I went in yesterday for my initial consultation with the sleep lab.  From what I described to the doctor, he said he's 90% sure that I have apnea and that I have all the classic symptoms.  I'm going in tomorrow night for the study.  The doc said that if the apnea sticks out like a sore thumb, they will go ahead and do a split study and if not, they will go 2 nights with a MSLT tomorrow morning/afternoon.  

I haven't had my thyroid checked lately, so they ordered a blood draw, which I did yesterday.  I have probably already read the answer to this question on the forum, but how does hypothyroid affect apnea?

When I get home tomorrow, I will post my results in the sleep studies forum.  I hope everybody here had an absolutely wonderful holiday!

Thanks again for all the help and suggestions,

Sleepy Scott

Dear Sleepy Scott,

There's a thread in this forum about hypothyroid and sleep apnea.  See http://www.apneasupport.org/viewtopic.php?p=6581&highlight=hypothyroid#6581

They say hypothyroid symptons can include snoring and unrefreshed sleep, symptoms in common with sleep apnea.  In addition, both can result in foggy thinking and memory problems.   So, testing for hypothyroid when you present signs of sleep apnea is actually a good idea.

When you get into the hypothyroid arena, you get into a massive controversy of how to diagnose and how to treat.  Some diagnose based on the levels of T3 and T4 hormones in the blood, while others say that doesn't measure thyroid function, just hormone levels.  Other diagnose with blood tests for Thyroid Stimulating Hormone (TSH), as it will rise above certain levels when the thyroid is out of whack; others say the "normal" range for TSH is much too large.  Some diagnose with free T3 and T4, either in the blood or in the saliva; others say only quacks would do that.  Finally, some diagnose based on symptoms - low body temperature and other clinical signs.  Once you're diagnosed, you use the same tools/tests/clinical signs to determine the right dose of medication.

Determining the correct treatment is another controversy.  There are drugs that supply T4 only, T3 only, and T3 and T4 combined.  Some are natural and some are synthetic.  The balance of T3 to T4 is another issue.  

I haven't found a good website that treats all the possibilities objectively, although http://thyroid.about.com/ is pretty good.  http://www.brodabarnes.org/ is a good start for the approach of looking a clinical symptoms of thyroid function (although some think Dr Barnes a quack).  

Good luck in determining whether you have zero, one, or two conditions!

- Ridge Runner

Well, I found out that I at least have 1 condition.  I had what was supposed to be a split study last night.  They gave me 10mg Ambien to knock me out for the sleep evaluation.  I only slept 2 hours.  They attempted to titrate me after that (F&P Flexifit 431 FF mask).  The mask was extremely comfortable, but I couldn't get back to sleep.  I'd start to doze off and they would up the pressure and I'd wake up.  I had the mask on for a total of 6 hours.  They had the machine set to straight CPAP, CPAP with Cflex, and BiPAP.  I especially don't like the BiPAP because the inhalation pressure about popped the mask off my face every time I took a breath.  CPAP and Cflex were a bit better.  It seems like It's going to take me a while to get used to it.  Do any of you have any tricks up your sleeve to trick yourself into compliance during the study?  It was a strange, but comfortable room.  I took my own pillows and comforter.  Any advice here would be monsterously appreciated.  I need this info before I go back in there tonight.  I leave my house this evening at 6:30 EST.  

I didn't get a copy of my sleep study yet because it isn't finished.  I go back for another round tonight.  They are going to give me Ambien right at the beginning.  It knocked me out after 15 minutes last night.  Hopefully, it will do the same tonight.  I did find out that my apnea episodes sometimes lasted up to 30 seconds and that my average desat was low 80s%.  I know that can't be good.

Anyhow, that's where I stand at the moment.  If you want to know how bull-headed I am when I set my mind to something, all you have to do is ask my wife.  I'm definately in this for the long haul... I just have to get a few wrinkles worked out.

BTW, Ridge Runner, the thyroid test that was ordered was the TSH.  I don't have the results yet.  Sometime in the near future, I'll check out those links, but I don't have time at the moment.  

Thanks again for all the support and answers,

Still Sleepy Scott

Hi Scott,

I'm a little confused, but if I'm reading this right, you're going back because you did not sleep enough for the titration part of the study, right?
I'm sure you will do fine because you will have more time.

I had it all done during the split study.  I swore I didn't sleep during the mask part, but apparently I did sleep enough for the test results.
I was miserable, and like you the high pressures kept me awake.  I was in tears from it all.  But at home things are much different.
Also, in my case, they tested pressures higher even then what was ultimately prescribed, not much higher, but as a test, and explains why I was miserable.
You'll do fine.

Let us know how it goes.


Linda

Well, I'm officially a member of the hose-head club.  I went in last night for my titration.  I couldn't sleep, so they had to give me Ambien.  It had me out cold within 15 minutes.  I used a ResMed Ultra Mirage FF mask.  It's not as comfortable as the F&P 431, but the 431 large won't seal properly because my chin won't fit into the chin cup (for lack of  a better term.  Anyway, I was titrated with bi-flex at 20/17.  It feels like Hurricane Katrina is inside the mask.

