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Sleep Apnea/Sort of Sleep Apnea


QUESTION: Every few nights I wake up gasping for breath, or with my heart  pounding, which made me think it was sleep apnea, even though I'm underweight and sleep on my side.

I've since recorded my breathing over dozens of nights, and I've checked the waveform and seen a few ten or sixteen second gaps, but only four or so a night.  I also discovered that I was snoring a lot.

The odd thing is, I'm snoring on the out-breath.  I can hear myself breathe in, and then on the computer there's the peak of the waveform where my breath is on the microphone, but often that peak is cut short, and there's a squeaky snoring noise, like the air is being forced through a narrow passage.

The next breath in won't be as deep, and if it goes on like that for ten breaths or so, or if the outbreath stops altogether, I can hear myself wake up and then fall back asleep without being aware of it.

I can mimic the sound while standing - not sure what I'm doing exactly, but the blockage is just below my mouth, since it also blocks air from being released that way.

So what exactly is this and what can be done?  Thanks.

ANSWER: Sean:  it appears you are describing classic symptoms of obstructive sleep apnea syndrome (OSAS).  And if you have researched sleep apnea, I assume you are familiar with a sleep study.  This would be the next step after you have a conversation with your physician.  Note that one does not have to be overweight or be a back sleeper in order to be at risk for OSAS.

If you do indeed pursue sleep testing to rule out OSAS, remember that home sleep testing is available for this purpose.  It works well for folks who do not have any significant health issues that would complicate this more convenient (and more economical) testing model.  Health issues such as congestive heart failure or chronic pulmonary disease are examples that render home sleep testing inappropriate.  Lab sleep testing is indicated in these situations.

In the end, please understand that effectively addressing sleep apnea is something one should pay attention to on a timely basis.  It has cumulative negative effects on your health and your quality of life and these will worsen over time if left untreated.  Life is too short...

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

QUESTION: Thanks, and will do on the sleep study.

My other question is how about every night I wake up at some point and have to go to the bathroom.  Sometimes it's just an hour or two into my sleep.  And the thing is, I go three times the volume that I usually do, even if I haven't drunk much water before bed, and the urine's practically clear.  A long nap can have the same effect.

What process is happening there?

ANSWER: Sean:  one of the symptoms of OSAS is excessive nocturnal urine production.  It is not uncommon for a person with OSAS to experience two to three times normal urine production during sleep periods and this symptom is one of the first to disappear once the person is successfully treated.  The mechanism behind this phenomenon lies in a complicated cycle of enzyme interactions that result from strain put on the heart during obstructive sleep apnea events.  This whole process essentially forces the kidneys into overdrive while you are attempting to sleep.

Hope this helps!

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

QUESTION: Good to know.  And for one last question, Iíve recorded the last few nights, and while I could find only a few 13-second actual apneas each night, thereís many instances of what I mentioned about the out-breath being squeezed shut, with a snore/squeak sound, while the in-breaths sound fine.

I searched about for that problem and found someone on a forum mentioning their overbite.  I have an overbite, and Iím sure thatís playing into it since while I can mimic the sound I hear on the recording, I canít make that sound with my jaw moved forward Ė the air is flowing through.

I don't see how CPAP can help with the out-breath, but I still need to take the sleep study so theyíll be able to see what I need, right?

Sean: I just found your question in my pending file.  Don't know how it remained in there as it is from June.  Please forgive the oversight. :(

In short, yes.  You would be well advised to complete a sleep study.  A screening app is nice but it is too limited in providing data we can use to arrive at a diagnosis...

Again, my apologies for this tardy response.

Sleep Apnea

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Dave Walsh RRT


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).


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.

American Academy of Sleep Medicine, American Association for Respiratory Care

BSc (Biology), ASc (RT)

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