AboutDave J. (Scoop0901) Expertise I can answer questions on sleep disorders, in general, and sleep apnea, specifically. I've been actively involved in providing direct support to individuals, family members, employers, and others on the topics of sleep and sleep disorders for more than six years, keep up-to-date on valid, peer-reviewed research, as well as treatment options.
I can answer general questions including, but not limited to polysomnography (PSG or sleep study) techniques; health issues associated with sleep apnea; compliance with a CPAP or BiPAP machine, mask selection and fitting; insurance coverage; ADA issues; and more, but cannot provide diagnosis over the internet.
Why can I answer only general questions? The question would be better asked why I will not answer specific questions. That's the easy part. Your health is unique, or, in redundant terms, "individually unique," meaning that while there's a lot of research that has been conducted in the world of sleep over the past few decades, there is none that can foretell any specific individual's future. What may hold true for your friend, for instance, may not be true for you. It's just like if both you and your best friend like to drive. You both want to own your own vehicles, having the freedom to move about a will, but your taste, your selection in vehicle is vastly different. For example, you may prefer an environmentally-friendly sub-compact car that gets 50 miles to the gallon, but your neighbor may prefer a H2 Hummer. The same holds true with health care issues. While one person may suffer issues X, Y, and Z, as fully supported by research, you may suffer issues D, T, and S, never experiencing anything the other person experienced.
Experience
As to my experience, let's start back on January 1, 2000, one of nine days I spent in an Intensive Care Unit (ICU) unit of a Northeast Philadelphia hospital. I was diagnosed with sleep apnea, along with a couple other sleep disorders, not to mention some very serious, very nasty health conditions related to many years of undiagnosed, therefore, untreated sleep disorders.
After somewhere around three months of fiddling with the equipment, adding a heated humidifier to the gear, and finding the right mask for me, I became 100 percent compliant with my BiPAP therapy. I have seemingly experienced what seems to be all the same, nay, all the classic problems everyone else who's ever used a CPAP, BiPAP, or other xPAP device has experienced, suffers. Things such as mask problems, humidification problems, among others.
I established a community education and support group, Awake in Philly, in Philadelphia, PA (USA), in May 2000, to help support and educate others about the true costs of sleep issues, including sleep disorders, sleep deprivation. We also work to educate the public, employers, and government and elected officials, as well as health care professionals about the dangers of these issues.
Since getting diagnosed, I've become a very vocal, very pro-active sleep activist, dedicated to helping others before they suffer the many woes that too often accompany untreated and undiagnosed sleep disorders and sleep deprivation.
In addition to working locally, I always think globally, yet act responsibly in all I do, yet have managed to extend the reach of my work nationally. I am involved with Awake In America, Inc., an all-volunteer national non-profit focused on sleep and sleep disorders. An all-volunteer organization is one where the people involved are committed to the efforts, and one in which no one is paid or compensated for their work with the organization, where all funds may be used for operations and actual work to fulfill the organization's missions. I know of no other non-profit corporation that can make that bold statement.
Awake In America was organized to assist others around the country to quickly and effectively launch support groups, but also to work on community awareness of sleep disorders, serve as an outreach source, among other issues. Awake In America also launched the only national xPAP Donation and Relief Program, which is designed to assist individuals without insurance or the financial means necessary, obtain equipment and supplies essential to treating diagnosed sleep apnea. We also have a national Sleep Study Relief Program, again, the first in the nation, and the only one of its kind in the nation.
Having spent more than 20 years as an investigative journalist and editor, I do careful, tedious research on all issues involving sleep and sleep disorders. I question everything in studies and reports, challenging findings, wanting to see if everything using strict scientific methods, uninfluenced by funding flowing from specific interest groups.
In the almost nine years of helping others, through Awake In Philly and Awake In America, as well as my personal blog on sleep, The Sleep Blog, I've done a tremendous amount of reading, much of which in the same books used to train sleep techs, as well as many of the same books that are on the shelves of many sleep specialists.
I've dealt with countless people, via email, instant messaging (IM), and on the phone, sometimes, basically doing the equivalent of providing a shoulder for them to lean or cry on. In the end, I offered ideas to help them overcome their challenges, and fortunately, I've been able to help a large majority of those people, but some required the hands-on, in-person approach of a physician or sleep specialist.
