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Sleep Apnea

CDreamer profile image
31 Replies

Today I went to the hospital for a masterclass in sleep apnea. There were 3 of us in the class which was taken by a very competent senior physiologist and psychologist who specialises in sleep conditions.

In October 2014 my EP wrote to my GP recommending a referral as he told me that latest research showed that the major reason for AF to recur after successful ablation has been shown to be sleep apnea so my GP referred me, I had a sleep study done which resulted in a diagnosis of mild sleep apnea and a recommendation of treatment with CPAP.

So now I have been issued with a machine for 7 days as a trial. The machine also monitors my airways during sleep and holds the info for downloading, I return for a 1:1 session in 7 days when the info is downloaded and I have a 1 consultation. There is phone support for any problems and we were encouraged to phone on a daily basis, even for minor questions. The number given is a direct line to team of physiologists of the clinical measurements department which is part of the cardiology unit.

I am then to be given a 'personalised' kit to keep and use. I then have an appointment with the consultant pulmonologist in 2 months time to assess outcomes.

I am SO impressed with this service and the fantastic support we were given.

Just had a trial run with the equipment as we were told to use it during the day so our bodies get used to it and may be my imagination but I felt much better with the mask on and machine running than not. Hoping I can get to sleep with it on tonight and it improves my general quality of life.

By the way all I did was go back to the GP and ask for a sleep study, she went through a very quick online questionnaire with me to see whether or not I met the criteria, which I did, so referred my in Nov. This was all NHS treatment.

I would strongly recommend to anyone who has difficulty sleeping to go get tested. The physiologist whom I saw runs a private clinic in Exeter called SleepyHead and she specialises in all sleep dysfunctions, not only sleep apnea.

I'll keep you informed as to how I get on with it.

Best wishes CD

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31 Replies
BobD profile image
BobDVolunteer

I am sure you know that if you have been diagnosed with sleep apnea it affects your right to drive --if you do.

CDreamer profile image
CDreamer in reply to BobD

Thank you were advised about that. It does not affect your ability to drive nor right to hold a license but just like any chronic condition it will be reviewed more regularly ie: you will be issued with a 5 year not 10 year license.

I am driving short distances and am already on a 3 year review so it's just yet another form to fill in.

BobD profile image
BobDVolunteer in reply to CDreamer

yup, just had to renew my license at 70 . Decided that I didn't need the 7.5tonne class so didn't bother with the medical. 3 year renewal s now even if we don't have to pay. Stupid thing was my old 10 year ran out n September and I had to pay for one for six months. ! I think you will find that SA is notifiable to DVLA and failure carries a £1000 fine. Have a look at their website under medical advice to drivers. Make sure you don't see the advice to doctors part as this is often different. For example doctors do not need to advise DVLA about AF but drivers DO. This came up at HRC last year when Matt Fay told everybody they don't need to tell DVLA which I and others had to correct him on.

CDreamer profile image
CDreamer in reply to BobD

Having been through this procedure for 2 conditions now I am thoroughly familiar with it.

I am currently awaiting the arrival of my new 3 year license, I wasn't asked for any money. I had to have 2 medical opinions and an eye test which was laughable for the Mg.

rosyG profile image
rosyG

sounds great well done

Good move. Good luck.

scooty profile image
scooty

Your experience with NHS Sleep Apnea is very different to mine at Southampton General! I was originally diagnosed in Australia and when we came back to the UK my GP signed me to Southampton. No advice, no testing, a noisy and hopeless machine. So I have put myself under the care of Resmed who manufacture the machine I was given in Australia. They have clinician, support and advice. So I'm glad you have had an excellent result - what hospital are you with? Seems to me NHS is a hit and miss on Sleep Apnea!

CDreamer profile image
CDreamer in reply to scooty

The machine I was given IS Resmed. I think it is very individual to the hospital, I am in Devon, the RD&E.

It seems to depend on the individual practitioners as well. This practitioner is very proactive and gives talks in the area and does a lot of education with GPS. However she was saying that, like so many other fantastic services, she thinks it will be cut as a non essential service. She has already set up a private practice in anticipation and to cater for other sleep disorders which have very long waiting lists.

It is all down to luck of being in the right place at the right time.

Good quality of sleep is very slowly being recognised as an essential for good health and the ability to heal, especially in cardiac patients, however, generally it is regarded as wish rather than a need by the medics.

Sorry you haven't had such a good experience. I certainly would go to Resmed if I hadn't.

