Sleep Apnea, episodes of anoxia.

Short periods of anoxia can happen regularly to people who have sleep apnea. Paula and I discussed this with another friend/co-worker. He got diagnosed with sleep apnea after a sleep test was done to look for the source of his heart problems. He didn’t know he had sleep apnea, but his wife knew; when asleep, he regularly stopped breathing for at least 10 seconds or longer [it seemed longer to her], before gasping loudly and taking a huge breath in. She was frightened the first few times she heard him do this and then assumed it was normal ..for him…It took at least ten years of sleeping like this for him to develop any visible health problems.

Also it took a long time for doctors to recognize sleep apnea as a health issue and longer to develop treatments for it.Probably, the most important advance in the history of sleep medicine was the discovery of sleep apnea in 1965.1 For years, specialists looked into obstructive sleep apnea (OSA) as a simple, intermittent closure of the upper airway; hence, early treatments focused mainly on eliminating airway obstruction. Prior to the 1980s, the only effective treatment for OSA was tracheostomy, which bypasses the upper airway obstruction. The introduction of continuous positive airway pressure (CPAP) therapy through a nasal mask in 1981 marked another important discovery that fueled interest in sleep medicine practice and research.2Since that time, our understanding of the features and consequences of OSA has progressed significantly, and it is now recognized as a major health issue. Obstructive Sleep Apnea: From Simple Upper Airway Obstruction to Systemic Inflammation Ann Saudi Med. 2011 Jan-Feb; 31(1): 1–2. doi: 10.4103/0256-4947.75770PMCID: PMC3101717PMID: 21245591 Ahmad Bahammam

His wife reported that her husband’s breathing rate was normal, same as hers. She knew about her own breathing rate and how to measure it because she had attended the same first aid class that we did. [read the blog about that alarming or magical first aid class [depending on your point of view] that changed EVERYTHING and led to our current understanding of bipolar depression and manic depressive insanity.

Paula and I think that short apneas in people with normal breathing rates at rest and during sleep cause the cardiovascular issues seen in sleep apnea. And these issues are silent for years before they become something felt as uncomfortable or unpleasant or frightening for the patient. And it is recognizable to the patient as irregularities in their heartbeats.

People with hidden abnormal breathing rates at rest and most likely during sleep [although this has never been studied because breathing rates are never measured at rest or in sleep and if they are, they are not thought of as a part of the patients medical problems.

Neither spirometry or polysomnography measure breathing rates and thus do not pick up on abnormal breathing rates. They measure lots of things about breathing, just not breathing rate per minute. This is because breathing rate at rest can have a wide range in different people and seem to lead to normal oxygenation of the lungs, for the most part.

But not always.

Paula and I would like to argue that a period of apnea [where you stop breathing for a short period] …..in a person who breathes too slowly at rest or in sleep may cause a switch to an energy saving state like the one Paula experienced. This energy saving state is protective in that it seems tp prevent permanent damage to the organs including the brain, but “mutes” their function in a co-ordinated and organized manner.

Let us examine this more carefully in the next blog.

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