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The dynamics of sleep

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Gravitar +0 points · over 3 years ago Original Poster

Having suffered sleep apnea for decades, my first diagnosis recommended an OAS treatment. This worked incredibly well (lucky me!). Shortly afterward a friend who had been using CPAP for years died in his sleep. Age 60, 6'6 380lbs. Coroners report cause of death-sleep apnea. He was found on his bed, on his back. Apparently just flopped down to rest and fell asleep (without CPAP). This guy was also taking prescription sleeping pills! How in the world was this allowed to happen? Deadly combination. Just wondering if doctors warn of this when you have sleep apnea and especially before prescribing CPAP? If you don't understand this relationship with OSA, sleep paralysis, and sleeping pills it could prove deadly. I did my own research on what OSA really is and now that I understand what REM sleep and REM atonia (sleep paralysis) is I have total control through learned disciplines and no longer need the OAS.

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Gravitar +0 points · over 3 years ago Original Poster

My point being 9 out of ten people with sleep apnea don't even know they have it. The reason most heart attacks happen between 1 am and 9 am? Think about that. Heart attack and stroke account for 33% of deaths in the U.S. Sleeping pills can override the signal the brain sends to jolt you out of REM sleep so you can breath. Otherwise you would suffocate, like my friend did. Middle age and older with blockage in your arteries? Blood oxygen levels get to low what's first thing to happen? Brain sends signal to heart to beat faster to get more oxygen. Heart works harder with less and less oxygen and can cause a heart attack.

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SleepDent +0 points · over 3 years ago Sleep Commentator

I am a dentist working in dental sleep medicine. I am sure that some health professionals do warn the patients about the dangers of napping without treatment. I do oral sleep apnea appliances. One of the first things I tell the patients is to never go to sleep without the appliance and if they are in a situation where there is a chance they could fall asleep, not matter HOW REMOTE, the oral appliance should be in place. Arthur B. Luisi, Jr., D.M.D.

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Gravitar +0 points · over 3 years ago Original Poster

Then I would have had to wear mine while driving...lol.

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SamInLasVegas +0 points · over 3 years ago

Do those oral appliances do any good? I've thought about trying one of those, but I'm skeptical

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SleepDent +0 points · over 3 years ago Sleep Commentator

I am a dentist working in dental sleep medicine. If the oral appliances were not effective, I wouldn't have a job for long. In my office they cost anywhere from $650 to $1650 or more. Do you think the public is stupid enough to just throw their money away on them? I can assure you that they are not. Many hundreds of thousands are in daily use in the USA and around the world. They are not for everyone, just as CPAP is not for everyone. A dentist experienced in dental sleep medicine can assess you as a candidate and tell you what your chances for success would be. Arthur B. Luisi, Jr.,D.M.D.

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Gravitar +0 points · over 3 years ago Original Poster

Absolutely they can work wonders. It can take a day or so to get used to it. Do not buy the ones for sale where you make your own bite impression. Have a dentist that's trained like sleepdent make a custom fit from your bite mold and you won't spit it out while asleep.

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sleeptech +0 points · over 3 years ago Sleep Enthusiast

Sleeping pills a definitely used too liberally without much understanding of, or though given to, the problems they can cause. I'm not sure what you are saying about REM sleep and "total control", though. REM atonia and and sleep paralysis are not the same thing (although they are believed to be related).

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Gravitar +0 points · over 3 years ago Original Poster

What is the difference between REM atonia and sleep paralysis? I understood one was just the fancy medical term for the other. In either case they both affect all the voluntary muscles in the body the same way. The tongue and the muscles that hold open the entrance to the larynx (windpipe) are voluntary and come into play as soon as you enter REM stage sleep. Smoking can irritate and contribute to blockage as can excess fat in the neck and tonsils and adenoids not having been removed (excess soft palate). Snoring is the sound made by air as it passes through these restrictions, causing them to vibrate. I was incorrect to claim total control when I should have said sufficient control. All warm blooded animals require a certain amount of REM sleep or they will die. Sleep study is a relatively new field and we are learning new things all the time. There are certain metabolic wastes that accumulate in the muscles and brain while awake that are only be removed during REM sleep. We don't really know why we dream but we do know it is a distinct feature of REM sleep. I like to compare the brain to a computer and REM sleep/dreaming to defragmenting your hard drive. It's a very complex biological system that has evolved over millions of years and requires a third of each 24hr cycle to rest and rejuvenate for optimum function. And like a computer if we don't get this our system will eventually crash.