Best wishes

scooty profile image
scooty in reply to CDreamer

Thanks CDreamer. I'm just grateful that I was given a Resmed machine at the beginning and I can say after using it now for over five years that my sleep has improved so much. The machine that Southampton gave me was a Philips, then they took it away for "servicing" which took two months and gave me the oldest noisiest machine that was unusable. There was no advice or readout of the quality of my sleep, no advice on air pressure. It was the Resmed clinician who said the pressure was wrong and that I was having too many apnea's during the night. Now that Resmed adjusted the pressure after seeing and discussing the readouts, everything is fine and back to normal. When I complained to my GP about Southampton he said I should write and complain to the hospital, I was loathed to do this, but now I see what is happening in Devon NHS, Southampton needs to improve their act, so I should complain.

heather-7 profile image
heather-7

Sounds like more help than here in the States. I have Afib and since my son has sleep apnea plus my father and grandmother both were horrific snorers I requested and was given a sleep study at clinic. I then returned for second night where I was hooked up again to measure sleep, movement of eyes and legs as well as heart and oxygen . It was determined that I also have mild sleep apnea and require a nasal CPAP mask. I go back to pulmonologist in 31 plus days (dictated by Medicare) to download info to see if mask is helping. I was given mask and machine by private company but only a few moments of instruction. The 1st night I must have twisted mask during sleep. When I got up to go to the bathroom, I came back to machine indicating that there was a leak in the mask's seal. I tried to correct but finally gave up and went to sleep.

Quite a few on website here in states have both Afib and sleep apnea.

Hoping this will help calm my Afib and also stop yours following your ablation.

Heather R

CDreamer profile image
CDreamer in reply to heather-7

We have a 2 hour masterclass, max no 4 per class, where we practised with the machines, got fitted for the masks etc. I go back for a 1 hour 1:1 next week for downloading the info and being fitted for a "personalised" machine. We have telephone access during office hours directly through to the physiologists.

I have an appointment with the pulmonologist in April to assess the outcomes and talk over treatment options and then on going access if and when needed.

It is the most efficient service I have ever encountered and I am currently seeing an EP and a neurologist at the same hospital with very mixed experiences!

CDreamer profile image
CDreamer in reply to heather-7

Hi Heather sounds like we have similar familial experiences, have a look at the ResMed site, very helpful.

heather-7 profile image
heather-7 in reply to CDreamer

Hi, I'm also using a ResMed Airsense 10 machine. The only thing when I got up 2 nights and replugged in mask and started macine it showed me a sad face meaning mask seal was broken. Tried to adjust mask but became too tired, went back to sleep still with sad face on machine..In AM before turning machine off there was smiley green face. Don't know if machine needs time to change or what. I will go to site.

HeatherR

CDreamer profile image
CDreamer in reply to heather-7

I am also having problems with the seal which is why I am not wearing for the whole night. I am fine until my jaw relaxes and that seems to break the seal waking me up with the air escaping and making a vibrating noise like a motor bike.

We were told not worry about things like that whilst acclimatising as they have lots of solutions which may mean wearing another type of mask which will be discussed at our 1:1 next week.

Hi, Im curious. Ive seen finger oximeters that record and can be downloaded for results. Is that what your machine is? Or are you wired up to a large machine?

CDreamer profile image
CDreamer in reply to

The sleep study involved a machine a bit like a holter ECG with wires attached as Heather described. This is £10k's worth of kit. You are fitted at the hospital, go home with it all on, and wear it overnight, return it to the hospital the following day. That is the testing equipment for diagnosis. Having been diagnosed then are offered the treatment.

If you are talking about treatment :- CPAP machine I volves wearing a tight fitting mask attached to a small machine which delivers pressurised air which keeps you air pathways open.

After only wearing it for part of the nights and for the last 3 I am already feeling the benefits with increased alertness and much more energy.

heather-7 profile image
heather-7

My machine has an sd card that records all info on my sleep while I wear mask and have the machine on.

At the sleep study I wore wires attached to my head, by my eyes, on my ankles and chest ( I may have forgotten all) plus a finger oximeter. The wires were attached to the machine blowing air into my nose via mask.

Heather R

Thanks CDreamer and Heather, appreciate the explanations. x

heather-7 profile image
heather-7

CDreamer

Woke up this AM with very dry nose with some bleeding. I have another mask that I will try tonight. Not fun when one is on warfarin.

Heather R

CDreamer profile image
CDreamer in reply to heather-7

Hi Heather we were told that if that happens then they can add a humidifier. Suggest you go back and ask. I saw them on the website and some machines have an integrated one,

I found it was the cold air last night but putting the tube inside the bedclothes so you warm the air seemed to do the trick.

CD

heather-7 profile image
heather-7 in reply to CDreamer

CD

Went to the supplier this morning; learned I was not putting mask on correctly. Also learned how with RESMed you can just take off one loop by nose in AM, leaving straps alone, and then put on in PM. I have a humidifier built in but with mask on wrong it didn't help. They also reset the mask given by sleep center. If air still leaking; they gave me a chin strap which isn't very comfortable. My husband laughed when told with machine on I can't open my mouth. LOL.

