Sleep apnea is causing me to fall asleep at work. HELP!

July 14, 2012 7:20 AM

I'm pretty sure I have sleep apnea and it's affecting me at at work.

Over the past year or so, I sleep, but do not feel rested after waking up. My girlfriend says I stop breathing in my sleep, and so I likely have sleep apnea.

Two problems as a result: I have only catastrophic health insurance that doesn't cover CPAPs or sleep studies, and can't afford to pay these costs out of pocket. Any ideas on how to get this done cheaply are much appreciated.

The second issue is more serious: I find myself dozing off while at work. I work in a corporate environment and sit in a cube all day. My bosses haven't noticed, but my co-workers have. I can't seem to stave off the sleep with caffeine or activity. If I sit down at my desk, it's a given I'll doze off within 2-3 hours. Any methods I could use to avoid this? I don't want to get fired.

Thanks!

posted by stedman15 to health & fitness (12 answers total)

This sounds pretty serious, so if I were you I'd find a way to get this treated somehow. Can you ask around for a sleep lab that has a sliding scale? Borrow the money? Go have an intake appointment with your doctor, tell him or her just what you told us, and say you have no money and what are his/her suggestions on how to proceed?

Do something because you sound like you could be a road hazard - if you are falling asleep when you sit down then you might be falling asleep at the wheel.
posted by Rosie M. Banks at 7:33 AM on July 14, 2012

It sounds like sleep apnea to me as well (I have it) and if it is, you really do need to get it treated. Not only that, you need to get it properly diagnosed, because if it's central apnea rather than obstructive apnea, a CPAP machine won't fix it.

Go and buy yourself some Obamacare.
posted by flabdablet at 7:42 AM on July 14, 2012

Apnea can kill you--it greatly increases your chances of heart attack and stroke. Medical services offer payment plans, this is something you want to take care of. The most affective way to deal with dozing off at work is to get quality sleep, and you will most likely need a machine for that. Getting treated will change (and save!) your life. It's worth the investment.
posted by Kimberly at 7:56 AM on July 14, 2012 [2 favorites]

First: I urge you to somehow get a proper sleep study and treatment to see if you do indeed have obstructive sleep apnea and level of severity. OSA _KILLS_, and I'm not just talking about falling asleep at the wheel or passing out and choking halfway through a hotdog: I'm talking about bad things like cor pulmonale, hypertension, stroke, and a lot of other official medical diagnoses.

I have no easy solution for you in terms of getting coverage for a study, potential diagnosis and treatment. What I can give you is some pretty ghetto advice.

- Have good sleep hygeine
- Sleep with a few extra pillows under your head if you sleep on your back, or sleep on your side.
- Get some BreatheRite strips. Try 'em out. Do this first: grab the sides of your nostrils with your thumbs and fingers and pull 'em out and breathe. Easier breaths? Get some of those strips, and go for the "maximum strength" kind
- Get a mouthguard, and when you set it give yourself a very, VERY slight underbite such that your lower jaw's teeth match up with or are just in front of your front teeth. Wear this at night. This keeps your lower jaw forward and may help keep your throat open when you sleep. Note: this is NOT an official mandibular advancement device. In practice I advice you to see a dentist first
- Lose weight if you're obese. Lose a little weight anyway, unless you're underweight. This is the biggest thing that may help in the long run.


Ok, that out of the way, here's what I'd do to get a sleep study without insurance: call every single sleep lab in the area up and say "I think I have apnea. I only have no insurance. I'd like to pay cash and I'm calling around. Can you do anything for me?" See what they say. Then call every neurologist and pulmonologist and say the same thing.

The point is, apnea kills. I'll reach out to a few colleagues and see if they have any suggestions for getting a proper eval and treatment on the cheap. If I get any decent replies, I'll post another comment here.
posted by herrdoktor at 7:58 AM on July 14, 2012 [5 favorites]

Of course seeing a sleep specialist is the best plan and it sounds like if you had the resources you would be doing that. With that said I'll tell you what I did to help myself before I was able to get my sleep study done.

