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Poor sleep drove me insane, and my long path to recovery

writing.samsonhu.com

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Re: Poor sleep drove me insane, and my long path to recovery

#231

Post by alfnor »

diob wrote: post #65
bboygravity wrote: post #27

Earlier quoted context omitted.

Interesting. I bet close to all young skinny people with sleep apnea must remain undiagnosed. My generalist doc basically said "if you really insist we can do a polysomnography, but I'm pretty sure you don't have it, you're young, skinny and sporty. There isn't really much that helps that you can do about it anyway". I did insist and it turned out that I do have it. The changes in life I experienced are similar to yo…

Yes, I was a young fit 23 year old, like, six pack abs and muscular. I finally got my sleep study, and I had 79 AHI! When I went to get the equipment, they thought I would be severely obese. It changed my life, but I worry how much long term damage was done until then. My friend told me when I slept over (around age 14) that I would literally stop breathing and he thought I was dead. Then I would suddenly gasp awake.…

Few medical doctors seem to grasp statistics. They solely consider trends, so it sucks to be a patient who is an outlier. Especially considering lifestyle factors and genetics aren't always properly controlled for in studies.

Just look at how something like different dosages of alcohol affects different populations!

I personally have a high BMI and high creatinine levels. No, I'm not obese with messed up kidneys (which the doctors thought); I just lift a lot and supplement with creatine.

Of course, doctors tend to be overworked, so I don't doubt they would be able to think clearly if they worked normal shifts and got adequate rest.

Re: Poor sleep drove me insane, and my long path to recovery

#232

Post by anonymousnotme »

Wagthesam wrote: post #3

This is quite raw and I'm actually somewhat afraid to share this. But I think sleep apnea is criminally under-discussed and underdiagnosed. It can f your life up sideways and can take years to diagnose. So sharing my story and hope I can advocate for it. If you have sleep apnea, no amount of sleep gadgets, good habits, exercise, will help you. You must fix the root cause

Agree. Some of the problems can start from childhood. Like mouth breathing and being tongue tied can leed to abnormal growth and supposedly cause the face to be taller and more narrow, which supposedly is a sign of narrow air ways. I am also looking at some of this. What have your found in terms of good resources? I am paricularily interested in allergy and the turbinates and finding a good ENT because looks septoplasty is needed. My belief is that enlarged turbinates (were not enlarged enought to cause issues 2 years back) are due more likely to environmental cause and or allergy. I asked my current set of ENTs how to look at enviroment as cause and they give me a dumbfounded look. (Tried several different anti-inflamatory drugs for turbinates that don't make much of difference.) I also have read in a few places that certain foods can cause enlarged turbinates. Part of the problem is that some times root cause can't truly be found until one tries a solution on a hunch and it works out. I have seen Kasey Li and he did not seem to like te drug enduced endoscopy (I thought it would be a great thing to do). It would be nice to have camera(s) or similar in the air way when one naturally sleep to find what is pinching off. He said the endoscopy will knock one out, but not necessarily put one in the same state as when one sleeps so that might lead to mis-diagnoses. Also, a lot of the surgeries will not be paid for by insurance unless one's AHI is higher than 15 on both back and sides. So, if one needs surgery for UARS (generally will not cause AHI to go that high), then one would need to pay out of pocket. Anyway, good resources with doctors that can look at the full picture are really needed and I really have not found a doctor that is able to look at the big picture and guide one to fixing it the real issue; they all seem to only focus on their narrow area of expertise. So any big surgery like EASE, MMA, etc is a big risk and the recover is not short, costs a lot and still might not fix the issue.

Re: Poor sleep drove me insane, and my long path to recovery

#233

Post by alfnor »

m0llusk wrote: post #192
bboygravity wrote: post #27

Earlier quoted context omitted.

Interesting. I bet close to all young skinny people with sleep apnea must remain undiagnosed. My generalist doc basically said "if you really insist we can do a polysomnography, but I'm pretty sure you don't have it, you're young, skinny and sporty. There isn't really much that helps that you can do about it anyway". I did insist and it turned out that I do have it. The changes in life I experienced are similar to yo…

Apnea is nearly universal among older weightlifters. It is not well understood, but it seems that relatively small changes to the physiology of the neck end up interfering with breathing. Many healthy and strong people don't have any idea what is making them feel bad until many other alternative explanations are eliminated.

I wonder if there's a more simple remedy like a tilted bedframe or a hammock or something.

Re: Poor sleep drove me insane, and my long path to recovery

#234

Post by Llamamoe »

bick_nyers wrote: post #154
Llamamoe wrote: post #102

Earlier quoted context omitted.

