Do I have sleep apnea? If so..what should I do?
March 23, 2011 10:32 AM   Subscribe

I'm a 27 years old female, I could stand to lose a few pounds, but I am not extremely overweight, and for the past few years have had complaints about my snoring.

I know that it's gotten louder over the past several years because in my early 20's I never had any complaints. We are pretty certain that my father has sleep apnea, although he is very stubborn about things like that and has gone undiagnosed. As long as I can remember he has been a very loud snorer, and every once in a while you can hear his breath catch and what feels like minutes later release. Often times he will hold his breath and have a little coughing spasm when he releases it.

At the holidays a year or so ago, when having a family discussion about my father's snoring and mocking the way he sounds, my boyfriend said that that is essentially what I sound like, and that sometimes it scares him because he doesn't think I am breathing. Also a few times over the past few years I'll wake up feeling like I'm choking or gagging on something. Everytime it has really freaked me out. My boyfriend also says that some nights I won' t snore at all. Also I am noticing that with in the past 3 years or so, I am a lot more tired than I used to be. I used to be the one of my friends that could be fully operational on small amounts of sleep and still stay up late the next night. Now even if I have 8+ hours of sleep I could be sleepy when 10pm rolls around. Is this just what happens when you get older?

So I suppose the question is do you think I have sleep apnea? Is this something that I would get genetically? Because most of the things I have read have to do with either being really over weight, or that most people who suffer from sleep apnea are men. If I do have sleep apnea does anyone have suggestions on treatment options? I don't want to have to sleep in separate beds if it gets worse! Does anyone have experience with the surgical options? Do they actually work? I would prefer not to be on a machine while I sleep for the rest of my life. Also, if I go to a sleep clinic, and it happens to be a night when I don't snore (or not as bad at least), are they going to be able to tell anything at all? Or am I going to have to make multiple trips to the sleep clinic? (Meaning multiple payments to the sleep clinic). Any advice on this would be helpful! Thanks!
posted by Quincy to Health & Fitness (29 answers total) 3 users marked this as a favorite
 
Start by having this conversation with your physician. The physician can then request a sleep study. Good luck.
posted by onhazier at 10:40 AM on March 23, 2011


Yes, that sounds like sleep apnea but a sleep study is the way to find out (and if the first one is inconclusive, see if you can do another - they can't tell if you're not snoring, so it may take multiple trips - but think of the benefits!). You would talk to a sleep specialist through your doctor. Treatment varies, and can be as easy as a C-PAP machine. Everyone I know who has had success has done so with a C-PAP, but I've heard of folks having corrected a deviated septum and getting rid of their sleep apnea, too.

But, yeah, talk to your doctor about it. Not being tired after 8 hours of sleep is worth it alone!
posted by ldthomps at 10:42 AM on March 23, 2011


Yeah it's sleep apnea. Lose the weight.
posted by clarknova at 10:43 AM on March 23, 2011


I have sleep apnea. The sleep center should be able to detect apnea events even if you're not snoring as badly as you can.

However, some doctors now order a kit to be sent to your home that you hook-up to yourself and it doesn't require a trip to the sleep clinic. Check with your doctor to see if that's an option for you.

It's important to get this diagnosed and corrected. Apnea is a great stressor on the heart. It contributed to the death of football player Reggie White. So it can be a killer.
posted by inturnaround at 10:43 AM on March 23, 2011


It could very well be sleep apnea, and you don't have to be overweight to have sleep apnea. I have a close relative who has sleep apnea. She is 5'9 and 120 pounds. Apparently a lot of it has to do with the structure of your tonsils, throat, and palate.
posted by charmcityblues at 10:49 AM on March 23, 2011 [2 favorites]


I've got sleep apnea, and it sounds to me like you do, too. Talk to your GP and get a sleep study done.
posted by Faint of Butt at 10:49 AM on March 23, 2011 [1 favorite]


Yeah it's sleep apnea. Lose the weight.

I'm a female and I'm not overweight at all and I have sleep apnea. I asked this question awhile back, got a sleep study as a direct result of having asked it, and am better for it. The CPAP is like white noise and my husband definitely prefers it to my snoring.
posted by desjardins at 10:50 AM on March 23, 2011 [2 favorites]


I have been a "noisy" sleeper my whole life. I had my adnoids removed at age seven. It did no good. As I've aged my weight has gone up and down. I still snore. I have an unrelated anxiety issue and that kept me going a sleep clinic. I use a wedge pillow. Sorry for the Amazon link. I'm on mobile.

