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Interesting. I bet close to all young skinny people with sleep apnea must remain undiagnosed. My generalist doc basically said "if you really insist we can do

Interesting. I bet close to all young skinny people with sleep apnea must remain undiagnosed. My generalist doc basically said "if you really insist we can do a polysomnography, but I'm pretty sure you don't have it, you're young, skinny and sporty. There isn't really much that helps that you can do about it anyway". I did insist and it turned out that I do have it. The changes in life I experienced are similar to yours. The doc's advice was double wrong in my case. Some other interesting thing I noticed: there seems to be something messed up about medical diagnosis equipment. At least in sleep apnea. I've done about 5 "sleep tests" in different countries with different equipment and the results varied between 0, a few 5-6 and one with 15 events per hour (no apnea, mild apnea and "medium"? apnea). The 0 to 6 where with portable "take home" devices, the 15 was a more serious feeling expensive looking in-hospital device with tons of wiring all over the body. So in short: the same patient can be cured and pretty severly suffering at the same time?! I'm not sure what's going on there but it smells like corruption in medical devices like that one Netflix documentary talks about. It was an episode of "dirty money" if I remember correctly.

rubicon33 4y ago
Can I ask what symptoms you had as a skinny / sporty individual with sleep apnea?
- diob 4y ago
  Needing 11-12 hours of sleep a night, frequent dreams of drowning or not being able to breath, daily headaches, falling asleep no matter how much you wish to remain awake (such as during school lecture or driving). . . And if you can, have your partner watch you sleep. Mine was what did it for me, she said I worried her half to death, and thought one day she would wake up to find me dead (I frequently would stop breathing, then suddenly gasp awake, and of course, I snored like a monster).
  - saiya-jin 4y ago
    My boss has this, he is 35 and not fat at all. His father died from heart attack when he was young. Poor sleep (more like never enough), for some probably unrelated reason got much worse during covid. Always a bit tired, always subpar with physical workouts, but never as extreme as falling asleep when you don't want to. Mentally working on maybe 50%, but he is super smart so still plenty of room. He snored according to his exwife. He went for tests, first time doctors thought machine was broken, his readings on apnea were off the charts. Second test confirmed it. Worst case they had seen, now has machine for sleeping and feels 100% better on everything. He believes his father had the same and its what killed him. Internal organs getting hammered over years, especially heart.
- Llamamoe 4y ago
  Either sleepy or tired-but-wired feeling. Reflux. Mouth breathing during sleep(dry/stinky mouth), jerking awake while falling asleep, waking up with a headache, breathless or more tired than you went to sleep. Bruxism. ADHD-like and memory problems. Low blood pressure with cold extremities. Nightmares.
  - findthewords 4y ago
    I've been dealing with similar problems for a few years now, ever since all my wisdom teeth were removed.
    - spirit557 4y ago
      I have wondered if children's diets precipipate this problem. Because so many kids grow up with varying levels of processsed or pre-digested foods (pulverized fruit pouches, not enough crunchy whole foods that require chewing etc) the jaw does not develop fully - so wisdom teeth removals and orthodontics for expansion seems like standard of care nowadays - but really it should not be that way. These cases should be rare but instead they are assumed common and normal. I quick search about this shows there is a relationship but I havent looked much into the details.
      - m_dupont 4y ago
        Idk why this is getting downvoted. There's a book called 'Breath' by james nestor where he devotes a lot of time to this theory. The book itself is mixed in terms of scientific quality but I found the stuff about diet influencing face shape to be very convincing. If your mouth doesnt grow properly then your airways will also be too narrow and you will have obstructed breathing.
      - dsego 4y ago
        Genetics, lack of breast feeding, soft foods, etc probably influence poor jaw development. Also mouth breathing due to allergies and nasal blockages, bad tongue placement, probably other factors. My snoring improved a lot in adult years when I learned to keep my mouth closed and breath through my nose. My tongue position was so bad that an ent suggested tongue ablation, but instead I learned to deliberately thrust my tongue against my palate so it doesn't collapse back. It's difficult because in childhood I basically learned to mouth breathe because my nose was always blocked. That probably caused a lot of my problems with cavities and poor jaw growth. I was also bottle fed mushy foods for the first few years, instead of having more solid foods. I did use a night palatal expander as a kid, but wasn't too consistent in turning the key and my parents weren't really persistent with it.
klooney 4y ago
I feel like that doesn't place enough weight on the bull hypothesis- the devices are bad because most things are bad, because being good is hard.
- TeMPOraL 4y ago
  Might be that, but on a meta level: the studies are too expensive and too big of a hassle, because there's not enough demand, because not enough people are being directed to make them, instead having their problems rounded up to e.g. obesity, because that's much easier for everyone than getting a test that's very expensive... You can see a feedback loop forming here.
  - MavisBacon 4y ago
    This, definitely this. Though apneas aren’t a component, I have a severe neurological sleep disorder that went undiagnosed largely due to physicians not ordering a sleep study. Even a sleep generalist I saw favored assuming psychological insomnia and regurgitated behavioral advice like no screens before bed and asked if I tried melatonin. As my sleep debt piled up and my sanity diminished each day, I threw my hands in the air and checked myself into the best behavioral health hospital in the U.S. They did a sleep study and low and behold I was having 100s, sometimes 1000+ involuntary movements per night while sleeping. On the road to recovery now!
    - Clamchop 4y ago
      Can you say more about the diagnosis and the treatment? I've had severe primary insomnia my entire life that appears to be getting worse with age and I rather rationally wonder for how much longer life will be worth living.
      - MavisBacon 4y ago