Question I just started using a CPAP machine and I am wondering how long it takes to adjust to the side effects. I find that upon waking I have abdominal cramps and gas which subside within an hour but the cramps are so severe that it is hard to sit up and straighten up. Is it reasonable to believe that this is just a short term effect while my body adjusts and this side effect will eventually stop or is this something I need to get used too? Thank you for taking time to read this. Ally
Answer Ally:
Thanks for writing, and please, whatever you do, commit yourself to faithfully using your CPAP for one year, no matter what, and not give up, even for a night.
What you describe in your message is not really something I would call a "side effect" -- but what I would call it is rather more of a a learning experience, though it is subconscious rather than hands-on.
Most of what you're describing sounds like normal stuff most people go through. The only thing that stands out -- with alarms -- is the one comment you made:
"I find that upon waking I have abdominal cramps
and gas which subside within an hour but the
cramps are so severe that it is hard to sit up
and straighten up."
If you are just laying in bed for that hour, change your habits. When you awaken, get up and walk around. Perhaps go sit on the toilet and push, as if you were struggling to push out a die-hard bowel movement that is set against exiting.
As for everyting else you describe, some people experience the gas issues early on in their xPAP theraspy; some people experience the issues later in their therapy; and others, well, sometimes it happens a year or two later, such as belching/flatulence issues.
The belching/flatulence is from you swallowing air while you sleep. Is it going to cause you harm? No. It's the same basic gimmick that kids do when they want to belch out the alphabet: they swallow air so they can produce the words they want. You're not swallowing it to do a task, but rather because your body is adjusting to dealing with a flow of wind during sleep.
What can you do, on your own, to stop swallowing air? Nothing, especially stress out about it. It's nothing to worry about. If you swallow so much that you feel like you have too much air in you, well, do some toe-touches by simply bending at the waist and reaching to your toes. You may find air escaping out both ends: your mouth and your bottom (or bum, if British/Aussie). You can also do some other types of bending/twisting exercises to eliminate the air quickly.
Your body will, after a time, figure things out on its own. That's how it will -- and must -- be resolved. There isn't anything you can do to train your body to not swallow the air. Once your body is settled, adjusted to the pressure, adjusted to having a constant wind blowing in your airway all night long, things will be resolved. It could take a few days, it could take a week or two. Again, it's all about you, your attitude toward the xPAP therapy, and your attitude about using the equipment. The subconscious really does feed on what you tell yourself and others. For example, if you tell others, "I really hate that CPAP machine!", then your subconscious mind will listen and will hate and fight the CPAP, as well.
Will you feel "worse" before you feel better? Yes. Just like with each new day, it's darkest before dawn, the same holds true with sleep. You have an untold amount of sleep debt. Like any other debt in life, you MUST pay off that debt. The body is an unforgiving, unkind loan agent. Once your sleep debt is paid off, perhaps in a few days, a few weeks, you will begin feeling much more energetic. It will be slow at first. Most people generally don't recognize the slight changes until one day they realize they aren't so fatigued. They notice when it's a major improvement, not when the body is reveling in praise of the newfound energy. When you first begin paying off the sleep debt, sleeping in deep sleep the first week or so, that's generally when you feel "worse" and then things get better.
In summary, Ally, this is something that many people who use xPAP devices report. It's usually tied to the person not being accustomed to using an xPAP, but generally disappears after a person becomes used to using the machine. What causes the flatulence and/or belching? The body swallows air while sleeping, and past that, it's nothing that's generally serious, just embarrassing for most folks. If you look at things from the lighter or humorous side, you'd probably be a hit around a group of beer-guzzling guys or pre-adolescent boys -- especially if you learn the on-demand "pull my finger" bit.
I hope this helps.
Cheers,
-dave
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| Dave Jackson * http://sleep.scoop0901.net * Phila., PA.
| "It is funny about life: if you refuse to accept anything but the very
|best you will very often get it." -W. Somerset Maugham
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DISCLAIMER: Any information shared in this email is not intended to replace medical advice, nor is any information to be is interpreted as an attempt to diagnose, treat, cure, or prevent any disease.
