Can I have sleep apnea with these symptoms?
I've been reading up on this condition, however, I am still not sure if that may be my problem. I do not want to go to the doctor for no reason. I was hoping that someone with this condition can help me find out if I do need to go see a doctor.
My symptoms are sleepiness during the day. Some days I am so sleepy that I am irritable and just not fun to be around. I am usually tired like I had no sleep the night before or as if I had been doing a lot of work, which is usually not the case. I cannot remember a night when I got less that 8 hours of sleep. I usually get 8 to 10 hours every night. Mostly 9 or 10. However, when I get up, I am dizzy and tired and I definitely do not feel well rested. I think twice before getting out of bed because I still feel tired. When I do get up I do not usually feel sleepy then, only tired. It is during the course of the day that i become sleepy. Sometimes very sleepy that I have to get up and do something or I will fall asleep. I am always tired.
I forgot to add that I do not snore, at least I don't think, but I really don't think so.
Asked By: chicabonita2181 - 5/13/2007
Having worked my part-time job at the local hardware store, I came home to have lunch with my wife. After lunch I went into the living room to read the Sunday paper, and my next recollection is that about a dozen people (including the police, EMTs, paramedics, my fire chief and the deputy chief) were milling around trying to get some response from me.
I was rushed to the hospital with an initial diagnosis of syncope. Myriad tests were ordered (an electrocardiogram, an electroencephalogram, a CAT scan, x-rays, blood work, and a carotid doppler, among others), but there was no conclusion as to the cause of my blackout. The EEG tech suggested that I might have a sleep disorder, and I mentioned this to several of my doctors. They did not respond at all to this idea.
After my release I had an MRI, 24-hour EEG, a cardiac stress test and more blood work. All results were normal. I requested a sleep study to be performed at the local sleep disorder center. The diagnosis was that I have severe sleep apnea.
"Could this have caused my blackout?" I wondered. The experts' answer continued to be, "We don't know, but possibly." The sleep center prescribed a BiPAP (Bi-level Positive Air Pressure) machine to correct the sleep apnea. A titration study (a test to find the necessary pressure for the BiPAP machine to work most effectively) was performed in January. It indicated that I needed to control thirty-seven apnea events per hour, and so required a BiPAP pressure of 14cm/10cm. I was told by the sleep center techs that I would experience an adjustment period and considerable frustration in getting used to the whole process.
I picked my new machine up from the Durable Medical Supply Company. They provided a very rapid introduction to the mask, which I would be wearing while asleep, and to the control switch on the machine. The really hard stuff came later. There lay many difficult nights ahead when I would be ready to throw the darn BiPAP out of the window but, because of the support I received from my friends and family, I persevered. I also called the American Sleep Apnea Association, and they were very helpful and encouraging - they reminded me that using the machine is an acquired skill. They were very, very right!
Late January 2004 brought another event where I woke up to find EMTs and paramedics in my bedroom. This time was different because my wife witnessed the episode and could describe what happened to the doctor. The only obvious similarity was that I bit my tongue both times. This time at the hospital I was diagnosed as having epilepsy and given Dilantin with instructions to follow up with my neurologist. When I left the emergency room I felt depressed, angry and very frustrated. I had a lot of questions chasing themselves through my mind. Why was I having these events? Could my problem really be epilepsy? Would I be able to drive? Could I still be involved with my fire department? Determined to find the answer, I made an appointment at a world-renowned teaching hospital to see the head of the epilepsy center.
While waiting for that, I saw my ophthalmologist. She told me that my eyes showed no evidence of seizures or of any of the changes often seen with epilepsy. I also went to see a dietitian to help me improve my energy level, lose weight, and get advice about what foods could help counteract the negative effects of the anti-seizure drugs. When I kept my appointment at the teaching hospital, I had another EEG and complete neurological exam. Although all my tests came back negative, the diagnosis continued to be that I "probably" had epilepsy. I told them about my sleep apnea and asked whether it could possibly cause a seizure. The doctor's response was, "I don't know, but I doubt it."
Leaving the hospital, I felt very discouraged. In mid-March, I had my third seizure during sleep. Later that night I joined the epilepsy support group at our local hospital, where I collected a great deal of helpful information. After that, however, I still questioned the diagnosis of epilepsy. My experiences had been totally different from those I'd heard described. One of the group members recommended yet another neurologist, but this one sounded more promising. So I made an appointment, brought all my test results with me, had yet another thorough neurological exam, and was finally diagnosed as having hypoxia (lack of oxygen to the brain) caused by severe sleep apnea.
In this doctor's opinion, the lack of oxygen to my brain had caused the seizures, probably in combination with a great deal of stress in my life and many years of being sleep-deprived. She changed my anti-seizure medication and communicated very clearly that I would need to use my BiPAP machine for the rest of my life. Now that my hunch that sleep apnea was the cause of my seizures had been confirmed, I felt very relieved but also very puzzled.
Why is so little known in conventional medicine about the role of sleep? If sleep occupies one-third of our lives, why do doctors pay so little attention to it when making a diagnosis as devastating (and heavily medicated) as epilepsy? I have now joined a sleep apnea support group and learned a great deal about the disorder. My weight loss has required several mask adjustments and re-calibration of the BiPAP machine along the way.
The great news is that all my friends and family have noticed that I am much more energetic, more alert, and that I no longer nap through social events. June arrived, and still another MRI showed no evidence of illness. I'd begun by taking sleep aids to help adjust to the BiPAP machine, but I really do not want to take more medication, so I've started working with a clinical hypnotherapist to help me fall asleep naturally. Although I am not convinced that I need the anti-seizure medication, I will continue to use it for the foreseeable future.
I have learned many lessons from my "magical mystery medical tour". The first is that you must be proactive when a diagnosis is presented to you. Do your research, talk to other people, and learn everything you can about your diagnosis before you accept it. Never be afraid to ask your doctors or healthcare professionals about alternative diagnoses or ideas. There was very little support for my idea that sleep apnea could be related or even the cause of my seizures, but I had to hang in there long enough to find someone to acknowledge the vital role that sleep plays in health -- and in illness.
Answered By: alfardie - 5/16/2007