Sleep Apnea

[firewatcher]

Sleep Med. 2010 Aug;11(7):714-720.

Autonomic alterations and endothelial dysfunction in pediatric obstructive sleep apnea.

Kheirandish-Gozal L, Bhattacharjee R, Gozal D.

Department of Pediatrics and Comer Children's Hospital, Pritzker School of Medicine, The University of Chicago, USA.

Abstract

The cardiovascular consequences of obstructive sleep apnea syndrome (OSAS) in children have started to emerge over the last decade. It is clear that the respiratory and sleep alterations that characterize this relatively prevalent condition induce substantial alterations in autonomic nervous system control, ultimately generating high sympathetic outflow and reactivity that reflect an imbalance between sympatho-excitatory and vagal inhibitory inputs. In addition to these important consequences, the constitutive elements of OSAS also elicit a rather extensive activation of systemic inflammatory pathways that in turn pose substantial risk to the integrity and functional homeostasis of the endothelial network. The complex interactions between the multiple injury-associated pathways recruited by OSAS are further compounded by the potential release of angiogenic factors and by the mobilization and homing of progenitor cells that have the potential to repair and restore the OSAS-disrupted vascular function. Improved characterization of the mechanisms involved in every one of these processes and identification of the determinants of susceptibility in pediatric populations along with the interactions with obesity will clearly modify our approaches to OSAS in the future. Copyright ? 2010 Elsevier B.V. All rights reserved.

PMID: 20620107

I wonder how many of us have undiagnosed apnea from childhood as our "cause" for POTS?

[potsgirl]

How interesting. Thanks for posting this. I know I should get a sleep apnea study done, but I have a hard time going to sleep in the best of circumstances. I don't think I could ever fall asleep in a 'study bedroom'. Anyone have any tricks?

[tinkerbella]

Well I'm having a sleep study done soon and it's held at a, "MARRIOTT HOTEL," now too make it easier for people to be in a more comfortable setting. I also take calcium when I wake in the night and can't get back to sleep. The doc said,"wouldn't it be wonderful if you had sleep apnea?"

Let's all go and have a big potsie party!!!!

<3

bellamia~

[dianne.fraser]

Potsgirl

When I had my sleep study, I slept in the world's most comfortable bed - all part of the service, apparently. Go for it.

Dianne

[issie]

I do have apenea. When they did my study they had me take Abien, that they prescribed. They said any other thing I normally take to sleep should be taken too. I have had a real hard time adjusting to the CPAP. Been trying for 2 years now. I think it keys up the adrenal issues because it really gets on your nerves. For some people it is a life saver. For others, like me, I know it helps because I have more oxygen in my system, but as for resting better -- Not so much. I do realize that when I don't use the CPAP, I do feel worse. I use it every night, but have times where I just can't sleep with it and wind up just sitting up to sleep. With my sleep study, the study, proved that the quality of my sleep was worse with the machine but it did cut my apeneas way down. They thought that the quality would get better with time, but I don't feel that it has. May be something that needs to be looked into again. I know I have adrenal issues and the hyper type of POTS. Also have EDS and feel smothered by my own body when lying down flat. I've found that elevating on pillows has helped that allot.

The doctors said that one thing that can help determine apenea is your anatomy. I have a really short neck, this is usally indicative of a person with apenea.

My father has apenea too and our face and neck structure is the same.

[Elfie]

I was tested for sleep apnea and do not have it-- guess the correlation doesn't work for me. Although I do have poor quality sleep and trouble falling and staying asleep because of POTS symptoms, I am getting enough oxygen in my blood when I sleep.

[jimells]

I suffered through a "mostly sleepless" study two weeks ago and finally got the results yesterday. I shouldn't have bothered, since they didn't tell me anything I didn't already know.

My "diagnosis" is "primary snoring" even though the observation was "occasional to intermittent mild snoring". A diagnosis of non-restorative sleep would have been useful, since that would be medical evidence that I'm sick, and not just a slacker, which of course is what Social Security Disability alleges.

I only slept 203 minutes that night, since they made me get up at 6:00 AM, two hours before my normal rising time, even though I was told before the test that I could stay in bed as long as I needed to. I was awake at 6:00, because they were kicking out the other patients, and the noise was disturbing my sleep. I believe they wanted me up for their own convenience, since I was also scheduled for the MSLT - 5 naps, one every two hours, and they wanted to get me out as soon as possible.

The electrodes didn't bother me too bad, but the plastic tubing under the nose and across the neck was very uncomfortable. I felt like a turkey all trussed up for the roaster!

For the MSLT, I went to sleep 4 out of 5 naps, latency was 4.5 minutes, 7, 10, and 12, but they said that was normal. The study did note poor quality sleep, "mild alpha sleep", increased stage 1, stage 3, and REM, and decreased stage 2, but they didn't tell me what any of that might mean.

The recommendations say "strongly encourage continued efforts as exercise and/or weight loss as appropriate - try to acheive 8 hours of sleep per night". But I already exercise as much as I can stand, since my part-time job is very physical, and I don't need to loss any weight, unless I want to be a model (Ha!). Research on the internet reveals that "more exercise - lose weight" is a generic thing that all sleep clinics tell to all patients. Why is it that doctors think they can lecture us into health and well-being? Does it make them feel superior? (Sorry for the rant)

I also found the Epworth Sleepiness Scale to be puzzling. It's a simple list of questions "How likely are you to fall asleep" during a variety of activities. The only time I'm likely to fall asleep is if I lay down to do it. But for me, that's the wrong question, because one of my serious problems is feeling drowsy, as in "less than fully alert", not "just about to fall asleep". Many days I feel like I am not fully awake for hours, or maybe the entire day, which I told them. I find it baffling the sleep study did not address this problem beyond how quickly I fall asleep while taking a nap.

Anyway, does anyone know what "mild alpha sleep" is, or what the abnormal sleep stage %'s might mean?

[iheartcats]

I remember having insomnia issues as a kid. I don't know how normal that is...or if it could have anything to do with this.

Can these heal or if you had sleep apnea as a kid are you pretty much forever damaged?

Is it worth getting tested now for apnea?

[houswoea]

Interesting. When I had a sleep study done, I didn't have any sleep apnea at all. I was scared I wouldn't be able to fall asleep because of all the weird wires, but it was all good! Although apparently I have narcolepsy, so I can't speak for the insomniacs.