Obstructive Sleep Apnoea

Frequently Asked Questions

1. QUESTION:
   Why is there a correlation between snoring, heart disease, stroke, hypertension and obstructive sleep apnoea?
   Why docs treat one or other of the symptoms without closer investigation? After all, that's why they go to med school in the first place and to get a more complete diagnosis of their patient's conditions.
   As I've indicated before, I've got hypertension, being treated. But I read a brochure and other stuff that now suggests I've got OSA as well.
   So is it an oversupply and re-breathing CO2 into our blood that causes the problems? And my headaches, too?

   • ANSWER:
     There is a correlation between snoring, heart disease, stroke, hypertension and obstructive sleep apnoea because they are all diseases with overlapping signs and symptoms. All are related to the blood vessels and blood gases.

     I see your point - doctors treat other symptoms without closer investigation.

     My view is that doctors do too many investigations. I am not a doctor.

2. QUESTION:
   What is the percentage of incidence of Obstructive Sleep Apnoea in Indian Popuation especially Tamilnadu?

   • ANSWER:
     You can try looking it up with the state's health department or the IMA association of TN

3. QUESTION:
   does viagra aggravate severe obstructive sleep apnoea?

   • ANSWER:
     I am not aware of this side effect from Viagra, I have seen plenty of OSA patients using Viagra, good luck

4. QUESTION:
   I have been diagnosed with Obstructive sleep apnea?
   Hi all i have just been diagnosed with obstructive sleep apnoea i start CPAP in a month does anyone know what make and model the CPAP Machine the NHS use please
   Thank you
   please help

   • ANSWER:
     There is at least one report online that the NHS supplies the RemStar Plus model CPAP machine.

     Quote:
     "They supplied a Remstar Plus and Ultra Mirage Mask, I was fitted by the sleep nurse and well you can guess the rest … but I will say it was exceptional service and care for all those involved."

5. QUESTION:
   My daughter had many medical problems, she is now gaining weight very slow can anyone help?
   She had a coarchtation of the aorta repaired at 36hrs old and a vsd which was repaired at around 6 months old. She has also had surgery earlier this year on her intestines because they were not in the right position (malrotation)at around 2 ½ yrs old, and more recently been diagnosed with severe obstructive sleep apnoea which she has had to have adenoids and tonsils removed. she has always suffered with chronic constipation. She is keen on eating but cannot chew solid foods so she is still on purees, she is very small she will be 3yrs old this week and weighs around 10 kilos, she gains only very little weight at a time, is there anyone who may have experienced anything similar or knows of anyone else that may be able to help me work out if these doctors are missing something as they have no idea as to why she is so little and not gaining the correct amount of weight or growing as she should be ????????????????????????????????????????

   • ANSWER:
     get her some pediasure. or some sort of supplement for now. she has had a lot to deal with. her body needs the nurishment. poor thing. my heart goes out to you and your daughter. look at it this way... at least she isn't losing any weight. right?

     is she on a cpap or bipap at night for her sleep apnea? or did the surgery on her tonsils and adenoids do the trick? if she is still having sleeping problems, that could effect her metabolism and eating. You tend to burn more calories when you keep waking up all night.

6. QUESTION:
   WHAT CPAP MACHINE DOES THE NHS USE?
   Hi all i have just been diagnosed with obstructive sleep apnoea i start CPAP in a month does anyone know what make and model the CPAP Machine the NHS use please
   Thank you

   • ANSWER:
     Unfortunately, there's no easy answer as it depends which manufacturer your hospital deals with. Respironics, Resmed, Devilbiss and Fisher Paykel are all the top suppliers of the NHS.

     Regarding what the other poster has written, the modern machines do not create horrific gales, and anything is better than sleeping with a snorer. Plus the fact once you get on your treatment you'll start to feel so much better, and more importantly decrease your chances of heart attack, stroke etc., which undiagnosed sleep apnoea sufferers risk.

     Good luck!

7. QUESTION:
   Do fat people snore more?
   An increased occurence of obstructive sleep apnoea (OSA) is associated with people fatter than they should be (higher BMI) and I'm guessing that they probably snore more. Many of us gain weight with middle age and many people find they start snoring in advance years so maybe there's a link that we can confirm by common experience. (OSA is a narrowing and collpsing of the breathing pasages during sleep which wakes people up (usually briefly) http://thorax.bmjjournals.com/cgi/content/full/56/suppl_2/ii45

   • ANSWER:
     Yes they do......it has been proven.....and I put on some weight and began snoring....I have lost it all now for about 6 years and do not snore anymore

8. QUESTION:
   Pending adenoid removal?
   I am 28 years old, and apparently I have very large adenoids for my age and very minimal airflow through my nose (only a tiny bit through my left nostril, nothing at all through my right). Anyway, I am due to have them removed on 20th October.

