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HI, Thanks for your question. My name isXXXXX and I am here to help you today. I will be happy to help you with your follow-up questions also.
I am an ENT and Head and Neck surgeon and can help you.
What is your question?
Hi Dr. Hasan, how r u ?
thanks for your help
You are welcome.
How can i help you?
I am 55, and had nasal polyps removed 7 years ago
my apnea is down I think
I used a security camera and videotaped myself (infrared) in the dark
I could note no apnea events in the 7 hours
being a layperson
i interpret apnea visually -- snoring, then 20-25 seconds of no snoring sound -- then waking up gasping for air
is this a fair visual assessment protocol
I am sorry but this is not a fair protocol because visual inspection is never sufficient.
isn't the end of an apnea session signified by a jerking kind of motion
However lets talk about your symptoms.
Yes it does but pattern is not the same for everyone.
the typical sleepiness, lack of good sleep, etc.
my sleep study in 2001
Do you have symptoms like daytime sleepiness?
and in 2007 -- both pre-surgical
yes, not terrible sleepiness
It was worse before your surgery?
i would rather not pay $$$ for a sleep study
yes, i think so
Yes i understand but lets see how you are doing now.
Ok do you have a partner?
and my ENT says that the polyps have not returned
that's why i bought the camera ;-)
also a parnter is not a good observer, ;-)
LOL, yes you are right.
not reliable to stay awake the whole night with clip board
Yes because partner has to sleep too.
i never snore on my side, and i have a cervical pillor
pillow that aids my rest
my 7 hour recording confirmed two things
1) i rarely snore on my side
2) I nearly always snore on my back
Do you get any complaint from your colleagues that you sleep on chair or while working?
not that bad
Was it same before and after surgery.
surgery wsa a long time ago ;-)
You never snore on back, that's good.
Ok i see.
i wrote above -- most of my snoring is ON BACK
i hardly ever snore on side
50% of time on back i snore
ok sorry i agree.
2% of time on side i snore
Well definitely it's not a standard protocol to monitor someone on camera this way.
and -- luckily -- my 7 hours was 80% on back
aaccording to video
80% of my night was spent on side
20% on back
95% of time on side -- no snoring
50% of time on back -- snoring
but considering the fact that you are not going for a sleep study and considering the apnea attacks you saw on camera and more importantly for me according to your current symptoms, i am of the opinion that you are doing good.
Ok you have done a good assessment then.
YES, but Dr. H., would you not say that MOST apnea is visually apparent
with jerking kind of motion
even subtle jerking
gasping for air, somewhat
I would say most are apparent this way by waking up suddenly by jerking movement but not all.
i know that sleep studies have 15+ variables examined
Snoring and sleep apnea are not one and the same thing.
if someone snores continuously
that is a sign of NO APNEA
Someone who snore doesn't have sleep apnea always.
as apnea is the absence of breaking
i kno w
apnea is the absence of breathing
so if the only variable I want to examine -- occurence of apnea --
For me reassuring thing is insignificant daytime sleepiness in your case.
and I was snoring 100% continously throughout the night
Yes that is what you can do.
and how many times you woke up gasping for air?
that's what i wanted to ask you
Then it's snoring simply and not sleep apnea.
i studied and listend to all my snoring and i could see no (minor) violent episodes
Are you over weight?
with a little tummy
let me check from chart.
Yes you should be around 160 to 165.
I guess reducing weight can really help you.
agreed, in so many ways
and more exercise
Let me give you a foolish idea.
but my main query tonight was getting ur advice about the poor man's sleep study ;-)
i used a $50 security camera with infrared -- a lot cheaper than $1500
i know that a real sleep study measures many many things
and is more useful
We usually ask our patients to sew a ball in the back of their trouser (in which they sleep).
but I just wanted to get ur expert advice
i have heard of that
do u recommend that ?
This doesn't let them sleep on back and as a result no snoring and no apnea.
let me ask you this.
Yes if you can tolerate but it's not badly needed for you.
I am impressed by your study.
if you -- dr. H. were sitting by my bedside for 7 hours, with no instruments
Really, not a bad idea.
A HORRIBLE TASK ;-)
BUT IF YOU WERE sitting by my bedside with strong coffee
could you -- say with 80% confidence -- that you could detect an apnea session
with your naked eye (and ears)
god forbid that you would have such a boring assginemtn ;-)
Being a doctor, NO
But being just an observer thinking on common sense, yes
so you mean an apnea session can be "invisible"
So combining these too, in my opinion you are doing good so far and no sleep study required right now.
Yes it can be.
invisible apnea will "slip by" my video system
But definitely it's a variable phenomenon.
that's a bummer
We call something apnea when oxygen concentration goes down.
that shoots a hole in my theory
yes, of course, that's the danger
so the key variable is oxygen in blood
not jerky motions
Without oxygen session going down how can we say that it's apnea.
No oxygen saturation must be monitored ideally.
If at anytime, you want, consider home sleep study.
they have such things I have read
It's cheap and you can get lots of info.
i need to go to physicain to get the script for this, correct?
Yes but private labs do this too.
one last question
is an apnea session always associated with snoring
But i reassure you that in my clinical experience you are doing good.
i know that snoring doesn't mean apnea
but does apnea always mean snoring
Yes snoring is a cardinal symptom of sleep apnea, specially obstructive sleep apnea.
so the lack of snoring is indicative of no OSA
thanks again, dr. h.
grateful for your help.
Snoring and daytime sleepiness has to be there.
You are most welcome.
good bye for now
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