Wednesday, August 8, 2012

Apnoea or Allergy?

When you have a medical problem, the kind of treatment recommended will vary according to whom you ask for help. A chemist will give you drugs, a surgeon will offer to cut the problem out, a faith healer will give you bullshit and a sleep clinic will fit you with a CPAP machine to keep you breathing at night.
For instance, if you happen to have a little sleep apnoea like me, you first take a sleep test to determine the severity of your symptoms. You go to a sleep clinic with your pillow and favourite teddy bear and they stick wires on your skin to your head and chest. They attach a blood oxygen sensor to your forefinger and tuck you in for an uncomfortable nights' sleep.
Once the severity of your symptoms are determined, you are fitted for a mask. A CPAP machine is calibrated to force enough oxygen into your airway to ensure that every night is as uncomfortable as can possibly be. After a couple of weeks of sleepless struggling as the CPAP machine tries to explode your sinuses with cold air, you toss the CPAP machine out. This is called being 'non-compliant'.
If you are unfortunate enough to have a GP who is savvy on up to date remedies for apnoea you will be chided on being non-compliant and then given a referral to see a maxillofacial surgeon as a possible alternative to CPAP. The surgeon will tell you to have a radiology scan of your head to see if the state of your sinuses and the size of your bank account will justify nasal surgery. After the surgeon carefully looks at the speed boat brochure laying next to your radiology scan he recommends carving up your sinuses to allow you to sleep easier and 'relieve' your suffering.
On the gurney you calmly recall your boss telling you that her nasal surgery left her in daily pain for the last seven years, but that 'rarely' happens. The surgeon and the anaesthetist give you winning smiles as they lean over you and say, “you will hardly notice anything.”
You wake up an hour and a half later and it was true, you didn't notice anything and everything is fine, until the local wears off. In the middle of the night you have to demand the nurse give you a shot of morphine as she doesn't really believe that Tylenol 'doesn't do anything' for you.
A week later, after removing five kilometres of gauze from your nose, you are ready to try out your new sinuses. Things are different. There is a clean, cool breeze every time you inhale through your nose and your sinuses drain like a faucet. When you bend over a little, a river of liquid snot runs out of your nose. Well, maybe that's an improvement. It is certainly much more entertaining than it used to be. But you still suffer from a light to moderate amount of sleep apnoea and you chalk it up to being a little overweight. So you resign yourself to taking a spontaneous nap every afternoon and needing more sleep than everyone else. Yeah, fuck it.
A couple of years later, you try some allergy pills for a couple of days while on holiday in the states. The pollen season is in full bloom and being in the Willamette Valley, you can hardly breath.
You are apprehensive about taking allergy meds. The last two kinds allergy pills you tried left you feeling like shit. Pseudo-ephedrine left you sleepless and benadryl put you to sleep. This new stuff, fexofenadine, really works without obvious side effects. So you take your new meds for a couple of days, until you leave Oregon and head off to other parts.
A few weeks later you take your daughter Anna to an allergist to look into desensitisation. You watch the doctor verify the diagnosis of dust mite and cat hair using a scratch test. The control, histamine, is put on the skin in one spot and then a sample of dust mites and of cat hair in liquid form is put on her skin in other spots. After a few minutes the skin becomes inflamed and swells up at each of the spots.
It occurs to you that this stuff runs in the family as you tell the allergist that the sniffling daughter leaves a trail of tissues behind her everywhere she goes. The ever-present bandanna hanky weighs heavy in your back pocket, and not just metaphorically. Maybe, just maybe, your sleep apnoea is caused by a reaction or swelling in your sinuses, throat and lungs caused by the dust mites which have bothered you for decades. But this doesn't occur to you until after you have left the allergist's office. If I bring it up to the allergist, I am sure he will agree and recommend a course of allergy treatment. Just like the sleep clinic and CPAP, the surgeon and surgery, this will be the end all of my problems. Except, all sarcasm aside, there is possibly a ring of truth to this.
It seemed intuitive to experiment with some allergy meds after suspecting there is some link between my allergies and sleep apnoea. So I took up a regimen of allergy meds for a couple weeks. I noticed that after a week that I felt more rested than I had been for ages. My relationship with food seems more relaxed. I am able to concentrate better. Very interesting.
I went to the Google and looked this up. It appears that there is also a link between my allergies and anxious behaviour. I read somewhere that ADHD and sleep apnoea are connected, where ADHD is claimed to be a consequence of the loss of sleep suffered by sleep apnoea. I have also read that loss of sleep associated with sleep apnoea is also blamed for overeating.
This whole chain of shit was started from the epiphany of seeing the inflammation caused by the scratch test being administered to offspring Anna and linking it to little observations I had made.
Then again, maybe it's just the yoga.