For the past few years I have been experiencing gradually decreasing quality of sleep, along with occasional episodes where I would wake up at night slightly out of breath (particularly during the early stages of sleep and/or early transition from wakefulness to sleep), as well as very rare episodes of insomnia. I went to see a sleep doctor approx 4 months ago (he is also an ENT) and did a take home sleep test. Ironically, when I did the take home sleep test, I barely slept at all (I estimate I may have actually dozed off about 2 hours) - every time I was about to transition to sleep, I would wake up. I told the doctor this but he nonetheless felt the data was valid and told me I had mild to moderate sleep apnea. He prescribed a dental appliance. I happen to grind my teeth, so I figured this would kill two birds with one stone. FYI: I know sleep apnea is not limited to overweight people, but just as FYI, I am a fit male, 30, non-smoker and rarely drink.
Fast forward to today and I am using my dental appliance on a consistent basis for about the past two months. However, I feel as if my symptoms have only gotten worse, not better. Moreover, they are an odd and confusing mix of both physical and mental. For starters, when I wear the dental appliance I wake up 1-3 times a night with very dry mouth. That alone might not be too concerning because I hear the dental appliance can cause that. However, there are other symptoms that are increasing in severity and/or frequency:
- a throat choaking/gagging sensation when I am sleeping with the appliance, which becomes especially pronounced as I transition from wake to sleep. This does not seem to abate even if I change sleeping positions.
- when I am asleep, the sleep contains lots of vivid dreams (more so than in the past) and feels very light. I do not wake up feeling rested (even less so than in the past).
- I have recorded audio of myself sleeping - I can be heard occasionally groaning/moaning.
- In the 1-3 times I wake up during the night, I can feel a moderate amount of sweat on my shirt. This did not happen very often before - now it is almost guaranteed every night.
- Insomnia/Trouble falling asleep: here is where the symptoms get varied and confusing. 100% of the time, I have struggles transitioning from wakefulness to sleep - I will drift off but wake up again. This will happen 2-4 times per night before I finally fall asleep (so it usually takes me 30-90 minutes to fall asleep and stay asleep). About 80% of the time, I am relatively confident this waking sensation is physical - I can feel my gag reflex being activated and a choking sensation below my chin but above my adam's apple. However, about 20% of the time, I can sense that I am waking from not breathing, but the lack of breathing does not seem to be physical/obstructive - it just seems like I "forgot" to breathe. About 1 day per week this kind of struggle to fall asleep results in insomnia - I will pretty much struggle like this the entire night and not really get any prolonged sleep (for some reason Sunday appears the most common).
- A week ago these issues started bleeding into the day: I would have dry mouth during the day; I would feel like my tonsils were really enlarged and were blocking my airways; I would frequently feel like I "forgot" to breathe during the day (for example, when I am concentrating on reading something) - when I noticed, a jolt of anxiety would course through my body. This may have been psychosomatic anxiety and it may have been my nervous system being on high alert. These daytime symptoms have largely gone away this week though.
I am waiting on my insurance to authorize another take home sleep test, but given the first experience, I am skeptical. My sleep doctor is kind of a dismissive dick - he always looks bored and tells me not to worry after 5 minutes. However, I am worried/very scared about the following:
- how do I know this isn't central sleep apnea? or mixed apnea? I think 80% of the time my symptoms are physical but there are times, as mentioned above, when they feel nervous system related.
- Antihistamines: I am worried about the issues of organ damage at night if it is central asleep apnea. Taking an antihistamine like zzzquil is like the only way I can get to sleep at this point (and even that is not guaranteed to work), but I am worried that that will make my apnea worse. So it becomes a difficult choice between no sleep or worsened apnea.
- I bought a pulse oximeter which has an alarm you can set for low oxygen saturation. I am using this as insurance to prevent getting into any severe episodes at night. Is there a level you recommend setting it at to be safe? On the flip side, I don't want to be woken up too frequently.
- I am also taking the following sleep aids: melatonin, magnesium, lemon balm, glycine, and valerian. Any issues with these? Can these be dangerous for my sleep apnea?
Please - any help, thoughts, advice, or just some simple commiseration would be welcome. Thank you.
