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Sleep Apnea: Daytime impairment and neuro-degeneration

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Only read the first page - seems right up my street - will read the rest later. Thought others might be interested.

Sleep Apnea is a common enough missed diagnosis in patients with ME as it is others I think - though in a recent study from Newton she found it was one of the most common misdiagnoses. I have recently been diagnosed with chronic obstructive sleep apnea myself - after 10 years of asking for a sleep study. Am awaiting treatment to commence.

Of course the difficulty facing those of us with ME is that sleep disruption - too much, too little - and 'unrefeshing sleep' has been seen as part and parcel of the disease. There may be a cross-over with the reported effects of sleep apnea, or it may be that more of us meet the criteria (and testing) for apnea than we realise.

Treatment can involve I think two main avenues: one is a 'mouth guard' to open the airways at night, and the other is nighttime oxygen delivered through a mask (which is the treatment I am lined up for I believe) which attempts to force a constant supply of oxygen down the throat.

Sleep apnea is essentially oxygen starvation to the brain resulting in the brain telling the body to breathe, because the body - for several reasons - stops breathing for short periods within (for me) more significant periods during the night.

So it's often a case of 'snoring' to take a deep breath, and the lack of oxygen and resulting impulse to suddenly 'wake' can result in 'episodes' or interruptions to the extent that it is thought (in my case), I am experiencing seizures.

But they aren't really sure. It does 'interrupt' your sleep rhythms leading to feelings of 'fatigue' during the day, and as can be seen from the paper - cognitive difficulties and (it is speculated) degeneration.

The symptoms are obviously of interest to those with ME and to those working on research into the condition.

I need to read more about this one though:

Daytime Impairment and Neurodegeneration in OSAS

December 2013

Magdalena Nowak, MD; Johannes Kornhuber, MD; Robert Meyrer, MD

Department of Psychiatry, University of Erlangen, Germany

Study Objective:

Controversy surrounds the pathogenesis of neurocognitive daytime dysfunction exhibited by patients with o bstructive sleep apnea syndrome (OSAS).

Underlying brain dysfunctions and damage have long been suspected as a cause of some of this impairment. Neuroimaging has enabled scientists to test these long-held theories.

This paper is based on a comprehensive review of recent publications on neuroimaging studies in this area. It seeks to highlight results of recent research, which suggest connections between persistent neurocognitive daytime impairment of executive functions, underlying signs of cerebral metabolic impairment and neurodegeneration, considering possible cerebrovascular impairment in OSAS patients.

We propose the existence of a neurodegenerative process.

Full Paper
 

aimossy

Senior Member
Messages
1,106
I have a close family member with this, when she got her machine after a week she said she felt like she had received a blood transfusion she felt so much better. She has the full mask that delivers the air pressure to keep breathing properly, but just air is used in her case not oxygen.
Hope you find something that helps you Russ, 10 yrs for it to be looked into!!! sheesh :depressed::)
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
I have a close family member with this, when she got her machine after a week she said she felt like she had received a blood transfusion she felt so much better. She has the full mask that delivers the air pressure to keep breathing properly, but just air is used in her case not oxygen.
Hope you find something that helps you Russ, 10 yrs for it to be looked into!!! sheesh :depressed::)

Oh maybe it is air then. People say oxygen but maybe they mean air. We shall see. I could do with some now. Got the flu :meh:
 

Marco

Grrrrrrr!
Messages
2,386
Location
Near Cognac, France
Just skimmed this one so far but very interesting.

I've just finished reading a paper on sleep disturbances (and other very familiar problems) in post-stroke patients and the sleep apnea paper covers similar ground.

Quite an overlap with ME/CFS in both conditions - not only the symptoms but elevated pro-inflammatory cytokines (TNF-a; IL6) and increased P300 latency to event related potentials (ERP - a measure of the electrical reactivity of the brain) a found in child CFS patients.

Chicken or egg though - is sleep apnea a risk factor for neuroinflammation of a result?

Good luck with the 'man-flu' btw ;)
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Half of all CFS patients were shown to have sleep apnoea in a study a few years ago. Half of those the treatment fails on. I do think that BiPAP rather then CPAP, which is a full nose and mouth mask, might improve the treatment rate.

Sleep apnoea cannot cause all the ME symptoms. If fatigue and poor sleep is the only symptom then its a prefered differential diagnosis. With PEM and probably other things it is unclear its more than a comorbidity, one we are probably prone to.
 

RustyJ

Contaminated Cell Line 'RustyJ'
Messages
1,200
Location
Mackay, Aust
Half of all CFS patients were shown to have sleep apnoea in a study a few years ago. Half of those the treatment fails on. I do think that BiPAP rather then CPAP, which is a full nose and mouth mask, might improve the treatment rate.

I have just been diagnosed with sleep apnea, and am being advised to go on CPAP. I also have lowered perfusion and neuro problems which studies show is not reversed with CPAP. Is there evidence that BiPAP may help here?

Doesn't the above paper indicate that sleep apnea does induce perfusion problems, ie other symptoms (though whether this is the same as ME/CFS symptoms might be another thing)
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
BiPAP works better because we often cannot breath through our nose while sleeping. If this is the reason, then BiPAP is superior. If its something else then it wont be an improvement over CPAP. When they struck this they thought they could fix it with cortisol sprays, but those don't work too well on us.