This post is as the heading, but first some context. It’s a bit of an essay.
I’m no doctor, so this is an account of my own experience – we each have to make our own decisions.
The take-away should you conclude it may be relevant is towards the bottom.
It’s perhaps old hat by now, I’m a bit out of touch – but better safe than sorry.
I posted quite a bit here up to around 2010 to communicate personal experiences with long undiagnosed (actually never diagnosed - despite clear symptoms and repeated communication to a sequence of docs of what the likely issues were) secondary hypothyroidism, auto immune thyroid disease, and a thyroid cancer.
Also with a long series of secondary conditions.
I also posted about mainstream medicine's (again from personal experience) minimal capability and enormous reluctance to engage holistically to diagnose never mind to treat metabolic conditions, and the associated repeated failure of so many of the stock tests for thyroid and auto immune function. (they cost me €1,000s)
Also on the importance of our taking pro-active responsibility for ourselves in how we co-operate with the medical system - of reading the research and other sources of information, of figuring stuff out, of maintaining a healthy scepticism, and of being led by our higher and bodily knowing and intuition.
Surgery and set piece treatments (eg scans, prescriptions) apart my breakthroughs were self-initiated.
The suspicions regarding the likely presence of thyroid and auto immune disease were proven correct after years of misery in 2005.
The pathology report which followed a thyroidectomy for a thyroid cancer (which only came to light as the initially incidental matter of a thyroid ‘nodule’ found during an extended hospital stay to search for the never definitively identified cause of dangerously high blood pressure) found after microscopic examination of my removed and much enlarged thyroid (it turned out to have grown down into my RH chest cavity) advanced auto immune thyroid disease and an encapsulated Hurthle cell cancer.
I also posted on some of the approaches (culled from reading, Thyroid UK was a big help, as were the other patient centred thyroid support sites) which following the crisis brought about a slow recovery - including the magic of T3, discovering the significance of high (and potentially low) cortisol levels in blood pressure, gut, fatigue and thyroid problems, the contribution of mercury and metals to thyroid and other problems, use of chelation therapy to remove dental mercury and other metals, how to blunt the effect of high night time cortisol using a phosphorylated serine supplement, the importance of continued elimination of problem foods, and of meditation and mind work.
Also that lifestyle changes are typically necessary - that responding to these conditions usually requires a bit more than just popping the pill and carrying on..
So much for background. The following takes up the story, and is to communicate the central role it turns out that the high night (or any other) time cortisol levels triggered by sleep apnoea may play in the various gut, thyroid auto immune and commonly related metabolic and secondary problems so many of us have run into - and the potentially highly beneficial effects of the CPAP treatment prescribed for obstructive sleep apnoea.
While my stamina never came back to anything like normal levels post 2005, it wasn't too bad.
Real fatigue and morning hangovers (symptoms, not in reality – it was taking an hour of headache and brain fog to properly wake up) unfortunately started to become an issue again during the past few years. More and more sleep seemed to be required to feel even half well.
A self requested referral for possible sleep apnoea resulted in a sleep study, and a diagnosis of severe obstructive sleep apnoea. (30/hr, down to about 80% blood oxygen at night)
Starting CPAP in recent weeks has (the positive effects were immediately evident) delivered something of a miracle. It’s inconvenient (requires a CPAP blower and face mask, and a bit of getting used to), but was immediately effective.
Results have included a massive improvement in energy, feeling rested during the day, memory coming back, no more multiple runs to the loo in the night, back to sleeping around 8rs (down from 10 - 12 hrs), stable gut, feeling great.
Preliminary signs suggest a significant reduction in blood pressure, although it’ll take time to confirm this.
An experienced sleep technologist I spoke to said that the reduction in blood cortisol levels is the key. That the newly stable gut, the improved energy, the well-being and the improvement in blood pressure are all pretty normal, and that it was possible that it could in time sort out my borderline glucose intolerance too.
Time will tell in respect of how much effect it truly has, and whether it changes how my thyroid replacement works.
The unanswered question of course is that of for how long the apnoea has been the driver of my tendencies to high night time cortisol. It's very likely that it recently worsened, but that it has been around for many years.
Despite my being a classic candidate not a single one of the many consultants and doctors seen over the years even mentioned sleep apnoea as a potential contributor to the high night time cortisol identified by a test I commissioned from a UK lab - never mind to the bigger picture.
The tendency was actually to dismiss the test – that it’s ‘normal’ for cortisol levels to be all over the place…
The point to be made here is that despite this practice sleep apnoea (even more so if combined with stressful life situations) has the potential to drive night time cortisol to levels that when sustained can cause serious problems.
The difficulty is perhaps to do with medicine's tendency to ignore variations in many markers like hormone levels unless they reach stratospheric levels. (this in turn is perhaps a reflection of a tendency to let illness fully develop rather than act preventively to nip it in the bud) The diagnosis of the classic high cortisol conditions caused by eg an adrenal disease like Cushing;s requires this – in part I gather because the levels of blood cortisol vary naturally so much anyway.
This implies that what the system has regarded as only normally raised levels of cortisol can become holistically/systemically hugely problematical when sustained in the medium to longer term - knocking on into gut, endocrine, auto immune, blood sugar level and other problems. Which ultimately have the potential to trigger a wide variety of serious illnesses.
We’re really only meant to trigger the fight or flight response when a lion jumps out from behind a bush, and we need to run away…
The good news is that the sleep apnoea world seems (in at least some cases) to be aware of the potential for high cortisol caused by sleep apnoea to cause havoc.
Anyway… Hopefully this will help a few.
It’s always our own decision, but it’s perhaps wise if it’s a possibility to add sleep apnoea to the list of conditions with the potential to contribute to metabolic, endocrine, gut, auto immune and related problems – and to not be deflected from seeking a sleep study if eg a GP or endocrinologist poo poos the possibility…