   I am just wondering if anyone has had this done or know of anyone who has had this done as an adult? I am asking because I am curious to know if a) before the op you were exhausted all the time like you haven't slept at all, and b) after the op and once you have fully healed, does this improve?

   I am exhausted all the time, always have been ever since i can remember, all throughout childhood and adulthood, but all tests under the sun (diabetes, aneamia, thyroid etc) have come back normal, so i'm kind of hoping that due to my enlarged adenoids that is the problem with me feeling tired all the time, and that when they are removed i will be resting better? (my son is also due to have his removed because of obstructive sleep apnoea - wondering if i may be experiencing something like this?)

   Thanks in advance

   • ANSWER:
     They don't do this operation as much as they used to so your consultant must be pretty sure it's going to help.

     If you nose is so badly obstructed you may not be getting as much oxygen into your lungs as you need-- that would make you very exhausted.
     Hope all goes well for you.

9. QUESTION:
   out of breath and so so tired?
   I have recently been diagnosed with both obstructive and central sleep apnoea and have been using the auto nitrate cpap machine. My wife still wakes me 2 or 3 times a night to say "your not breathing" but i also get really bad chest pain (not heart related) more ribs and sternum pain.
   Over the past few months i have also noticed on odd occasions throughout the day that i am not breathing and when i realise its almost like a panic attack and i am gasping for air. this is really strange as i've never heard of anybody not aware that they are not breathing whilst awake.

   • ANSWER:
     We help many OSA and some CSA patients with their ongoing therapy so what you describe is something that to a degree we have heard before.

     Unfortunately, you have mixed sleep apnoea and especially the central part of it makes it complex. An Auto-CPAP machine, which automatically titrates as you describe, works great for obstructive sleep apnoea. If you only had OSA, your wife wouldn't be observing any worrisome breathing lapses any more. Some people new on CPAP get that chest pain which is usually put down to the fact your lungs are simply not used to these mass volumes of air. The lung is pretty much a muscle and connected to various bits inside your chest so once it starts expanding through CPAP to what it used to, it takes a while to become as elastic again as can be. Most CPAP patients (commonly knows as hoseheads) find this discomfort settles after a couple of weeks. It's like if you start running regularly, you first have some muscle aches to get through but once those muscles are used to the new levels of exercise, they won't complain much any more.

     But indeed, keep your clinic in the loop about these side-effects so they can log them and stay up to date.

     Now the complex part. Central Sleep Apnoea, as you probably know, is a matter of the brain failing to communicate with the lungs. It's simply forgetting to tell your body to breathe. That indeed can be scary.

     CPAP isn't generally the preferred treatment for central sleep apnoea. Most end up on BiLevel treatment, sometimes with a backup timer. A CPAP machine doesn't breathe for you. It simply gives pressurised air to remove any obstructions. But during a central apnoea event, there is no obstruction so the CPAP simply pumps in air. It doesn't help you breathing fully into the lungs and certainly doesn't help you breathe out. And breathing out is as important as breathing in.

     So with BiLevel therapy, you get two distinct pressures. IPAP and EPAP. That's an i for inhalation pressure and an e for exhalation. Or inspiration and expiration. In and out are different to help you breathe better. Some BiLevel (or BiPAP) devices then have a timer. These are often referred to as BiLevel ST. The T stands for timer. These become actual ventilators, as in, breathing machines. So they monitor your breathing and when you stop breathing of your own accord (central), it will start breathing for you.

     Now I'm not saying this is what you need, just making you aware of it. You may want to ask your sleep consultant whether a BiLevel machine may be appropriate for your case.

     You may also want to consider the facilities at your current clinic. There happens to be a massive difference in quality and capacity between clinics. As your case is much more complex than "simple" OSA, you will want to be at the best equipped sleep clinics like John Radcliffe, Leicester General, Royal Brompton or St Thomas for example. If you are out "in the sticks" you probably have a lesser equipped and lesser experienced/educated clinic.

     So keep talking with your current clinic and make them aware of your symptoms and side effects. Keep a log as relying on your memory isn't a good idea with sleep apnoea. You might find patterns when you log dates and times, as well as how well you slept etc.

     Hope that helps and please consider joining the CPAP UK Forums linked below. There are over a thousand CPAP users there who can share tips.

10. QUESTION:
    What is the percentage of incidence of Obstructive Sleep Apnoea in Indian Popuation especially Tamilnadu?

    • ANSWER:
      contatc your local health authorities in the district ,if they have conducted a statistical study or have prevalence and incidence figures in that area