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jnk +0 points · over 3 years ago

REM, for some, is when most of their apneas occur. But that is not true of all OSA sufferers.

Atonia is a good thing during REM, since our being partially paralyzed during that stage of sleep helps to keep us from physically acting out our more vivid dreams. It can be very unpleasant to experience atonia during wake, though, which is often what people are discussing when they use terms such as 'sleep paralysis' and 'REM atonia' in a clinical setting rather than a research setting.

As is so often the case, the meanings depend on context and intent.

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Gravitar +0 points · over 3 years ago Original Poster

Then let's be clear, atonia during waking is a direct result of sleep paralysis or REM atonia. It occurs usually when you wake from a dream(REM sleep) and in that microsecond or second before the neurons that are firing to keep you asleep and the waking neurons haven't been connected. Sometimes can occur when falling asleep. Two entirely different sets of neurons send either sleep signals or wake signals from the brain. It's perfectly normal. Who hasn't woken from a dream in which they were running away from someone and tried to make their legs run and yell but couldn't for a second? Nothing to fear. This is a pathway to understanding OSA and exactly what's causing the problem. The obstacle then becomes the way. It is possible , I believe, to drill down further and for all but the severe and high end moderate cases to wean themselves of CPAP and OAS like I did.

p.s. regular sleep can be described as an inactive brain in an active body whereas REM sleep is a hallucinating brain in a paralyzed body.

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jnk +0 points · over 3 years ago

I will also attempt to be clear:

(1) REM is necessary and beneficial, as is the atonia that accompanies it during that stage of sleep.

(2) A PSG is necessary to document that someone no longer has OSA and would no longer get any benefit from PAP therapy.

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Gravitar +0 points · over 3 years ago Original Poster

agreed. Sleep Disordered Breathing is reaching epidemic proportions in this country. If 9 out of ten people with OSA don't even know they have it but may be looking for answers to their complaints on this forum, they may be reluctant to seek treatment after reading about all the problems. PAP therapy is not affordable to many folks. Judging from the amount of people here that are taking PAP therapy and still getting subpar results it appears there may be an interest in alternatives. There is no better motivation than waking up with that feeling of getting a good nights sleep. If I cure ALL my symptoms, why would I go pay the doctor to tell me I'm well?

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Gravitar +0 points · over 3 years ago Original Poster

In full agreement. But, OSA by it's shear nature, could return at any time you discontinue the disciplines. Just as people quit diets and gain back all the weight they lost. If ALL my symptoms go away. No snoring, plenty of energy and feel well rested upon awakening. Multiple uninterrupted dreams at night. Blood oxygen levels and blood pressure normal, Then why would I go pay a doctor to tell me I'm well again? If nine out of ten people that have OSA don't even know they have it but are complaining of the symptoms a lot of them after seeing all the problems and expense people have with PAP therapy are going to be reluctant to go there. What's wrong with trying a proven alternative first. There is no better motivation than waking up after a good night's sleep. Of course I can't guarantee anything. Not everyone has the willpower to do what it takes to be healthy, just look around. 2 out of three Americans are overweight or obese. Research has shown that over 75% of people with OSA are overweight or obese. Sleep disordered breathing is reaching epidemic proportions in this country and research is showing there is a direct relationship to OSA and weight gain.

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jnk +0 points · over 3 years ago

Yes. Research confirms that untreated OSA may cause weight gain.

Many with OSA need treatment even when asymptomatic.

People with no problems don't go searching for help forums. So the masses who use CPAP every night without issue are the silent majority.

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sleeptech +2 points · over 3 years ago Sleep Enthusiast

How do you know if all of these things (blood oxygen level etc) are normal if you don't check? And what exactly is this "proven alternative"? If it works then where's the harm in having a study to prove it? I'm not sure it is wise to encourage people to abandon their treatment. That is the sort of thing that should be done with great caution, education and in consultation with a trusted medical professional.

CPAP works. And it works for the vast majority. OSA is a common condition, and in a country the size of the US there are probably tens of millions of people who suffer from it and millions of them who use CPAP. If only one percent of those millions of CPAP users has a problem with CPAP (and it's probably more than one percent) that one percent would still consist of tens of thousands of people, if not hundreds of thousands. So the fact that there are many people with stories about how they struggle with CPAP is not at all surprising. Further more it is not evidence that it doesn't work, but rather evidence that heaps of people use CPAP because heaps of people need it. CPAP is not for everyone, but it sure is the best tool we have for the large majority, especially when applied with some care and expertise.