My family says it made a big difference. It took a little getting used to being a different height but it didn't take long to adjust.
posted by dorkydancer at 10:50 AM on March 23, 2011


Before you beat yourself up about the weight, remember that sleep deprivation can contribute to weight gain, so dealing with the apnea (if that's the problem) might help you shed some pounds.
posted by Ollie at 10:50 AM on March 23, 2011 [1 favorite]


I (used to) snore. In January, we started a low-carb thing, and since then I have lost nearly 20 pounds and my snoring has almost vanished. I wasn't hugely overweight - not in the morbidly obese category, anyway - but I never feel "snuffly" in the morning anymore. I'm attributing this mostly to the extreme drop in my consumption of gluten. It can't be the lack of dairy, since I'm eating lots of that, and I have a hard time believing that losing as little as 15 pounds (which is about when we started noticing my lack of snoring) would unclog my breathing passages enough to make a difference. So I think it's the gluten - it's certainly not completely eliminated from my diet, but the main sources of it (bread, pasta, beer *sob*) are gone, and so's the snoring.

YMMV, as with pretty much everything.
posted by rtha at 10:51 AM on March 23, 2011


Have a partner with a CPAP machine, I can say that the machine is much less of a bother than the snoring was. On the other hand, it makes snuggling a bit more challenging, since when it's time to sleep he has to pretty much roll over and put his mask on.

I know he thinks it's a hassle at times, especially when he's traveling and has to take it with him. Also, if he's got a cold and can't breathe through his nose, it doesn't work and I end up in the spare room because of the snoring.
posted by cabingirl at 10:51 AM on March 23, 2011


Oh, and to be clear, I'm not saying that what you're experiencing isn't apnea - it very well could be, and you should talk to your doctor about that. Just saying that it may not be the whole story.
posted by rtha at 10:53 AM on March 23, 2011


It's possible that a small weight loss can help the apnea; I noticed that I was snoring (waking myself up) and had some really weird choking feelings; for unrelated reasons, I lost a fairly small amount of weight and it turned out to have been sort of a "trigger" weight for all kinds of things. I'm not at all thin now; there's just a particular max weight for me above which I go from fat-and-healthy to fat-and-snorey-and-all-kinds-of-other-stuff.
posted by Frowner at 10:55 AM on March 23, 2011


Short answer: you probably do have sleep apnea, but only a sleep study will be able to confirm/deny it. You should mention it to your doctor, who will point you at a place to get the study done. Some number of breathing interruptions are considered normal, more are considered "sleep apnea". Get it checked out.

It may not have anything to do your weight. While apnea is more common in overweight people, it's also not unusual for people to have varying degrees of it without being overweight at all.
posted by georgikeith at 10:57 AM on March 23, 2011 [2 favorites]


My dad's got sleep apnea, and it has to do with the size of his tongue - weight loss wasn't a factor at all.
posted by restless_nomad at 10:59 AM on March 23, 2011 [1 favorite]


Note regarding sleep studies: see if whomever you select can do both the diagnosis and the CPAP adjustment (if one is needed) in a single visit.

Otherwise it's another overnight stay & big wad of cash to get the machine adjusted, which in my case meant I decided not to bother and thus still have sleep apnea because I can't afford to do the second study.
posted by aramaic at 11:04 AM on March 23, 2011 [1 favorite]


You'll have to ask a physician for a referral to have a sleep study done.

I had a test done last fall which was done at home with a machine that gets strapped to your chest, a cannula up your nose and, a gadget that clips to your index finger. Along with reams and reams of questions about sleeping habits &c.

Yeah it's sleep apnea. Lose the weight.

You don't have to be overweight to have sleep apnea, mine is has to do with the shape of my throat and isn't influenced by how thin, or fat, I've been. If I can stay off my back when sleeping I don't have problems breathing.
posted by squeak at 11:07 AM on March 23, 2011 [1 favorite]


Seconding squeak. You don't have to be male or overweight or even snore to have sleep apnea--these are harmful stereotypes that probably keep a lot of people from getting help. Losing weight may or may not help fix it, and since it can kill you, please don't muck around with it or take advice from random internet people (especially people who think it can always be cured with weight loss, different sleep positions, or special pillows). Go to a doctor (get referred to an ENT or sleep specialist), particularly if you have any other symptoms such as daytime sleepiness, fatigue, forgetfulness, being prone to fall asleep in darkened rooms during the daytime, etc.