        Prior to diagnosis and treatment I was beginning to wake up up pretty much every 60-90 minutes through the night and then I'd do the only thing that helped at the time which is smoke some cannabis, fall back asleep, wake up 90 mins later, rinse repeat until dawn. I always woke up exhausted, even if i managed to only awake a few times through the night. Muscle pain and severe cognitive deficiency Basically with my disorder (Periodic Limb Movement Disorder or PLMD) it's categorized by episodes of 100s of rhythmic body movements which will sometimes wake me up, but even if they don't I wake up very tired from the movements. The current treatment has been nightly diazepam (aka valium). The first-line medication for PLMD in the US is actually a dopamine agonist called Mirapex that is often used to treat parkinson's disease. The American Scholar published a piece about Mirapex in September titled "The Degradation Drug," [https://theamericanscholar.org/the-degradation-drug/ https://theamericanscholar.org/the-degradation-drug/] It's a medication known to cause dramatic personality changes and life altering compulsions like gambling and even child pornography. Evidence of efficacy for this specific condition is so thin it absolutely blows my mind this medication is handed out thoughtlessly (they really just want to delay prescribing a heavy sedative), I've told my neurologist I will never touch a dopamine agonist again and caution others to do plenty of reading before going on one
searchableguy 4y ago
Many advice trying a CPAP device first instead of going for a sleep study if you suspect apnea for this exact reason. The sleep tests are expensive and often not accurate.
- Yeahsureok 4y ago
  *likely US based medical advice A sleep test is $100 ($75 USD) here.
  - grugagag 4y ago
    Yes, it costs you an arm and a leg in the US if you don’t have a good insurance
    - TecoAndJix 4y ago
      My sleep study cost roughly $2300 with insurance (US). I purchased my own machine and supplies because going through insurance requires you to rent the machine. It phones home and if you don’t use it every night it impacts your coverage! No thanks. You need a script to purchase the machine too which you need a sleep study to get. Then billed periodically for supplies. Also, the initial settings they configured for the machine did not work and I had to adjust them on my own using an application called OSCAR. The website CPAP talk is a great place for folks who are new to using a machine btw. I definitely still feel ridiculous putting a mask on every night but it has been absolutely life changing for my energy levels and health. Please do not delay if you think you have this - I promise it is worth it!
      - 7speter 4y ago
        Heh, pretty excited that my cpap machine is coming today
      - Wagthesam 4y ago
        I was quoted 3k for a psg by my sleep specialist. I went and got one from axg sleep diagnostics out in Sacramento, for around 600
diob 4y ago
Yes, I was a young fit 23 year old, like, six pack abs and muscular. I finally got my sleep study, and I had 79 AHI! When I went to get the equipment, they thought I would be severely obese. It changed my life, but I worry how much long term damage was done until then. My friend told me when I slept over (around age 14) that I would literally stop breathing and he thought I was dead. Then I would suddenly gasp awake. Anyways, if you're having trouble remaining awake, definitely get tested. If you have everyday headaches, get tested! Life can be much better.
- alfnor 4y ago
  Few medical doctors seem to grasp statistics. They solely consider trends, so it sucks to be a patient who is an outlier. Especially considering lifestyle factors and genetics aren't always properly controlled for in studies. Just look at how something like different dosages of alcohol affects different populations! I personally have a high BMI and high creatinine levels. No, I'm not obese with messed up kidneys (which the doctors thought); I just lift a lot and supplement with creatine. Of course, doctors tend to be overworked, so I don't doubt they would be able to think clearly if they worked normal shifts and got adequate rest.
bentoner 4y ago
The intensity of my sleep apnea varies from night to night, and you might be similar? Based on oxygen levels, mine also varies from subclinial to "medium" apnea. I was deemed not to have sleep apnea based on the take-home test or the in-hospital test... but I wore my oxygen-logging ring during the in-hospital test to check it was calibrated to the hospital's equipment (it was), and the specialist then diagnosed me based on my measurements of oxygen levels on other nights.
- ad404b8a372f2b9 4y ago
  What brand is your ring? I know some doctors that would love that!
  - joveian 4y ago
    Likely an Oura Ring: https://ouraring.com/ https://ouraring.com/ It sounds like one of the better sleep trackers (and not just sleep) if you aren't bothered by the whole "send detailed and continuous personal information to the cloud" thing. I'd recommend staying away from that kind of thing, though..
  - bentoner 4y ago
    I have a "Wellue Checkme O2 wrist oxygen monitor". (The Oura ring didn't measure blood oxygen back then.)
- shafyy 4y ago
  What are O2 levels that suggest sleep apnea?
  - synu 4y ago
    This page has some really good info: https://www.beverlyhillstmjheadachepain.com/sleep-apnea/pulse-oximeter-report/ https://www.beverlyhillstmjheadachepain.com/sleep-apnea/puls.... It appears that going below 94% 5 times per hour would indicate mild sleep apnea.
- elric 4y ago
m0llusk 4y ago
Apnea is nearly universal among older weightlifters. It is not well understood, but it seems that relatively small changes to the physiology of the neck end up interfering with breathing. Many healthy and strong people don't have any idea what is making them feel bad until many other alternative explanations are eliminated.
- alfnor 4y ago
  I wonder if there's a more simple remedy like a tilted bedframe or a hammock or something.
  - cstrahan 4y ago
    There are products that are essentially an inflatable backpack you can wear while sleeping, ensuring you never roll over on your back (laying on your back makes it easier for your tongue and other soft neck meat to obstruct your airways, so anything to avoid that can help a bit).
elric 4y ago
When I was in my early 20s, I weighed under 60kg (which put me at a BMI of 19ish). I was tired all the time. I went through the usual gauntlet of tests, including a sleep study. The doctors couldn't find any explanation, and after months of this I sort of got used to it. The months turned into years, and in my mid 30s, my upstairs neighbour complained about my loud snoring. Back to tests, another sleep study. Diagnosis: sleep apnea. They then asked me why I never got treatment in the first place, because apparently that first sleep study indicated sleep apnea ... but because the AHI was on the lower end, and because I was young and skinny, the doctor didn't think it was relevant for me to know. Sigh.
- pareidolia 4y ago
  AHI really doesn't mean anything besides the trivial: the density of apneas and hypopneas (relative to the applied definition of both) https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.13066 https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.13066

