleep apnea: central CSA, obstructive OSA, and complex or mixed sleep apnea. In CSA, breathing is interrupted by a lack of respiratory effort; in OSA, breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common.
Regardless of type, an individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognised as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.
Obstructive sleep apnea OSA is the most common category of sleep-disordered breathing. The muscle tone of the body ordinarily relaxes during sleep, and at the level of the throat the human airway is composed of collapsible walls of soft tissue which can obstruct breathing during sleep. Mild occasional sleep apnea, such as many people experience during an upper respiratory infection, may not be important, but chronic severe obstructive sleep apnea requires treatment to prevent low blood oxygen (hypoxemia), sleep deprivation, and other complications.
Individuals with low muscle tone and soft tissue around the airway (e.g., because of obesity) and structural features that give rise to a narrowed airway are at high risk for obstructive sleep apnea. The elderly are more likely to have OSA than young people. Men are more likely to suffer sleep apnea than women and children are, though it is not uncommon in the last two population groups.
The risk of OSA rises with increasing body weight, active smoking and age. In addition, patients with diabetes or “borderline” diabetes have up to three times the risk of having OSA.
Common symptoms include loud snoring, restless sleep, and sleepiness during the daytime. Diagnostic tests include home oximetry or polysomnography in a sleep clinic.
Some treatments involve lifestyle changes, such as avoiding alcohol or muscle relaxants, losing weight, and quitting smoking. Many people benefit from sleeping at a 30-degree elevation of the upper body or higher, as if in a recliner. Doing so helps prevent the gravitational collapse of the airway. Lateral positions (sleeping on a side), as opposed to supine positions (sleeping on the back), are also recommended as a treatment for sleep apnea, largely because the gravitational component is smaller in the lateral position. Some people benefit from various kinds of oral appliances to keep the airway open during sleep. Continuous positive airway pressure CPAP is the most effective treatment for obstructive sleep apnea. There are also surgical procedures to remove and tighten tissue and widen the airway.
As already mentioned, snoring is a common finding in people with this syndrome. Snoring is the turbulent sound of air moving through the back of the mouth, nose, and throat. Although not everyone who snores is experiencing difficulty breathing, snoring in combination with other conditions such as overweight and obesity has been found to be highly predictive of OSA risk. The loudness of the snoring is not indicative of the severity of obstruction, however. If the upper airways are tremendously obstructed, there may not be enough air movement to make much sound. Even the loudest snoring does not mean that an individual has sleep apnea syndrome. The sign that is most suggestive of sleep apneas occurs when snoring stops.
Other indicators include (but are not limited to): hypersomnolence, obesity BMI >30, large neck circumference (16 in (410 mm) in women, 17 in (430 mm) in men), enlarged tonsils and large tongue volume, micrognathia, morning headaches, irritability/mood-swings/depression, learning and/or memory difficulties, and sexual dysfunction.
The term “sleep-disordered breathing” is commonly used in the to describe the full range of breathing problems during sleep in which not enough air reaches the lungs (hypopnea and apnea). Sleep-disordered breathing is associated with an increased risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, diabetes, and sleep deprived driving accidents. When high blood pressure is caused by OSA, it is distinctive in that, unlike most cases of high blood pressure (so-called essential hypertension), the readings do not drop significantly when the individual is sleeping. Stroke is associated with obstructive sleep apnea.
In the June 27, 2008, edition of the journal Neuroscience Letters, researchers revealed that people with OSA show tissue loss in brain regions that help store memory, thus linking OSA with memory loss. Using magnetic resonance imaging MRI, the scientists discovered that sleep apnea patients’ mammillary bodies were nearly 20 percent smaller, particularly on the left side. One of the key investigators hypothesised that repeated drops in oxygen lead to the brain injury.