If you do have sleep apnea and you have a sleep study, they'll probably be able to notice the problem occurring before the snoring actually occurs. Chances are, apneas are happening all the time, while snoring is only happening some of the time. Everyone thinks they won't be able to sleep or the problem won't manifest, but they usually get the data that they need in the time that you sleep.


@aramaic -- people at cpaptalk.com have some creative workarounds. (e.g., self-adjusting machines aren't cheap, but they're cheaper than a second sleep study. They may know about places that work on sliding scales, etc., too.)
posted by wintersweet at 11:25 AM on March 23, 2011 [1 favorite]


I have sleep apnea as well, likely caused because I have a "big tongue and a short neck" (thanks, doc). I also have enlarged turbinates in my nose which make breathing harder.

Because I don't have "obstructive" sleep apnea (meaning I snore, but my brain gets oxygen so I'm not in any danger), my insurance wouldn't cover a CPAP machine. So, my sleep specialist referred me to a sinus specialist. I'm not really through exploring my sinus-related options, but I mention it just to point out that it may not be a CPAP-or-nothing scenario for you. My sleep specialist also offered some suggestions that I could try myself, to see if they helped.

It was very easy to get a referral to the sleep specialist for a study - I just went to my regular doctor, told him what was going on, and I got a referral right there.

There's a really good chance you will snore during the sleep study, but if you are concerned about that ask the specialist during your intake visit.

Don't put this off - obstructive sleep apnea is definitely a condition you want to address ASAP (if you have it, and you won't know if you have it until you get that study done).
posted by DrGirlfriend at 11:51 AM on March 23, 2011 [2 favorites]


Sleep apnea does not primarily affect fat men. Anyone can get it. Losing weight may or may not fix it.

My neurologist told me that the majority of his OSA patients who have lost significant amounts of weight still have OSA even when they are thin.

I lost 120 lbs and I still have OSA. Granted, mine has improved to the point that it can barely be classified as sleep apnea, but it's still a concern. Don't just lose some weight and assume that you're cured.

My dad had incredibly severe sleep apnea and died at the age of 52 the night he went to sleep without his CPAP machine. However, he was also 450lbs, an alcoholic, and a heavy smoker.

Bottom line, go to your doctor. Tell them what you told us. They should schedule you for a sleep study or give you a referral to an ENT or a neurologist. If they don't, get a second opinion. Sleep apnea isn't something to mess around with.
posted by elsietheeel at 12:01 PM on March 23, 2011 [3 favorites]


I share some of your symptoms, namely, gagging and coughing during sleep. This turned out to be asthma. As soon as I began treatment, I started sleeping through the night. GERD can also cause coughing in your sleep.
posted by Lieber Frau at 12:03 PM on March 23, 2011 [1 favorite]


By any chance, do you sleep with a pretty firm pillow (one that would keep your head more upright) versus a flat, feather pillow and on your back? I have been snoring alot more in the past few years as well, and I use a very flat pillow, and am a back-sleeper. It makes me wonder if the angle of the head also could be a factor...
posted by foxhat10 at 12:29 PM on March 23, 2011


Someone near and dear to me snores when their weight is over a certain amount. Seriously, for this person five pounds makes all the difference. However, it's best to talk to a doctor and go over the range of options. Another person I know is very overweight, has a serious problem with sleep apnea and is basically now a narcaleptic with depression issues. They refuse to get treatment for any of these things but I suspect the sleep problems are the engine in this system. It's so worth it to get a professional opinion!
posted by amanda at 12:42 PM on March 23, 2011


Best answer: First, it's entirely possible that you have it through genetics. Your story is almost exactly mine. I was diagnosed at age 24, and I'm female and 120 pounds. My dad also has it, although he won't get treated for it (and although he's not skinny, I wouldn't call him fat either) so in my case it is genetic.

You say:
"I would prefer not to be on a machine while I sleep for the rest of my life."
Well, I would prefer that too, but I'd also prefer to have a million dollars, and that's not going to happen either.

Unfortunately, the machine is the best treatment option right now. There are mouthguard-type things you can use, but they aren't as effective. None of the surgeries are anywhere close to 100% effective either, and some of them are pretty drastic for something that isn't a surefire cure. There's one where they remove part of the back of your tongue, which can sometimes result in difficulty swallowing. Not something I'd want to deal with.

