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Sleep Apnea/What Kind of Sleep Apnea is This

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QUESTION: Ill be seeing my doctor soon for a possible referall for a sleep study, and before I go in Id like your feedback on what I might have going on.

I've had sleep apnea symptoms all summer (I'm 46 and sleep on my side), and so I started recording my breathing for a few hours each night.

It turns out that my apneas are less than one an hour, and that what I have instead are out-breaths that rasp and wheeze and squeak, as if theyre being blocked.

I'm wondering if this is the same as regular obstructive sleep apnea, and if it's treated the same as well.

So if you can, please check out this video I posted, which shows the sleep patterns and their sounds.  And thanks.

http://www.youtube.com/watch?v=sG0vg2X5I18

ANSWER: Sean:  first, let me thank you for sharing that video.  Please leave it up on youtube so I can refer my patients to it.  It is a good example of what sleep apnea can sound like.

What I am hearing on your video is quite consistent with what we see in obstructive sleep apnea syndrome (OSAS).  One does not have to have complete airway closure to suffer from this condition.  When the airway is partially open (and this is when we hear snoring the most), it produces essentially the same effect on the body as a full closure.  These partial closures are referred to as hypopneas.

I'm glad to hear you are following up with your doctor on this issue.  Note: if you do not have any significant health issues (such as CHF or COPD# and do not have any other sleep co-morbidities #such as insomnia, sleep walking, etc.), you may qualify for a simple in-home sleep study rather than going into a sleep lab for a night or two.  Speak with your doctor about the types of testing and what he/she feels is appropriate for your case.

Good luck and stay well!

---------- FOLLOW-UP ----------

QUESTION: Thanks for the swift reply, and glad the video helped.

When a friend heard the sounds, he thought there might be something blocking the breath in my nose.  Is there anything in the nasal passages that could cause such sudden blockages in the breath, or would this all be from the throat?

And even though the obstructions are on the out-breath, would CPAP still work to help hold the throat open?

Answer
Sean:  upper airway obstruction can be caused by airway narrowing that occurs anywhere from the tip of your nose to the epiglottis in your throat.  As for the sounds you hear on your video, those are actually inspiratory noises and not expiratory.  True, one can experience airway narrowing on exhalation but this is a secondary byproduct of a relaxed airway more so than the main event of OSAS.  And in the end, anything that can keep the airway open while you sleep is the goal of therapy.  CPAP and oral appliance therapy are the two most effective therapies (tracheostomy is 100% effective but is too drastic an approach and is used only in extreme situations where conservative measures fail).

Sleep Apnea

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Dave Walsh RRT

Expertise

Registered Respiratory Therapist and Licensed Respiratory Care Practitioner (IL). Thirty-five years in the field of Respiratory Care with the last twenty-five years spent concentrating in the area of sleep disordered breathing. Established the first hospital based compact multiphysiologic recording program for the diagnosis and treatment of obstructive sleep apnea syndrome (OSAS).

Experience

I'm proud to have built a comprehensive sleep disorders center in Chicago during the '80s and to then go on and build the first hospital based home sleep testing (HST) program in the country. I now own and operate Sleep Case Management, a Division of DRW&Associates Inc, providing sleep disorders case management services to physicians and their patients in northern IL along with providing home sleep testing and arrangements for in-lab sleep testing.

Organizations
American Academy of Sleep Medicine, American Association for Respiratory Care

Education/Credentials
BSc (Biology), ASc (RT)

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