rubicon33 4y ago

Can I ask what symptoms you had as a skinny / sporty individual with sleep apnea?

diob 4y ago
Needing 11-12 hours of sleep a night, frequent dreams of drowning or not being able to breath, daily headaches, falling asleep no matter how much you wish to remain awake (such as during school lecture or driving). . . And if you can, have your partner watch you sleep. Mine was what did it for me, she said I worried her half to death, and thought one day she would wake up to find me dead (I frequently would stop breathing, then suddenly gasp awake, and of course, I snored like a monster).
- saiya-jin 4y ago
  My boss has this, he is 35 and not fat at all. His father died from heart attack when he was young. Poor sleep (more like never enough), for some probably unrelated reason got much worse during covid. Always a bit tired, always subpar with physical workouts, but never as extreme as falling asleep when you don't want to. Mentally working on maybe 50%, but he is super smart so still plenty of room. He snored according to his exwife. He went for tests, first time doctors thought machine was broken, his readings on apnea were off the charts. Second test confirmed it. Worst case they had seen, now has machine for sleeping and feels 100% better on everything. He believes his father had the same and its what killed him. Internal organs getting hammered over years, especially heart.
Llamamoe 4y ago
Either sleepy or tired-but-wired feeling. Reflux. Mouth breathing during sleep(dry/stinky mouth), jerking awake while falling asleep, waking up with a headache, breathless or more tired than you went to sleep. Bruxism. ADHD-like and memory problems. Low blood pressure with cold extremities. Nightmares.
- findthewords 4y ago
  I've been dealing with similar problems for a few years now, ever since all my wisdom teeth were removed.
  - spirit557 4y ago
    I have wondered if children's diets precipipate this problem. Because so many kids grow up with varying levels of processsed or pre-digested foods (pulverized fruit pouches, not enough crunchy whole foods that require chewing etc) the jaw does not develop fully - so wisdom teeth removals and orthodontics for expansion seems like standard of care nowadays - but really it should not be that way. These cases should be rare but instead they are assumed common and normal. I quick search about this shows there is a relationship but I havent looked much into the details.
    - m_dupont 4y ago
      Idk why this is getting downvoted. There's a book called 'Breath' by james nestor where he devotes a lot of time to this theory. The book itself is mixed in terms of scientific quality but I found the stuff about diet influencing face shape to be very convincing. If your mouth doesnt grow properly then your airways will also be too narrow and you will have obstructed breathing.
    - dsego 4y ago
      Genetics, lack of breast feeding, soft foods, etc probably influence poor jaw development. Also mouth breathing due to allergies and nasal blockages, bad tongue placement, probably other factors. My snoring improved a lot in adult years when I learned to keep my mouth closed and breath through my nose. My tongue position was so bad that an ent suggested tongue ablation, but instead I learned to deliberately thrust my tongue against my palate so it doesn't collapse back. It's difficult because in childhood I basically learned to mouth breathe because my nose was always blocked. That probably caused a lot of my problems with cavities and poor jaw growth. I was also bottle fed mushy foods for the first few years, instead of having more solid foods. I did use a night palatal expander as a kid, but wasn't too consistent in turning the key and my parents weren't really persistent with it.

