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Sleep Apnea - worth checking

Nige

If you wake without ever feeling refreshed from sleep, no longer remember any dreams, if you snore loudly, if you or a partner notice odd breathing noise or periods when you stop breathing, it’s worth asking your doctor for a sleep apnea test.
The chances of you developing this post stroke are much higher than previously.

There seem to be 3 ways in achieving a diagnosis. The first is a simple questionnaire.
Secondly if your answers suggest more investigation is needed, then the investigation can take place in two ways

invited to spend a night in hospital where you are monitored
at home where you will wear a device on your head and a sensor on one finger.

Everyone stops breathing at times during the night, up to 5 times an hour is considered normal.
If it gets above this figure, the solution is either

a mouth guard to help keep the airways open. This is often considered the second best solution.
A cpap machine. This pumps pressurised air via a face mask to help reduce the number of times your airways close. This can be nasal only, mouth and nose or more of a fuller face mask.
You may have to try a number of masks to find one that is suitable. Keep a look out for any pressure sores.
You might find, if you can tolerate the mask and machine that you feel much more alert in the day and your need for as much sleep reduces.
You can see the results on the machine and often via an App.

An apnea is an event when you stop breathing. After a very short while, your brain is on high alert looking for a solution asap. You might not wake up at this point but your brain has. This disrupts the sleep patterns and you might not enter any deep sleep. Smart watches might indicate sleep stages but they are an estimate, not fully reliable.

There are two types of apneas

obstructive when your windpipe closes
central when your brain does not send a signal to initiate a breath.
Obstructive is by far the most common. It is possible to have both and some machines can show both types in their report data.

Feeling tired post stroke is normal. However it might be that the stroke is not the only cause of the fatigue.
Lots of but very poor quality sleep will not help much.

DeAnn

This is definitely worth checking as it’s very significant in those who have had stroke. So significant in fact, and the US they generally check for that unless you have decided not to do that.

Nige

DeAnn There is a different approach in the UK for some reason Deann. Given that something like 70% of survivors may develop it, I am not sure why.

I wonder if in part, the tiredness for so many after stroke might in part be linked to Apnea ?

Central sleep apnea is specifically mentioned online as caused by stroke. This is where the brain fails to send a signal to trigger a breath. Not as common as obstructive. Both aided with a cpap machine.

Apparently the second best option is a mouth guard but I don’t know much about it. I do know there was a pilot taking place in the UK where they were trying both the CPAP machine and mouth guard together.

Nige

I am currently looking to see if there is a definite link between taking Baclofen and Central sleep apnea.
I have obtained data from my cpap machine to give me an average over 30 days.
My first test is to drop the evening dose of Baclofen from 20 (my daily dose is 3 × 20mg) to 15mg.

The reason for doing this is that as part of recent surgery, I forgot to take all of my scheduled medicine at 1.30pm and when I came round, the hospitals medicine schedule didn’t have Baclofen on it until the morning. The outcome was the lowest central sleep apnea count in many many months, averaging 1.2 an hour. Coincidence, complete one off ? Impact of anaesthetic?

Early indications are that even a small dose reduction seems to help. Will I suffer from the drop stiffness wise, will I suffer withdrawal.

Andrew

Nige I very much like the fact that you are experimenting around, varying amounts by smallish amounts, recording the results and making decisions based on that. We shouldn’t just blindly follow the views of the “experts” because they aren’t - they have had some training and merely know more than us in general terms. Even specialists only have a general feel for what might be going on, but we know at first hand what the effects are. What works for you won’t be quite the same as for someone else with ostensibly precisely the same symptoms and the same general prescription.

Nige

Andrew Absolutely Andrew. With pain for example, even if I can think of something that the pain might be like, I have no idea if a nettle sting feels anything like the same to them as it does to me. I don’t know if they have pulled a hamstring, had a dead leg, had numbness etc.
I had a follow up with a consultant today in the sleep clinic. He was happy for the experiment to continue for a couple of months.
He asked if I ever feel refreshed following sleep and I had to say it was very rare. I suspect that as the brain is on full alert for the non breathing episodes, that the pain must mean real danger plus the general wiring has been damaged, it’s no wonder sleep doesn’t feel as good as it used to.

Scroll-Me :)\<-&->


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