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  1. #1
    Totally harmless unless riled JLB's Avatar
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    Default Sleep Apnea and the trail

    I did a 50 mile stretch last year, and rattled the trees with my snoring. I never did get a good nights sleep, and really hadn't had one in years before I got on the trail. I was really exhausted by the end of each day, and couldn't figure out why. When I came off the trail, instead of being healthy, and hearty, I was a wreck.

    For years, evidently, I have had (undiagnosed) sleep apnea
    this is a condition where the little flap on the back of your throat closes off, and you basically stop breathing, until your survival instinct kicks in, and you gasp. You never wake up, but it keeps you from getting the restful REM sleep.

    I never suspected anything, but noticed however long I slept, even if it was 10-12 hours, I was tired when I woke up, and I compensated with caffiene.

    Finally my wife told me that I stop breathing in the night, and sometimes up to 45 seconds.

    I went in and got a sleep study done, and if you have 25 episodes per night, you have Sleep Apnea. Sleep Hypoxia goes along with it, and it's the average oxygenated blood flow.

    My study came back with 129 episodes in 6 hours, and an oxygen loss down to 82% average.

    My doctor, having heard that I had just spent 50 miles at altitude, told me that was a huge risk, as this can cause high blood pressure, and fatigue.

    So, there are two courses of action:

    Get an operation to remove the flap.

    Get a C-Pap machine, which fits over your nose, and pumps 7 psi of pressure into my larynx, keeping the flap open.

    My uncle had just died in minor surgery, so i opted for the machine, and felt 18 years old again after just one night of 6 hours. I honestly thought I had slept 10 hours. It was amazing.

    So, my dilemma: I can only go a couple 2-3 days on the trail at altitude before I need to recuperate with a good nights sleep with my C-Pap, or I could get the operation, which isn't always succesful.

    I could also move my next section hike to a lower elevation state, but don't know where to begin.

    Does anybody else have this problem? It's said that 10% of all people have some form of sleep disorder, and the older you get, the worse it gets.

  2. #2
    Section Hiker - 339.8 miles - I'm gettin' there! papa john's Avatar
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    I have it as well. Unfortunately, I could not get any sleep with the CPAP machine despite having tried numerous headgear. The unit is now in the closet. During the evaluation, I register several hundred episodes during the night. The doctor said I was the most atypical OSA patient he had ever seen. I have none of the physical symptoms of the typical OSA patient.

    Which headgear are you using?

    I have seen devices that you can wear on your head that claim to keep your jaw positioned so that blockage does not occur and there are also dental appliances that do the same. I also read where there is no good data to indicated that these devices actually work.
    Papa John


  3. #3
    Registered User orangebug's Avatar
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    There is good data that CPAP works in only about 50% of OSA (Obstructive Sleep Apnea) patients. It is the preferred treatment as it does not require intrusive procedures and potentially lethal side complications. In those who fail on CPAP, surgery is often offered as having fewer risks than continued apnea events. I describe it to patients as having someone smother you with a pillow ever few minutes until you begin to arouse and regain your airway.

    Hypertension, accidents, and sudden death are among the complications of untreated OSA.

    Appliances to reposition the teeth or the head have not been shown to work. It would be terrific, as they are relatively cheap and even less intrusive than CPAP. If you have OSA and need treatment (assuming exercise, weight loss, smoking cessation and such were inadequate), a hiker would have to decide either to have surgical interventions, change sports, or experience frequent smothering each night on the trail.

  4. #4

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    Quote Originally Posted by JLB

    Get a C-Pap machine, which fits over your nose, and pumps 7 psi of pressure into my larynx, keeping the flap open.
    Be happy that the CPAP is working for you. But please know that it is not putting out 7 psi. The "7" is centimeters of water, I suspect. Around 0.1 psi.

  5. #5
    Thru Hike 1998-1999
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    Quote Originally Posted by JLB
    I did a 50 mile stretch last year, and rattled the trees with my snoring. I never did get a good nights sleep, and really hadn't had one in years before I got on the trail. I was really exhausted by the end of each day, and couldn't figure out why. When I came off the trail, instead of being healthy, and hearty, I was a wreck.

    For years, evidently, I have had (undiagnosed) sleep apnea
    this is a condition where the little flap on the back of your throat closes off, and you basically stop breathing, until your survival instinct kicks in, and you gasp. You never wake up, but it keeps you from getting the restful REM sleep.