I know I'm going to have serious problems getting used to the pressure.  I really don't want to be dependent on either a prescription or an OTC sleep aid.  Anybody have ideas on how to solve this without a drug?  I was thinking along the line of some sort of herbal treatment that would knock me out.  I will take any suggestions, no matter how crazy they sound.

My machine is the Respironics BiPAP Pro 2.  The sleep tech set my ramp time for 15 minutes.  The user manual has a section on changing the initial ramp pressure, but there's no section dealing with changing the ramp time.  Does anybody that has this machine know a way that I can reset this for longer?  What's the max ramp time?It normally takes me more than 15 minutes to go to sleep.  If I'm beyond the ramp and still awake, I almost can't stand to keep the mask on.

I did get a really great night's sleep last night.  I'm looking forward to getting these initial minor wrinkles ironed out.  I don't have a copy of the sleep study as of yet.  I asked the sleep tech and he said that I need to ask for it when I go back for my follow-up.  I will post it in the sleep-studies section when I get it.

Thanks for all the help thus far and also in advance for your suggestions this time.  I really appreciate all the helpful insight.\

Sleepy Hosehead Scott

Hi Scott,

I take Valerian at bedtime. No hangover in the am. You do have to remember take it a little while before you go to bed.


_________________
When I woke up this morning my girlfriend asked me, 'Did you sleep well?' I said 'No, I made a few mistakes.' Steven Wright

Scott - call the sleep clinic and they should be able to walk you thru changing the ramp time.  I have a different machine, but I can set my ramp to as much as 30 minutes.  I would think that your machine should have the same ability.  After a few months, I was able to do away with the ramp completely - but my pressure is only at 13 compared to your 20 (wow!).  Who knows - you may be able to do the same eventually.

Welcome to the hosehead club!!!!

Scott,

For an herbal silution that may help you fall asleep is Melatonin.  It is a substance that your body normally produces when you are sleeping.  I have it but have not tried it yet.  I will soon though.

Hi Soon to be "Not Sleepy Scott"

Each Flexi-fit mask comes with 3 sizes of interfaces.  I'm not sure why they didn't try the medium.  If you have trouble with the ResMed FF mask, try the Flexi-fit with a medium interface.

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

I just got back from an appointment with my DME.  I was the first person that the mask-fit person can remember fitting the Comfort FF mask on.  I took my pillows with me and it even doesn't leak when I lie on my side (my normal sleeping position).  I can't tell you how shocked she was.  They are going to mark December 1, 2005 on the calendar.  She also let me take a flexifit 431 home to play with for a few weeks.  I'm supposed to trial both of them and give 1 back.  Vicky, the reason they didn't try the medium is that the large is too small for me.  I have a very long head from north to south.

Merlin, they changed my ramp time from 15 minutes to the max, 45 minutes.  It starts off with a pressure of 6 and goes up from there.  She showed me how it's done, but because it's in the clinical portion of the menu, she said that I am not allowed to touch those settings.  The thing that sucks about it is if I want to change it again, I have to take it over to the other side of town to them.  I have a 1992 Ford F-150 and no job at the moment.  

MrRob and deedster, I will definately try both of your suggestions for sleep aids.  I won't be able to afford to get anything for a while, so I'll have to tough it out for probably the first week or so.  How much do a month's supply of both cost (ballpark figure)?

Linda, you read my post right.  I wore the Flexifit 431 mask for a total of 6 hours.  Every time I'd start to doze off, they'd increase the pressure, and I'd wake back up.  It was very frustrating.  I already had 10 mg Ambien earlier for them to knock me out for the non-pap portion of the night.  They flatly refused to give me more, even though I cried and begged and whimpered and moaned.

Ridge Runner, I still haven't checked out the hypothyroid sites yet.  I haven't had a chance.  I will put it toward the top of the list of computer things to do.

I guess I'll end this essay now.  Sleep well!  I will try to do the same.  We'll see what happens.  I'll post tomorrow.

Thanks again!
Sleepy Scott

For Valerian, watch your local discount drug ads. I can usually find it buy one, get one free, around $6 for one.  I also cut out coupons from the Sunday paper for $1 off. Some brands are Sundown, Nature's Resource, Nature's Bounty, Natrol, and store brands.


_________________
When I woke up this morning my girlfriend asked me, 'Did you sleep well?' I said 'No, I made a few mistakes.' Steven Wright

Here are a couple of tricks that are pretty cheap to try in the mean time.  When I first started CPAP, after hooking up and laying down, I would take a tennis ball and use it to massage the area of the chest around the base of the sternum (between and slightly below the breasts).  It's amazing how much tension that releases and relaxes you.  My chiropractor told me that most people store their stress in that area.  Also - you might try playing some quiet relaxing music (no AC/DC, Metallica, etc.!) while you are trying to fall asleep.  That will give you something to concentrate on rather than the CPAP, mask, etc.  I have a CD by Suzanne Ciani that was my favorite (beautiful piano!).

Before you know it - you won't need any of these tricks!  I know it doesn't seem like it right now - but it will get better!!!!!