36 year old male, 5'8 and 165 pounds. I have hovered around 140-145 since I was a late teenager. This year, I jumped to 165 for some reason. I'm active, lift weights, etc. Since my early teen years, I have always been much more exhausted than what felt like normal. Never figured out why. Had a bunch of medical tests, blood work, etc., done at the beginning of the year. Also checked thyroid, but it was normal. Everything seemed fine medically, but I apparently fainted from sheer exhaustion for about 10-15 minutes during one of the blood draws. Blood pressure shot down to 60/60 with 52bpm heart rate. They never figured out why. That was the first and only time that happened and it did not repeat during a blood draw on another day. I had never fainted during one. I have always been very twitchy/jumpy since I was a kid. Others noticed it. I still am, for some reason. They said my reflexes were too high. Went to a neurologist and she said that my reflexes were normal and healthy for someone my age. For the "jumps" that I get sometimes, she said I might want to have an MRI of my back.
Went to ENT doc. Had an MRI of the brain. Deviated septum was casually noted, but nothing wrong. Eventually had a CT scan of the sinuses. In July, I had turbinate reduction surgery for enlarged turbinates and also had a deviated septum with right-sided spurring corrected. I breathe way easier and my nasal airway is much quieter when I breathe. Before, my breathing was loud and took much longer than normal to let out a full breath.
Had a sleep study on March 27th. Their pillows were hard, their bedding felt like sandpaper and nobody told me that I should probably take a melatonin or two right before the sleep study. I slept 2 hours 45 minutes for the whole study period.
Results: "The polysomnogram shows severe sleep fragmentation. Sleep efficiency was reduced. There were 13 obstructive apneas and hypopneas present for an overall apnea-hypopnea index (AHI) of 4.7. There were 50 respiratory events including RERAs for a RDI of 18.1 Supine AHI: 6.1. (Supine time 290 minutes). REM AHI: 9.2. (REM time - 6.5 minutes). The total time with oxygen saturation under 90% was 0.0 minutes with a nadir of 92%. The desaturation index was 4.4 (#events/hour). Cardiac was normal sinus rhythm. Snoring was present. Periodic limb movement index - 0/hr sleep and PLM arousal index - 0/hr sleep."
That confuses me. A hypopnea by definition is abnormally slow or shallow breathing. An apnea by definition is temporary cessation of breathing, especially during sleep. I don't know for sure if those numbers would have been twice or three times as high if I would have gotten that much more sleep for the study. The sleep doctor said I was 0.3 from the minimum 5.0 AHI required for mild sleep apnea diagnosis. Not sure if this would have been higher had I slept more. However, he also noted no drop in oxygen levels, so now I'm confused. If it was obstructive, why isn't my oxygen level dropping any? I woke up a lot during my study, but they didn't seem to think I have sleep apnea. In the mornings, I feel awful and drained of energy, ready to go back to bed as soon as I get up. So if I am waking up as if it is obstructive and yet it obviously isn't obstructing but for a few seconds (if at all), then all that I am doing is waking up.
Some mornings I know when I wake up a lot of times, but not sure why. There are times when I jump awake like that feeling when you're dreaming that you're falling and jerk awake. Only that happens a lot some nights and not so much on others. Other times, I wake up with this loud pop-like noise that sounds like it is in my face/head and cannot figure out what in the world it is. It sounds like something cracking in my maxillofacial area, but could possibly also be ear-related. Nothing was ever found to be wrong in my ears. It seems to happen mostly when I'm laying on my back. Laying on my side and stomach seem to make me rest better, but that's not very comfortable and laying on my stomach makes me press my tongue into my teeth even more. Sometimes when drifting off to sleep, a leg or arm might jump once or twice and that's it.
My jaw does pop a little (probably TMJ-related), but nothing too major. An orthodontist did mentioned one time that my teeth all seemed ground flat, so I probably do grind. I also have a very pronounced crenated/scalloped tongue all the way around all edges and also on the top edge every morning. I get that almost daily. I get canker sores from those places sometimes. I likely thrust my tongue and/or bite the edges of it while sleeping. The ENT doc said it looked a little too big sometimes or something. I also feel that my bottom jaw seems to naturally move forward a good bit when I sleep. I'm planning to get a mouth guard (but I'm reading that they move teeth), but I don't think these things are the cause of my frequent awakening
I'm at my wits' end. Got any advice? I'm planning to have another sleep study at the beginning of the year. Would they be able to determine if I have some type of central sleep apnea during the same sleep study? I have GOT to find out what this is. It feels awful.