    I never suspected anything, but noticed however long I slept, even if it was 10-12 hours, I was tired when I woke up, and I compensated with caffiene.

    Finally my wife told me that I stop breathing in the night, and sometimes up to 45 seconds.

    I went in and got a sleep study done, and if you have 25 episodes per night, you have Sleep Apnea. Sleep Hypoxia goes along with it, and it's the average oxygenated blood flow.

    My study came back with 129 episodes in 6 hours, and an oxygen loss down to 82% average.

    My doctor, having heard that I had just spent 50 miles at altitude, told me that was a huge risk, as this can cause high blood pressure, and fatigue.

    So, there are two courses of action:

    Get an operation to remove the flap.

    Get a C-Pap machine, which fits over your nose, and pumps 7 psi of pressure into my larynx, keeping the flap open.

    My uncle had just died in minor surgery, so i opted for the machine, and felt 18 years old again after just one night of 6 hours. I honestly thought I had slept 10 hours. It was amazing.

    So, my dilemma: I can only go a couple 2-3 days on the trail at altitude before I need to recuperate with a good nights sleep with my C-Pap, or I could get the operation, which isn't always succesful.

    I could also move my next section hike to a lower elevation state, but don't know where to begin.

    Does anybody else have this problem? It's said that 10% of all people have some form of sleep disorder, and the older you get, the worse it gets.
    I also use a c-pap machine and have for years..when I was getting ready to hike in 1998 I asked my doctor what I should do...and he told me to take the machine and use it every night....lol... I explained to him about the trail...anyway I used the breath rite strips and really didn't have any trouble sleeping...and was told didn't snore too bad....I was woke up for my snoring a couple of times....after the weather got a little better I tented every night I could as I slept better in a tent anyway...

  6. #6
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    I dont know if I have a sleeping problem, but I do snore terribly. So I tent as I can put the tent on a slope helping my breathing and use the BreatheRite strips (the tan colored not the clear...better adhesive) and have improved both the snoring and amount of sleep I get. Good luck with your problem and I hope they find a solution that keeps you on the trail.

  7. #7
    Totally harmless unless riled JLB's Avatar
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    Quote Originally Posted by sliderule
    Be happy that the CPAP is working for you. But please know that it is not putting out 7 psi. The "7" is centimeters of water, I suspect. Around 0.1 psi.
    Actually, I think they said it was 7 bar, whatever that means.

    To the poster above: I use a gel type nose mask, and straps over the head. I've gotten used to it, and don't even know it's there any more.

  8. #8
    Totally harmless unless riled JLB's Avatar
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    Quote Originally Posted by orangebug
    There is good data that CPAP works in only about 50% of OSA (Obstructive Sleep Apnea) patients. It is the preferred treatment as it does not require intrusive procedures and potentially lethal side complications. In those who fail on CPAP, surgery is often offered as having fewer risks than continued apnea events. I describe it to patients as having someone smother you with a pillow ever few minutes until you begin to arouse and regain your airway.

    Hypertension, accidents, and sudden death are among the complications of untreated OSA.

    Appliances to reposition the teeth or the head have not been shown to work. It would be terrific, as they are relatively cheap and even less intrusive than CPAP. If you have OSA and need treatment (assuming exercise, weight loss, smoking cessation and such were inadequate), a hiker would have to decide either to have surgical interventions, change sports, or experience frequent smothering each night on the trail.
    I'm a fairly fit guy for my age, 42. I do have a very thick neck, and always have had a stocky frame. I am definitely not a lean type of guy, but I have a body fat index in the low teens, and work out regularly. i'm 5'7", and hover between 190 and 200 pounds, depending on my training.

    http://www.fototime.com/{843B2357-93...8}/picture.JPG

    http://www.fototime.com/{E427AA3C-AF...B}/picture.JPG

    As you can see, losing weight isn't a problem, as it's all muscle mass, but the thickening of my neck from exercise may have the same effect as a roll of fat.

  9. #9

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    I have a friend with sleep apnea, she says that approximately 90 percent of cases is caused by obesity. She can't lose the weight so she has a breathing machine. Is this an accurate statement?

  10. #10
    Registered User Clark Fork's Avatar
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    Default Appliance Link

    JBL:

    With a 7 setting, you have been diagnosed with a somewhat mild case in terms of correcting your condition.

    At least look into an appliance: See Link: http://www.medicalnewstoday.com/medi...p?newsid=13666



    There are several types one of which requires warming before putting it in. If you pursue it, ask for an appliance that does not require warming unless you think you can warm water before bedtime each trail evening.

