Sleep apnea

[Wendigo]

I was diagnosed with severe obstructive sleep apnea in 1998. Since then I've been using a BI-PAP machine to regulate my sleeping and this has dramatically improved my overall health and sleep.

I am planning for the first time since this diagnosis to engage in long-distance hiking again; beginning with week-long trips and working back up to longer distances.

I would be interested in hearing from medical professionals, sleep therapists, or hikers with apena about their experiences in dealing with apnea and hiking. Do you let it prohibit your time out on the trail? Do you avoid hiking at all? What information have you been able to gather from doctors about the risks of hiking without sleep apnea equipment?

My understanding is that untreated apnea can lead to heart, respiratory, stroke, and other problems, if untreated. The issue is whether or not departing from treatment for a limited time is risky to the patient. Sleep technicians I've spoken with indicate that time without treatment merely necessitates sleeping on your side at night and dealing with snoring and morning headache problems.

Wendigo wishes you well in all your journeys!

[orangebug]

My understanding is that untreated apnea can lead to heart, respiratory, stroke, and other problems, if untreated. The issue is whether or not departing from treatment for a limited time is risky to the patient. Sleep technicians I've spoken with indicate that time without treatment merely necessitates sleeping on your side at night and dealing with snoring and morning headache problems.

Exceellent question, but I don't think anyone really knows the answer. OSA (obstructive Sleep Apnea) is associated with increased risks of sudden death, hypertension, irregular heart beat, gastro-esophageal reflux, aspiration pneumoonia and other problems.

You haven't mentioned what you have attempted in treatment other than Bi-PAP. Weight loss and surgeries to reduce upper airway resistance are other options. Weight loss is by far the most important treatment - although I've had OSA in an 18 yo girl who weighed 98 pounds at the time. Some people find that it is positional, but sleepers are famous for moving about at night. There is some controversy that once adverse effects occur from OSA, treatments may not be beneficial. :confused:

If you have OSA, you will annoy and frighten you shelter mates. The snoring will be maddening, the long silences will be terrifying.

Are you more likely to have a catastrophe while hiking overnight? Possibly, but I don't know how likely. Would hiking and general improved conditioning reduce your OSA? Ditto. Should you consult with a sleep specialist or ENT about treatment options? By all means, yes, in the real world!

Bill...

[Creaky]

I had an operation called a Uvulopalatoplasty -- removal of part of the uvula. Considerable "sore throat" pain for a week or so. Some trouble swallowing fluids "down the wrong pipe." But it worked to correct both sleep apnea and the astonishingly loud snoring and snuffling that I made when I WAS breathing. It has made a big difference in my ability to get a good night's sleep, and has made it possible for me to sleep in shelters and huts without worrying about driving everyone else crazy with the noise.

[The Scribe]

I was diagnosed with severe apnea last fall. I was told I averaged 115 episodes an hour during my study. The thought of wearing a CPAP mask drove me to the bookstore for Atkins' book.

That was October.

35-40 pounds later, in July I underwent another study. According to my scrooge Dr., I still have it but was down to 15 times per hour.

I started hiking this spring and have done a pair of 10-mile day hikes in the past month in The Whites with one more planned at least. I have been out five times overall since the beginning of May. Something not possible last summer.

Reflux issues have gone away, blood pressure is down (cutting my meds in half), I feel awake, and feel great (no more headaches).

I found in my experience, weight loss was NEVER discussed at all as an option. It all seemed like a sales job for the CPAP machine. I did use mine till the end of 2003. I refused to use it in 2004 and has been sitting in a closet all of this year. No skin off my nose, but Anthem/Blue Cross is paying a pretty penny every month for it. It is going back.

I realize there are people with this problem where weight is not an issue, but I would bet my bottom dollar it is for most. It's funny, on one hand they talk about how many more people have apnea now than used to, and on the other, they talk about how fat America is getting.

Go figure.

pcm

[orangebug]

I found in my experience, weight loss was NEVER discussed at all as an option. It all seemed like a sales job for the CPAP machine. ...

I realize there are people with this problem where weight is not an issue, but I would bet my bottom dollar it is for most. It's funny, on one hand they talk about how many more people have apnea now than used to, and on the other, they talk about how fat America is getting.
Back when I learned about Sleep Apnea in med school, this was also called Pickwickian Disorder" after the grossly obese Dickens character. Back then, the only treatment was a tracheostomy - opening a hole in your windpipe just above your collar bone. We also did not have the resources for telemetry, O2 saturation/desaturation and the like.

When you have the technology to make a diagnosis and treat a condition, you make the diagnosis more frequently.

Many docs fail to discuss weight loss, mostly out of a sense of frustration that patients just will not do it. We know that exercise is vital. We know that the latest wonder diets work at best for a few months. We know that our patients claim to eat like birds, while we imagine carrion eaters gorging on their feasts. We hope that the intrusiveness of CPAP and surgery (which has significant complications) will motivate some to take better care of themselves.

I also question the validity of the initial sleep study. 150 episodes of apnea per hour? Over 2 episodes per minute? I've seen 50; 30 is miserable. 15 is pretty grim. That means you only get 4 minutes of uninterrupted sleep at a time.

Congratulations on your work to save your life.