Resistant hypertension and sleep apnea

It is well known that sleep apnea can cause high blood pressure. And that high blood pressure can of course cause heart problems including heart attacks. Doctors will usually prescribe blood pressure medicine for those with high blood pressure whether they are sleep apnea sufferers or not. What is interesting to note is that the blood pressure isn’t always controlled by just medication; this is also referred to as resistant hypertension. According to an article on the web a good deal of folks with resistant hypertension also has sleep apnea.




What can you do about resistant hypertension?

According to About.com“Because resistant hypertension is usually the result of some underlying issue, treatment focuses on correcting this underlying issue. If a hormone imbalance is the cause of the resistant hypertension, then treatment efforts are focused on correcting the patient’s hormone profile.”



Dr. Henry Black a Clinical Professor of Internal Medicine at the New York University School of Medicine, states that 70% to 80% of resistant hypertension patients have obstructive apnea. Doctor Black also states that the cpap machine will only help lower the blood pressure if it is used for a long time. Doctor Black also says that more research is needed to find ways to lower blood pressure for those with sleep apnea.



I have high blood pressure and sleep apnea; luckily my BP can be controlled by diuretics and blood pressure medicine. As for the cpap mask I never could get used to it.



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Are dental devices as effective as CPAPs?

If you have sleep apnea then you probably searched out every possible remedy imaginable. From mouth exercises to playing the didgeridoo to more traditional cures such as surgery and the CPAP machine. It is a lot to consider because some things work for some folks and others don’t. Surgery, at least some surgery, can take a long time to recover from and may only have a small chance at working. The usual fix for sleep apnea is the CPAP machine, which also has issues for many sleep apnea sufferers, such as not being able to get used to the mask and the air blowing down your airway. Another option would be dental devices, but from what I have read in the past their success has only been minimal. A new study is suggesting that may not be true.




According to a press release from the website ihatecpap.com “CPAP can no longer be considered the "Gold Standard" of treatment for mild to moderate sleep apnea. There is a rapidly changing dynamic in the field of sleep medicine. It should be noted that CPAP and Oral Appliances are equal with "careful titration". It remains to be seen if home sleep studies can meet the "careful titration" standard.”



Unfortunately in my own case my sleep apnea is severe so it probably wouldn’t work for me which is bad because I never was able to adjust to the CPAP mask. The last doctor that I saw suggested that surgery might be my only option.



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Central Sleep Apnea

When most people think about sleep apnea they think about obstructive sleep apnea where the airway in the back of the throat is blocked causing the sleep apnea sufferer to gasp for air many times per hour while they are sleeping. This is by far the most common form of sleep apnea. The other sleep apnea is central sleep apnea which has nothing to do with a blocked airway in the back of the throat but it can be as dangerous as obstructive sleep apnea.

What causes central sleep apnea?

Central sleep apnea is where the brain sends signals that cease breathing. According the WebMD “Central sleep apnea is often associated with other conditions. One form of central sleep apnea, however, has no known cause and is not associated with any other disease. In addition, central sleep apnea can occur with obstructive sleep apnea, or it can occur alone.”

Possible illnesses or conditions

• ALS 
• Parkinson’s disease 
• Alzheimer’s 
• Stroke 
• Injury to the brain stem 
• Encephalitis

  

A lot of the symptoms that obstructive sleep apnea sufferers have central sleep apnea have also. Such as being tired during the day, poor memory, mood problems and going to the bathroom at night.

  

If you feel that you have central sleep apnea check with your doctor, they might want to set up a sleep study for you. Like OSA a cpap machine could be the cure for you.

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Cleaning the CPAP Mask and machine

A few weeks ago I wrote about how folks with allergies can have a problem with the CPAP mask. One of the ways to deal with this is cleaning your CPAP mask and machine regularly. I received a very informative comment on how to do this.




Here is the comment…

Anonymous said...


I've been a CPAP user, actually APAP which is much better, for about 4 years now and I wish I had it when I was a child as I probably wouldn't have fallen asleep in class so frequently or had been so lethargic and apathetic.


You're right about having to keep the equipment clean but cleaning is simple and takes maybe 15 minutes a week. A quick search can provide numerous cleaning techniques, none much better than pre-washing the equipment, humidifier, hose and mask with non-lotion based soap and then disinfecting the equipment with a 5 minute soaking in a 50/50 solution of white vinegar and water. Let the parts air dry and then wash your hands before re-assembly.


The side effects of not cleaning the equipment vary in the individual with common complaints of minor sinus issues, headaches, sore throat, fatigue, light headedness, basically all the things you'd expect from a non-working CPAP machine and the return of apnea.






Great information!



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Is drinking bad for your sleep apnea?