    As far a finding out if it works, you can have an oxygen test after you get used to the appliance. You don't have to have a full overnight sleep test. You hook up one finger to a machine and it records your O2 levels. The read out can tell you if it is working by analysing your O2 levels.

    There is a positive correlation to obesity but some non obese people do have Obstructive Sleep Apnea. Surprisingly, this is a relatively new area of research and study with much being found out all the time so it is well to keep up with the news. Obesity is linked with OSA because when you are tired, your body wants more food to boost energy.

    The cost usually exceeds $1,000 dollars and there is no guarantee it will work or that you can adjust to having your lower jaw set forward all night. I just had a re-evaluation after losing 45 lbs. Due to the weight loss, my condition has moderated. I am next going to be evaluated for an appliance. I will report in on the results. If there is some indication I could be helped by an appliance, I am going that route but at the same time I am still taking off lbs.

    Now, if they only made a ultra-lite moonlight powered c-pap machine.

    Clark Fork in Western Montana

  11. #11

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    Quote Originally Posted by JLB
    Actually, I think they said it was 7 bar, whatever that means.
    It means that they don't what they are talking about. Put 7 bar in you nose and someone will be cleaning your sinuses off the ceiling.

  12. #12
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    7 bar is roughly 100 PSI. What I assume you heard JLB was 7 millibar as that is only 0.1 PSI.

  13. #13
    Registered User Dances with Mice's Avatar
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    First 50 miles of the AT is "high altitude"?
    You never turned around to see the frowns
    On the jugglers and the clowns
    When they all did tricks for you.

  14. #14
    Totally harmless unless riled JLB's Avatar
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    Quote Originally Posted by prozac
    7 bar is roughly 100 PSI. What I assume you heard JLB was 7 millibar as that is only 0.1 PSI.
    It must be 7 psi then.

  15. #15
    Totally harmless unless riled JLB's Avatar
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    Quote Originally Posted by Dances with Mice
    First 50 miles of the AT is "high altitude"?
    Compared to sea level, yes.

    I have apnea at my altitude (sea level), and hypoxia of 82%, which means my blood oxygenation level drops to that level, or at least it did the night they did my sleep study.

    Now since air density decreases by about 1% for each 300 feet increase in height, or 3 C increase in temperature, at 3000 feet, I've lost at least 10%, compared to what I'm used to, HOWEVER, since the temps usually are lower at that height, I may only be losing around 5%. That's still pretty significant, when you start with an 82% oxygenation content baseline, and you are fatigued from walking all day. It takes it's toll.

  16. #16
    Totally harmless unless riled JLB's Avatar
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    Quote Originally Posted by Ridge
    I have a friend with sleep apnea, she says that approximately 90 percent of cases is caused by obesity. She can't lose the weight so she has a breathing machine. Is this an accurate statement?
    It's genetic, but having a fat neck pressing down on your wind pipe can make it worse. My grandmother and father are world class snorers.

    The problem is, being tired all of the time, you tend to gain weight.

    Luckily, I've always had a fairly high metabolism plus exercise a lot, and have never been fat.

  17. #17

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    Quote Originally Posted by prozac
    7 bar is roughly 100 PSI. What I assume you heard JLB was 7 millibar as that is only 0.1 PSI.
    CPAP pressure is described in terms of centimeters of water. Same concept as inches of mercury. 1 cm H20 = .98 millibar.

  18. #18
    Totally harmless unless riled JLB's Avatar
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    Quote Originally Posted by sliderule
    CPAP pressure is described in terms of centimeters of water. Same concept as inches of mercury. 1 cm H20 = .98 millibar.
    So, what pressure am I, converted to psi?


    One wierd thing, when you open your mouth, you can feel the air rushing out.

  19. #19
    Section Hiker - 339.8 miles - I'm gettin' there! papa john's Avatar
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    I found a conversion calculator that converted it this way:

    7 millibar = 0.101526416411146 pounds per square inch(pressure)
    Papa John


  20. #20
    Registered User Goon's Avatar
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    Quote Originally Posted by Ridge
    I have a friend with sleep apnea, she says that approximately 90 percent of cases is caused by obesity. She can't lose the weight so she has a breathing machine. Is this an accurate statement?
    Not being in the medical field I can't say for most folks, but I was an olympic class snorer and would wake myself occasionally when I stopped breathing. All that stopped after I lost signficant weight and I don't even snore anymore.

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