Sunday, August 10, 2014

The Sleep Anywhere, Any Time Gene . . .

I really don't understand how the time gets away from me, but I'm beginning to suspect that it's something another friend mentioned:  I'm at an age when slowing down is no longer optional - it's mandatory.  I hate to think that  :-D

It's been an interesting couple of weeks that actually started in March  . . .

In early March I had my annual physical.  One of the things I talked to my awesome doc about was how I was tired nearly all the time.  He asked some questions, I answered truthfully, and the upshot was that he wanted me to have a sleep study to see if I had sleep apnea.  Great.

I had the study at the end of March, and yes, was diagnosed with Obstructive Sleep Apnea (OSA).  What does that mean?!  It can mean a lot of things.  Most commonly, it means that a person actually stops breathing while they sleep.

I, however, have what I'm told is a relatively unique case.  This won't surprise anyone who knows me.  I have long been a trend-setter among my friends, and often at the forefront of whatever is coming next.  And, for women of a certain age this could very well be what's coming - quite likely in a different form than mine, but coming just the same.

OSA has long been thought of as "a man's condition." Men far outnumber women in OSA diagnoses, UNTIL women reach menopause, when we catch right up.  I learned this from the special sleep dentist I had to go and see.  She explained to me that hormones have a lot to do with the integrity of the muscles in the tongue and mouth - and when the hormone levels change, our tongues don't always seem to stay in the right place any longer during sleep.

How is my case unique?  Well, first, my AHI number (that's Apnea Hypopnea Index) is only 6.  The lowest number you can have and be diagnosed, is 5.  So that makes my case very mild.  Second, I never stop breathing.  I don't have any apneas (but they still call it OSA anyway).  I have what they call hypopneas, which is where my airway becomes partially obstructed - I never stop breathing, but my airway is blocked enough that my oxygen saturation level drops way too low; and third, my case is completely positional.  These hypopneas ONLY happen during REM sleep when I'm sleeping on my back - which, apparently, is the only time I have REM sleep - it doesn't occur when I'm on either side.

Why is this bad?  It's bad because my sleep study showed that I am chronically sleep deprived and probably have been for a pretty long time.  I thought back, and came to the conclusion on my own that I probably haven't had restorative, uninterrupted REM sleep for at least a couple of years.  When I'm in REM sleep, I'm on my back.  When my airway gets occluded by my tongue sliding backwards instead of staying put, my oxygen level drops.  It drops enough for my body to panic and shoot out a blast of adrenalin to get things going again.  It's called a micro-arousal.  It's not enough to wake me up all the way, just enough to punt me out of REM sleep. I could think I slept all night, when I never got more than five or ten MINUTES of REM sleep at any given time.

This diagnosis explains a LOT for me.  Falling asleep in two or three minutes - not normal (and indicative of chronic sleep deprivation - this was already happening to me more than a decade ago).  I thought waking up to pee multiple times a night was normal for a menopausal woman.  It's not.  Having trouble staying awake at 10 o'clock in the morning - not normal.  Drowsy driving at 10 o'clock in the morning - really not normal.  Falling asleep on the train into the city in the morning - not normal.  Feeling like my body is made of lead during a workout - not normal.  Having memory issues - again, not normal (and that one's scary - I mean, in another life I memorized countless plays, musicals, songs, dances - you name it.  That I would struggle horribly with memorization of simple pipe tunes has been really unnerving, to say the least).

ALL those things can be the result of OSA - even a mild case of OSA.  Perhaps more importantly for many, OSA can also lead to high blood pressure, heart disease and mood problems (thankfully, these things I do not have).

In my family we call it the Sleep Anywhere, Any Time Gene, and I always said I got it from my mom.  Upon reflection, however, I'm reasonably sure now that my mom had sleep apnea, and I'm reasonably sure she had a far more severe case than I have.  She would sit in a chair to read a book, and she would fall asleep.  She was often tired.  She snored life a freight train, a very common symptom of OSA.  I do not snore other than the occasional snuffly snorty kind of mild snore.

Thinking I was condemned to a lifetime of sleeping with a CPAP machine, I was not a happy camper . . .  


4 comments:

Michelle said...

Can't wait to read the rest of the story!

Kristyn McCain said...

I know my DH has sleep apnea and I am on him to talk to the doctor about it.

candy said...

I hope there is a good answer for you

A :-) said...

Thanks you guys. :-) Krysten, I hope your husband will get treated if he does have sleep apnea.