Good luck; I'm hoping I get 2 smiley faces throughout the night.

Heather R

CDreamer profile image
CDreamer in reply to heather-7

Oh well done! Hope that sorts your probs out. I have my follow up app today so will let you know how it goes. I am still having probs so hoping for some solutions.

It does help to share doesn't it!

heather-7 profile image
heather-7 in reply to CDreamer

Woke up last night and monitor said mask seal not right. Looked in mirror and tried to fix mask but still got red sad face. While in bed I kept moving mask part around my nose and finally got a green smiley face that was still there this morning. I must get on my side during sleep and bump the mask. Hope I don't have to do this every night.

Hope you find solution to your problem and thanks for sharing.

Heather R

CDreamer profile image
CDreamer in reply to heather-7

I went back to the hospital and saw the sleep specialist physiologist yesterday. I was having similar problems in that I was awoken every night after a few hours by the noise of air escaping which sounded like a motor bike! She said it was because my pressure just kept on rising until it reached the maximum, something she had never seen before?!

Anyway she gave me my own machine and showed me how to use it and set the pressure at 15 with a 15 min ramp and given me a nose mask and a chin strap, I had a much better night and went through most of the night without being disturbed and felt better for it. I found the nose mask much more comfortable, especially when sleeping on my side. I still have the full face mask if I want to change back but I think I am going to stick with the nose mask.

Sleep well.

heather-7 profile image
heather-7

I have a much lower pressure but still having trouble with nose mask shifting when I sleep on my side. Last

night I wore mask for about 5 hrs before getting up with sad face that I couldn't get rid of by shifting mask around while looking in mirror. I'll try again tonight.

Here Medicare says you must wear mask for 70% 0f nights (31-90) and for at least 4 hrs per night for them to pay for rental. Hope I make it. Don't see Dr. until early March.

Glad that they fixed your machine, with so much pressure, no wonder you couldn't sleep. Did you wear the chin strap? It feels very uncomfortable to me.

In Feb. the Cleveland Clinic in Ohio is having a chat about failing CPap. I'll watch it.

Keep sleeping well.

Heather R

CDreamer profile image
CDreamer in reply to heather-7

Morning Heather, the chin strap does take a bit of getting used to and I haven't got to 4 hours a night yet, 3 hours has been my max.

We were told that it doesn't become an effective treatment unless you can wear it for 4 hours so I guess that is why, but that it takes most people 2-4 weeks to build up to that length of time because your body needs time to acclimatise.

Even so, I know I am sleeping much better, even after I have thrown it off so I know it is efficacious for me. My left nostril was closing and I notice the difference. I am seeing the consultant pulmonologist in April so I guess they give us a good run at it before pulling the plug.

I would be very interested in what the Cleveland Clinic say, if it available on the Internet would you please send me the link.

Best wishes CD

heather-7 profile image
heather-7

Good morning or evening in your part of the world. I got 6 hrs. on my machine but I think 1 hour I was in and out of sleep. Silly me, if I keep my mouth shut when machine is on I get a smiley face. I must have opened it during sleep so had a downcast face when I woke up about 5:30. I just took off mask . Tonight I'll try chin strap.

It does sound like you're getting more one on one help. That would help me but I'm sorry to say we don't have it. I'll have to ask Dr. about pressure as one time I woke up; my mouth was closed but I had to work to keep it that way as air seemed to bubble out between my lips ( strange feeling).

Good luck!

Heather R

heather-7 profile image
heather-7 in reply to heather-7

P.S. I will look up link

Heather R

CDreamer profile image
CDreamer in reply to heather-7

That is exactly the problem I had when the pressure was too high ie 20cm/water, now it is set at 15 it is much easier to keep the mouth closed and I have found that if I set my tongue against my teeth it somehow give a better seal. It is a very strange sensation I agree, that is what made the motor bike like noise. I don't have smiley faces on my machine so you are one up on me there!

I got about 6 hours as well last night, so improving all the time but I did wake several times - ironic actually - partner snoring and then pausing breath!

Thanks for the link by the way!

heather-7 profile image
heather-7

Here is link:

chat.clevelandclinic.org/ch...

Heather R

heather-7 profile image
heather-7

I'm still having some congestion and bleeding nose. I'm using saline spray during the day and at night before putting on mask.Also using a saline gel on and in my nose. Sat. night woke to hose making funny sounds. Went to site on internet and got help. There was water in tube ; when I put hose on floor out it came. I lowered my humidity level to 6 last night; wore chin strap and got almost 5 hrs. of sleep. Removed mask because sinuses were starting to hurt due to dryness.

Going in tomorrow to try a full face mask and have heated hose checked. The latter doesn't give me any options on my machine and it should.

Hope something works better.

Heather R

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