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jnk +0 points · over 3 years ago

Nicely said. I voted with the up arrow.

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sophie +0 points · over 3 years ago

Ditto. I get real concerned with some of the advice offered here, especially that which bashes pap therapy. I have struggled for two years and finally have my correct treatment: an apap machine. Point is, sleep tech is right--cpap works. If you are on pap therapy, do not abandon your treatment. As suggested above, work with in consultation with a trusted medical professional.

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Gravitar +0 points · over 3 years ago Original Poster

didn't bash CPAP. Made clear that it was possible to wean yourself off it and OAS in some cases accept high end moderate to severe OSA like I did. Where did I say I didn't have bloodwork done? Never suggested anyone abandon CPAP treatment, much less without doctors supervision. It's a bit more complicated than what could be explained in the space here. It's a lifestyle change. You have to learn how to let gravity and REM atonia work together to do the same thing the OAS does. And you will never accomplish it sleeping on your back. And it has a lot to do with nutrition. Too many people choosing fast food and sleep deprivation as a time management option. It's kinda like man trying to learn to fly for thousands of years and when he finally figured out the basics, he took off. Certainly there will be exceptions. There always are. My dentist who fitted me for my OAS told me the basics about this alternative, I just refined it. As far as a study to prove it, feel free. You'll have to try and see if it works for you. I promise your trusted medical professional cannot give you any reason not to. Western medicine is focused on treating the symptoms and not finding a cure. I'll give you an example but it's going to cost you 17 minutes of your time. Keep in mind a healthy circulatory system is essential to getting oxygen flow to the brain. The brain consumes as much energy, as measured by glucose and oxygen metabolism, during REM sleep as it does when awake and working out a complicated math problem. https://www.youtube.com/watch?v=O0lEmXJD7p4

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sophie +0 points · over 3 years ago

Most any medical professional would agree that a healthy circulatory system is essential to getting oxygen flow to the brain. A blood test is not the diagnostic approach to sleep apnea--a sleep study is. Again, for newly diagnosed people, please discuss your individual situation with your healthcare provider.

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Gravitar +0 points · over 3 years ago Original Poster

The blood test was in response to sleeptech above. The video was just an example of how we can take a pre-emptive and preventive approach to treat these new epidemics. You'll never hear what you learned from that video from a cardiologist. When arteries are blocked it's time for stints, OSA is more prevalent in middle age overweight males. Losing weight and nutrition is a small piece of the bigger puzzle that we are trying to work out. There is no argument that sleep apnea needs to be treated asap and CPAP is still the gold standard for treatment.

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sleeptech +0 points · over 3 years ago Sleep Enthusiast

A blood test is not a way to assess your blood oxygen level. In fact, no test carried out while you're awake is suitable for assessing the possible effect of OSA on you oxygen levels. The only way to do that is to measure your oxygen level constantly for an entire night's sleep. And the only way to fully interpret overnight oximetry is in the context of a PSG so that you can see the cause for any variation in oxygen levels. Plus, oximtery is only part of a the complex picture which is understanding and diagnosing sleep.

In reference to your earlier comments about REM atonia/sleep paralysis, REM atonia is the entirely normal phenomenon of the majority of your muscles hyper-relaxing in REM sleep (presumably to stop you acting out your dreams). It happens every time you dream (roughly every 90 mins of your sleep) every night. Sleep paralysis is a disorder in which you wake from sleep and are unable to move at all for an significant period of time. Not just seconds but many minutes. I have had patients who have experienced sleep paralysis for periods of 20 minutes or more. It is quite rare though. The idea that it happens because you wake from REM sleep and your body somehow forgets to turn your muscles on again, leaving you in a similar state of atonia as in REM, is a theory only, albeit a very plausible one. Like most sleep phenomena we understand very little of the mechanism behind it.

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Tom +0 points · over 3 years ago

There is no 100% cure for sleep apnea. The only thing you can do is keep using your cpap. And also if your overweight try to lose weight. I have OSA. I’ve been on cpap since June 2013. This year will be my 5th year on it. I am also hypothyroid.

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Gravitar +0 points · over 3 years ago Original Poster

What does your hypothyroid have to do with your sleep apnea? I know its relation to weight gain.

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