There is a long list of things that you shouldn’t do if you have sleep apnea. Taking sleeping pills is right up there at the top of the list. They relax the muscles in the back of the throat causing even more airway blockage. Pain medication can also be a problem if your doctor doesn’t know that you have sleep apnea, which is another good reason for having a sleep study. And of course one of the worst vices for sleep apnea patients is alcohol. The same reason that sleeping pills are bad for sleep apnea patients applies to alcohol and OSA. But now a new study has come out that question whether drinking is all that bad for those with sleep apnea.




According to a study by the University of Missouri there doesn’t seem to be a connection between drinking and sleep apnea. The study consisted of 1,699 adults who were around the age of fifty. But the study did indicate that those that drink to fall asleep have a chance of hazardous drinking.



Not everyone believes that this study is valid because they had to take the participants at their word as to how much they drank which might result in underreporting on alcohol consumptions.



According to an article on Webmd “"If you ask people how much they drink, they will probably under-report, and if you ask about sleep problems, they will over-report," says Michael Breus, PhD, clinical director of the sleep division for Arrowhead Health in Glendale, Ariz.

"I find it hard to believe that heavy drinkers are quality sleepers," he says. "They won’t have a hard time falling asleep, but staying asleep is another story."



So this shouldn’t be a green light for those with sleep apnea to drink, especially to drink to fall asleep.




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Used CPAPs and sleep apnea

As I have stated in various posts on this blog, I have tried to use the CPAP machine but it didn’t work for me. I tried it not only once but twice and both times were failures. There are many reasons such as, the noise, the air leaks, the strangeness of wearing a mask at night and probably other things that I just can’t remember. Luckily my health insurance paid for both experiments with the CPAP machines. From what I understand new ones can be rather expensive. I saw the price range from the upper hundreds to thousands of dollars for new ones that would make sense considering that some machines are more sophisticated than others. The masks can be bought separately. I also saw that many places sold used CPAP machines, which surprised me.




It seems like perfect sense to buy a used CPAP machine if you can find one that has the right features for you. Although I have to wonder why the original owner gave up on the machine you wouldn’t want to buy it if it didn’t work right. if you are considering buying a used one make sure that you are buying from a reputable seller. It probably won’t be the last CPAP that you will ever buy because a CPAP machine wouldn’t last forever. I have read of folks that have had them for 14 or 15 years and some that had to buy a new one after a few years.


Keep in mind that you have to have a prescription and a sleep test in order to use a CPAP machine. The sleep test is really important because that is where you will find out what your CPAP setting is.


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Diving reflex and sleep apnea

How long can you hold your breath under water? If you haven’t been trained to hold your breath while diving or swimming under water you will probably only last a minute or two before surfacing. Some trained divers can hold their breath for periods up to 9 minutes. So what does this have to do with sleep apnea? The term mammalian diving reflex shows that when you are under water you ability to hold on to oxygen is greater than when you are sleeping.




What is mammalian diving reflex?

According to Wikipedia “The mammalian diving reflex optimizes respiration which allows mammals to stay underwater for a long time. It is exhibited strongly in aquatic mammals, but exists in a weaker version in other mammals, including humans. Diving birds, such as penguins, have a similar diving reflex. Every animal's diving reflex is triggered specifically by cold water contacting the face – water that is warmer than 21 °C (70 °F) does not cause the reflex, and neither does submersion of body parts other than the face. Also, the reflex is always exhibited more dramatically, and thus can grant longer survival, in young individuals.”



Some sleep apnea patients may activate a protective mechanism that preserves and regulates blood flow to the brain and the heart vessels. For more information on this subject go to http://focus.psychiatryonline.org/cgi/content/full/3/4/557



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Sleep apnea and chronic fatigue syndrome

Being tired is a big issue for sleep apnea sufferers who have yet to find an effective cure for their disorder. Of course it is no wonder when you consider that you wake up hundreds of times each night which eliminates any chance of getting a good night sleep. And you also probably know of the mental anguish that comes with lack of sleep such as irritability and loss of memory even depression. You may also have something that is known as chronic fatigue syndrome.




What is chronic fatigue syndrome?

According the CDC chronic fatigue syndrome is” or CFS, is a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. Persons with CFS most often function at a substantially lower level of activity than they were capable of before the onset of illness.”



What causes it?

The general cause of CFS is unknown but it is believed that the end result of many conditions cause CFS.



What treatments are available?

Treating CFS can be difficult since the cause of it is unknown. Counseling and therapy are sometimes used as well as antidepressants.



What is the connection between CFS and sleep apnea?

Since not getting enough rest is a symptom of CFS sleep apnea would have to be considered a trigger of CFS. If the sleep apnea is cured by cpap or surgical means that would probably help with the CFS.