klooney 4y ago

I feel like that doesn't place enough weight on the bull hypothesis- the devices are bad because most things are bad, because being good is hard.

TeMPOraL 4y ago
Might be that, but on a meta level: the studies are too expensive and too big of a hassle, because there's not enough demand, because not enough people are being directed to make them, instead having their problems rounded up to e.g. obesity, because that's much easier for everyone than getting a test that's very expensive... You can see a feedback loop forming here.
- MavisBacon 4y ago
  This, definitely this. Though apneas aren’t a component, I have a severe neurological sleep disorder that went undiagnosed largely due to physicians not ordering a sleep study. Even a sleep generalist I saw favored assuming psychological insomnia and regurgitated behavioral advice like no screens before bed and asked if I tried melatonin. As my sleep debt piled up and my sanity diminished each day, I threw my hands in the air and checked myself into the best behavioral health hospital in the U.S. They did a sleep study and low and behold I was having 100s, sometimes 1000+ involuntary movements per night while sleeping. On the road to recovery now!
  - Clamchop 4y ago
    Can you say more about the diagnosis and the treatment? I've had severe primary insomnia my entire life that appears to be getting worse with age and I rather rationally wonder for how much longer life will be worth living.
    - MavisBacon 4y ago
      Prior to diagnosis and treatment I was beginning to wake up up pretty much every 60-90 minutes through the night and then I'd do the only thing that helped at the time which is smoke some cannabis, fall back asleep, wake up 90 mins later, rinse repeat until dawn. I always woke up exhausted, even if i managed to only awake a few times through the night. Muscle pain and severe cognitive deficiency Basically with my disorder (Periodic Limb Movement Disorder or PLMD) it's categorized by episodes of 100s of rhythmic body movements which will sometimes wake me up, but even if they don't I wake up very tired from the movements. The current treatment has been nightly diazepam (aka valium). The first-line medication for PLMD in the US is actually a dopamine agonist called Mirapex that is often used to treat parkinson's disease. The American Scholar published a piece about Mirapex in September titled "The Degradation Drug," [https://theamericanscholar.org/the-degradation-drug/ https://theamericanscholar.org/the-degradation-drug/] It's a medication known to cause dramatic personality changes and life altering compulsions like gambling and even child pornography. Evidence of efficacy for this specific condition is so thin it absolutely blows my mind this medication is handed out thoughtlessly (they really just want to delay prescribing a heavy sedative), I've told my neurologist I will never touch a dopamine agonist again and caution others to do plenty of reading before going on one

searchableguy 4y ago

Many advice trying a CPAP device first instead of going for a sleep study if you suspect apnea for this exact reason. The sleep tests are expensive and often not accurate.