Either sleepy or tired-but-wired feeling. Reflux. Mouth breathing during sleep(dry/stinky mouth), jerking awake while falling asleep, waking up with a headache, breathless or more tired than you went to sleep. Bruxism. ADHD-like and memory problems. Low blood pressure with cold extremities. Nightmares.

I've rationalized that this is a combination of getting older, ADHD, and childhood trauma. Will have to look more into apnea.

I actually have a write-up on a pet theory that a substantial proportion of ADHD cases are likely undiagnosed non-apneic sleep disordered breathing: https://gist.github.com/Asmageddon/4a952260c0fc9875f477d6813...

Re: Poor sleep drove me insane, and my long path to recovery

#237

Post by Llamamoe »

soiler wrote: post #215
bick_nyers wrote: post #154

Earlier quoted context omitted.

I've rationalized that this is a combination of getting older, ADHD, and childhood trauma. Will have to look more into apnea.

It could be all of the above. I was diagnosed with "mild" sleep apnea and a CPAP hasn't really made an improvement on my day-to-day. The main difference is that occasionally I used to wake up feeling completely hung over and near death, and now that no longer happens if I'm using my CPAP. Most days, I am still tired - I am learning that is probably due to depression/anxiety (working on treatment now), ADHD (can't tre…

The problem with CPAP is that it prevents full airway collapse and apneas very effectively, but often just converts them into subtler collapse ending with arousals. It also introduces its own disruption through expiratory resistance, reducing arterial CO2, patient-ventilator asynchrony if you're using any EPR or bilevel features, etc... bleh.

Re: Poor sleep drove me insane, and my long path to recovery

#238

Post by Llamamoe »

moogly wrote: post #170
Llamamoe wrote: post #102

Earlier quoted context omitted.

Either sleepy or tired-but-wired feeling. Reflux. Mouth breathing during sleep(dry/stinky mouth), jerking awake while falling asleep, waking up with a headache, breathless or more tired than you went to sleep. Bruxism. ADHD-like and memory problems. Low blood pressure with cold extremities. Nightmares.

> Low blood pressure Low blood pressure for UARS, but high blood pressure with OSAS.

Traditional OSA as found in elderly/obese people yes. But a lot of young people are still on the UARS side of symptom presentation even when they cross the threshold for OSA.

Re: Poor sleep drove me insane, and my long path to recovery

#239

Post by Llamamoe »

spirit557 wrote: post #118
findthewords wrote: post #107

Earlier quoted context omitted.

I've been dealing with similar problems for a few years now, ever since all my wisdom teeth were removed.

I have wondered if children's diets precipipate this problem. Because so many kids grow up with varying levels of processsed or pre-digested foods (pulverized fruit pouches, not enough crunchy whole foods that require chewing etc) the jaw does not develop fully - so wisdom teeth removals and orthodontics for expansion seems like standard of care nowadays - but really it should not be that way. These cases should be r…

They do, yes. There's a substantial body of research showing that soft diets lead to undersize jaws in a number of mammals, humans are just semi-unique in that our airways are very soft and floppy and it doesn't take much for collapse to start happening.

If you can't switch your diet to one that involves chewing for the sake of your kid, try and make chewing gum a regular snack.

Re: Poor sleep drove me insane, and my long path to recovery

#240

Post by Llamamoe »

PragmaticPulp wrote: post #84
Wagthesam wrote: post #3

This is quite raw and I'm actually somewhat afraid to share this. But I think sleep apnea is criminally under-discussed and underdiagnosed. It can f your life up sideways and can take years to diagnose. So sharing my story and hope I can advocate for it. If you have sleep apnea, no amount of sleep gadgets, good habits, exercise, will help you. You must fix the root cause

> But I think sleep apnea is criminally under-discussed and underdiagnosed. I agree that it’s under-diagnosed in people who have it, but it’s actually discussed very widely across social media and in person. I have some sleep medicine professionals in my extended social circle. It’s common to hear stories of people coming in convinced that they must have sleep apnea after reading about it online, but their sleep stud…

> but their sleep studies are nearly perfect.

This is because most labs only score AHI, often using 4% desat criteria, which underscore prevalence/severity possibly by as much as 80%.

Most younger, non-obese female patients fall on the UARS side of the spectrum, with RERA events dominating over apneas and hypopneas- where an older man with 3 AHI might have 6 RDI, an excellent result for their age, it's common for a young person to have 15+ RDI, at which point most people struggle with day-to-day functioning.

> One of the hallmarks of incorrect diagnoses is that a lot of her patients stop the _PAP machines after less than a year because they’re not helping anything.

This in no way implies incorrect diagnoses. CPAP dropout rates are 40%+ even in people scored using the least sensitive criteria. CPAP just genuinely sucks, especially for anyone whose nasal breathing is poor. Most people with UARS don't benefit from it at all, but get way better with oral appliances, skeletal treatment, or nasal surgery.

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