There are plenty of people that choose to live with untreated sleep apnea because they hate the machine so much. I hate it too, but I've learned to tolerate it. I don't enjoy it, and it makes air travel a pain, but that's the price I have to pay for feeling awake. Considering all the medical conditions that people have that seriously impact their day-to-day life, sleep apnea is definitely on the easier end of the scale. After all, aside from travel, it only impacts your life when you're going to sleep. It's like the old joke some comedian made: "Why do people get nice furniture for their bedroom? Most of the time spent in that room is when they have their eyes closed?" Likewise, why reject an effective treatment when the only inconvenience is to wear a machine while you are unconscious?

It does take time to get used to it, but there are strategies for that. (MeMail me if interested.) It took a few weeks before I was able to fall asleep while using the machine at about the same rate I could fall asleep without it. Now, I would never want to go without it. It's my necessary evil. I can't imagine going back to the tired feeling I used to have.

One other diagnostic question that no one has mentioned, because it is a little-known symptom: do you ever wake up in the night feeling hot and sweaty for no reason? That used to happen to me all the time. During the day I'm always cold, but sometimes in the dead of winter I would wake up sweating. It is a symptom of the sleep apnea. Definitely get a sleep study.
posted by LaurenIpsum at 12:53 PM on March 23, 2011


Response by poster: Thanks to everyone for all of your answers, Ive known I need to see my pcp, but this has defiantly helped clear up some questions I'd rather hear from people who live it!

@LaurenIpsum - I do wake up hot or sweaty for no reason frequently, for some reason I've always attributed it to other factors, but definitely have had that symptom
posted by Quincy at 1:17 PM on March 23, 2011


Response by poster: Definitely not defiantly! Predictive text fail.
posted by Quincy at 1:19 PM on March 23, 2011


I could have posted your question twelve months ago. Guess what? I have sleep apnoea!

Women can have sleep apnoea. Not-overweight people can have sleep apnoea.

You diagnose it by having an overnight sleep study.

You treat it with a CPAP machine.

If you do have sleep apnoea, and you treat it with a CPAP machine, the following benefits can occur:

* you won't wake up with a pounding headache anymore;
* you will be much less grumpy/grouchy;
* you will be more alert/talkative during the mornings;
* drowsiness between 1pm and 4pm will get a lot milder;
* you will become a much safer and more assertive driver;
* far less nightmares;
* far less waking up bathed in sweat;
* you will have more energy;
* your heart won't have to work as hard;
* your risk of high blood pressure, stroke, heart attack will be reduced.

CPAP machines really, really suck for the first one to four months, but stick with it, after that you get used to them - and they improve your quality of life so much!

If you can't tolerate the nose mask, get a full-face mask, which lets you breathe through your mouth instead.
posted by Sockpuppets 'R' Us at 4:43 PM on March 23, 2011


I'd like to point out that if you try in earnest to tolerate the CPAP machine and find that you really, truly can't, the mandibular advancement devices/oral appliances actually do work for some people. After a year of taking off the CPAP mask in my sleep EVERY night (and having trouble falling asleep nightly as well) I got an MAD made. My sleep dentist and neurologist had me do a second sleep study as well as a bunch of imagining done and the appliance worked REALLY well at keeping my airway open during sleep.

Unfortunately, due to TMJ disorder, I can't keep the damn thing in all night either. But they can work for some people.
posted by elsietheeel at 11:17 AM on March 24, 2011


If it is apnea and you do wind up getting a CPAP, go to www.apneasupport.org and they will help you with all kinds of tips and tricks for getting used to a CPAP.

Remember, there are all different makes and models of CPAP - these days you can get a very unobtrusive nasal-pillow type of thing that hooks up to a wee little shoebox device that emits a quiet purr. CPAPs these days are not the bulky, full-face Darth Vader machines - even if you do need a full-face mask they are less bulky now.

Apnea is very serious business and nothing to fool around with! Heart attack, stroke, accidents caused by falling asleep at the wheel...all these can result from untreated apnea. Some sleep partners of apneics have actually been deafened by the noise.

Just speaking for myself about the snuggling/sleep partner aspect - I'd rather deal with the CPAP than a partner's thunderous snoring. Super-loud snoring can achieve the same decibel level as a chainsaw or pneumatic drill. CPAPs are nice quiet hummy little things that can be quite soothing.
posted by Rosie M. Banks at 2:10 PM on March 24, 2011


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