Psycho-Babble Medication | about biological treatments | Framed
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Re: Is this strange or what?

Posted by Mark H. on September 28, 2001, at 22:10:42

In reply to Is this strange or what?, posted by sgtbob on September 27, 2001, at 5:28:49

I concur with Marie that your doctor was likely describing sleep apnea, which is when the body stops breathing properly during sleep, depriving the brain of oxygen and causing potentially serious damage to other organs, especially the heart, which overworks while trying to deliver enough oxygen to the brain.

There are two general types of sleep apnea, which are not necessarily exclusive of each other: obstructive sleep apnea (OSA) and central sleep apnea (CSA). Obstructive sleep apnea is caused by soft tissue blockage of the airway. The result is loud snoring. Someone listening or watching will notice that a person stops snoring -- stops breathing, actually -- for several seconds up to half a minute or so, until the level of CO2 in the bloodstream builds up to the point that the sleeping brain kicks in with an emergency message and awakes the sleeper enough to gasp for his next breath. While OSA is more common in men who are overweight (more soft tissue in the throat), it is not limited to them.

Central sleep apnea is a bit more mysterious. Apparently, the body just gives up breathing until the same "wake up and gasp" message is sent from the brain.

In either case, the apnea sufferer is unaware of perhaps 90% or more of his "wakings." But a person with severe apnea never really gets a good nights sleep because of it. This leads to almost constant tiredness and crankiness during the day. Besides creating stress on the heart, it also causes very real danger for the apnea sufferer when driving (and for everyone around him on the road).

As for your over-the-shoulder diagnosis, I'd give your doctor the benefit of the doubt, at least until you can question him about it. Some doctors do not distinguish between true narcolepsy and what is sometimes called "idiopathic hypersomnia," which is just a fancy term for being unexplainably sleepy all the time. Also, perhaps within the VA system, a diagnosis of narcolepsy allows him to provide you with services, tests, support and medications that may not be covered for the more vague determination of hypersomnia -- I don't know this to be true, I'm just suggesting that he may be using the system to help you, and that instead of becoming alarmed, you may wish to ask him to clarify it for you.

Likewise, a sleep test can cost a couple of thousand dollars or more, but if he can get you a CPAP machine to try through the VA and it helps you -- well then, the success of the treatment will provide the diagnosis. I'm not claiming that this is the ideal way to do medicine, but we live in times when good doctors are often hampered from taking the best steps for the patient in the right order due to financial constraints and procedural restrictions.

If you're interested, do a Google or other search engine search on CPAP, and you'll learn a lot about the machines, their features and costs in a few minutes.

Best wishes,

Mark H.




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