Yeahsureok 4y ago
*likely US based medical advice A sleep test is $100 ($75 USD) here.
- grugagag 4y ago
  Yes, it costs you an arm and a leg in the US if you don’t have a good insurance
  - TecoAndJix 4y ago
    My sleep study cost roughly $2300 with insurance (US). I purchased my own machine and supplies because going through insurance requires you to rent the machine. It phones home and if you don’t use it every night it impacts your coverage! No thanks. You need a script to purchase the machine too which you need a sleep study to get. Then billed periodically for supplies. Also, the initial settings they configured for the machine did not work and I had to adjust them on my own using an application called OSCAR. The website CPAP talk is a great place for folks who are new to using a machine btw. I definitely still feel ridiculous putting a mask on every night but it has been absolutely life changing for my energy levels and health. Please do not delay if you think you have this - I promise it is worth it!
    - 7speter 4y ago
      Heh, pretty excited that my cpap machine is coming today
    - Wagthesam 4y ago
      I was quoted 3k for a psg by my sleep specialist. I went and got one from axg sleep diagnostics out in Sacramento, for around 600

diob 4y ago

Yes, I was a young fit 23 year old, like, six pack abs and muscular. I finally got my sleep study, and I had 79 AHI! When I went to get the equipment, they thought I would be severely obese. It changed my life, but I worry how much long term damage was done until then. My friend told me when I slept over (around age 14) that I would literally stop breathing and he thought I was dead. Then I would suddenly gasp awake. Anyways, if you're having trouble remaining awake, definitely get tested. If you have everyday headaches, get tested! Life can be much better.

alfnor 4y ago
Few medical doctors seem to grasp statistics. They solely consider trends, so it sucks to be a patient who is an outlier. Especially considering lifestyle factors and genetics aren't always properly controlled for in studies. Just look at how something like different dosages of alcohol affects different populations! I personally have a high BMI and high creatinine levels. No, I'm not obese with messed up kidneys (which the doctors thought); I just lift a lot and supplement with creatine. Of course, doctors tend to be overworked, so I don't doubt they would be able to think clearly if they worked normal shifts and got adequate rest.

bentoner 4y ago

The intensity of my sleep apnea varies from night to night, and you might be similar? Based on oxygen levels, mine also varies from subclinial to "medium" apnea. I was deemed not to have sleep apnea based on the take-home test or the in-hospital test... but I wore my oxygen-logging ring during the in-hospital test to check it was calibrated to the hospital's equipment (it was), and the specialist then diagnosed me based on my measurements of oxygen levels on other nights.

ad404b8a372f2b9 4y ago
What brand is your ring? I know some doctors that would love that!
- joveian 4y ago
  Likely an Oura Ring: https://ouraring.com/ https://ouraring.com/ It sounds like one of the better sleep trackers (and not just sleep) if you aren't bothered by the whole "send detailed and continuous personal information to the cloud" thing. I'd recommend staying away from that kind of thing, though..
- bentoner 4y ago
  I have a "Wellue Checkme O2 wrist oxygen monitor". (The Oura ring didn't measure blood oxygen back then.)
shafyy 4y ago
What are O2 levels that suggest sleep apnea?
- synu 4y ago
  This page has some really good info: https://www.beverlyhillstmjheadachepain.com/sleep-apnea/pulse-oximeter-report/ https://www.beverlyhillstmjheadachepain.com/sleep-apnea/puls.... It appears that going below 94% 5 times per hour would indicate mild sleep apnea.
elric 4y ago

m0llusk 4y ago

Apnea is nearly universal among older weightlifters. It is not well understood, but it seems that relatively small changes to the physiology of the neck end up interfering with breathing. Many healthy and strong people don't have any idea what is making them feel bad until many other alternative explanations are eliminated.

alfnor 4y ago
I wonder if there's a more simple remedy like a tilted bedframe or a hammock or something.
- cstrahan 4y ago
  There are products that are essentially an inflatable backpack you can wear while sleeping, ensuring you never roll over on your back (laying on your back makes it easier for your tongue and other soft neck meat to obstruct your airways, so anything to avoid that can help a bit).

elric 4y ago

When I was in my early 20s, I weighed under 60kg (which put me at a BMI of 19ish). I was tired all the time. I went through the usual gauntlet of tests, including a sleep study. The doctors couldn't find any explanation, and after months of this I sort of got used to it. The months turned into years, and in my mid 30s, my upstairs neighbour complained about my loud snoring. Back to tests, another sleep study. Diagnosis: sleep apnea. They then asked me why I never got treatment in the first place, because apparently that first sleep study indicated sleep apnea ... but because the AHI was on the lower end, and because I was young and skinny, the doctor didn't think it was relevant for me to know. Sigh.

pareidolia 4y ago
AHI really doesn't mean anything besides the trivial: the density of apneas and hypopneas (relative to the applied definition of both) https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.13066 https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.13066