I tend to have stuffy nose problems at night so I made sure that I used a neti pot or Simply Saline an hour before bedtime and I followed that up with the Advanced Breathe Right nose strip before I went to bed.

Try not to sleep on your back. I can breathe easier lying on my side. Use pillows as support if needed.

This was a biggie: go to a medical supply and get a wedge pillow. You can pick up a decent, basic wedge for about $40 (USD). I found that being elevated helped me breathe better. It takes a few nights to adjust but it really helped me rest better. With pillow support I can sleep on my side on the wedge too.

Sleep apnea is a serious condition and really needs proper treatment. I wish you good luck in managing it.
posted by dorkydancer at 8:13 AM on July 14, 2012

All right, got a couple calls back. Here's some more info:
Medical device companies that make/sell CPAP machines often have programs where older/used machines are given free of charge to patients in need. Example: ResMed, locally to me, current has a machine up for grabs. You can ask sleep lab MDs if they have any similar setups.

Whatever the case is, you'll need an initial workup and studies done to obtain a diagnosis before any machine is given. You might not have OSA, and if you do, it might not be severe enough to warrant a jump to CPAP (though your symptoms point to it).

I'm not sure how much initial visits cost where you are, but after an initial visit and if apnea is suspected, you could get an ApneaLink study, which is done at home. Around here, is just short of $200 cash.

If it's positive and you have more than a certain number of events where your breathing stops and your oxygen levels drop, you'd get a formal study with a CPAP machine if indicated, and adjustment of said machine's settings (how hard the air is blowing into you). The sleep MD might just start and finish with a formal sleep study and skip the ApneaLink. A formal sleep study around here is about $600 cash.
posted by herrdoktor at 8:36 AM on July 14, 2012 [3 favorites]

I found out I had sleep apnea by waking up one morning with a heart arrythmia. This is a beg/borrow/steal situation. You may not have insurance, but do you have parents? Friends? A bank line of credit? Does your state have aid for the indigent? How about a neighboring state? Can you buy a CPAP on Ebay/Craigslist? Turn over ALL the rocks.
posted by Cool Papa Bell at 8:44 AM on July 14, 2012 [2 favorites]

In my area, there are lots of CPAP machines listed on craigslist in the $200-$300 range. That is much cheaper that what I paid for mine WITH insurance.
posted by a humble nudibranch at 9:21 AM on July 14, 2012

I just want to note that while your symptoms might point toward sleep apnea, you might not have it, and if you did, it might not warrant CPAP. Regardless, I do not advise you to purchase or use a CPAP machine without a diagnosis, adjustment of pressure/setting, proper fitting or follow-up.

In other words, you should NOT buy a CPAP machine off of Craiglist and just start using it.
posted by herrdoktor at 10:10 AM on July 14, 2012

I want to reiterate that sleep apnea can kill you and damage your brain and heart. You need a proper diagnosis and treatment for whatever your problem is. If it's not sleep apnea, you don't want to get stuck with a machine for life. If it IS sleep apnea, you want to find out if you are one of the lucky few who can fix it forever with a surgery or something. You need to see a specialist and you probably need a sleep study. If I were you, I'd make it a priority to switch jobs and get real health insurance or I'd sign up for one of the new programs that gives you real health insurance, assuming you're in the US (some state programs have already launched).

You can talk to people at CPAP Talk for ideas about self-treatment, but I don't think it's the smartest thing to do at all.

Best wishes.
posted by wintersweet at 3:58 PM on July 14, 2012

IANYD, but you could also have narcolepsy. You should see a doctor ASAP.
posted by jmd97 at 8:03 PM on July 14, 2012

I think I have apnea. On June 20 I went to my local Kaiser office and got fitted with an at-home sleep study device. I dropped it off the next day (after a night of really crappy sleep!) and they told me it could take up to a month to hear back. 26 days and counting...

My point: if you find a way to get tested, don't plan on finding anything out quickly. Try to find a Plan B to keep yourself awake at work until you get the test results back.

Maybe you can set an alarm on your cell phone to go off every hour and force yourself to get up and walk around the office.
posted by tacodave at 3:43 PM on July 16, 2012