Va Sees Huge Increase In Sleep Apnea Cases

[pacmanx1]

http://www.vawatchdo.../nf060710-2.htm

[john999]

If this is a trend the VA is going to find a way to tighten up the regs on sleep apnea. They will probably define it as a lifestyle disease. That is just my opinion form dealing with the cheap bastards.

[dwragon]

It like everything else, its systemic, ie, once one condition arises, it causes other conditions to arise because the body is trying to compensate, but has been thrown off balance. It causes a ripple effect.

[john999]

To show sleep apnea as a secondary condition is probably an ordeal unless you had symptoms on active duty. If you have been out of the service for 20 years and are now obese then you know what VA will say.

[navydoc2]

I was thinking about filing a claim based on weight gain from my psych meds.

[pacmanx1]

Fibromyalgia & Chronic Fatigue

Fibromyalgia & Sleep Apnea The Relationship Between Fibromyalgia & Sleep Apnea, and How to Live With Both

By Adrienne Dellwo, About.com Guide

Updated September 30, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Fibromyalgia¹ and abnormal sleep breathing commonly go together. Sleep apnea is considered a possible cause or contributing factor for FMS, and FMS may increase your risk of sleep apnea. Any sleep disorder can make FMS symptoms² worse, so treating sleep disorders is often a big help in managing FMS. Sleep apnea is one of the more serious sleep disorders because it can lead to life-threatening conditions.

What is Sleep Apnea?

People with sleep apnea frequently stop breathing while asleep. The need for air can wake them up or bring them out of deep sleep. It's not uncommon for this to happen every few minutes, resulting in poor quality sleep.

The most common type of sleep apnea is called obstructive sleep apnea (OSA), in which the airway gets blocked at one of several possible sites. The obstruction can be from excess tissue in the air passage or nasal passages, or a large tongue or tonsils. When the tissues relax during sleep, they block the airway. Obesity increases the risk of OSA.

When sleep apnea stops your breathing, your blood oxygen levels drop, your heart beats faster, you get a burst of stress hormones, and your body rouses you to restart breathing. Some people have no idea this is going on, but some awaken with a gasp.

Sleep apnea carries an increased risk of several other health conditions, some of which are serious and potentially life threatening. Associated conditions include:

• Stroke
• Heart disease or heart failure
• High blood pressure
• Heartburn and reflux
• Diabetes
• Erectile dysfunction
• Depression
• Sudden death
  
  Treatment can help lower your risk of developing these problems.
  Why Do Fibromyalgia & Sleep Apnea Go Together?
  
  
  So far, we don't know why fibromyalgia and sleep apnea go together. It's possible that apnea-caused sleep deprivation contributes to the development of FMS. It's also possible that lax connective tissues associated with FMS may make airway obstructions more likely.
  • Learn more: Possible Causes of Fibromyalgia³.
    Diagnosing Sleep Apnea
    
    
    Sleep apnea is diagnosed by a polysomnogram, or sleep study. These are done at a sleep lab, where you're hooked up to electrodes and monitored throughout the night by a technician.
    
    Your doctor may refer you for a sleep study if you report symptoms of sleep apnea or other sleep disorders. Most people with FMS are not given a sleep study, but some doctors and researchers say sleep studies should be done more often to help identify and treat sleep disorders that exacerbate FMS.
    • Learn more: Sleep Studies & Fibromyalgia⁴.
      Symptoms of Sleep Apnea & Fibromyalgia
      
      
      Some symptoms of fibromyalgia and sleep apnea are similar, which can make it harder for you to detect and for your doctor to diagnose. Shared symptoms include:
      • Unrefreshing sleep & excessive daytime sleepiness
      • Difficulty concentrating
      • Personality changes
      • Depression⁵
      • Insomnia⁶

    Sleep apnea symptoms that aren't associated with FMS include:

    [*]Episodes of obstructed breathing during sleep[*]Loud snoring[*]Dry mouth upon waking[*]Snorting, gasping or choking that wakes you up[*]High blood pressure

    If you have FMS and notice these symptoms, you should talk to your doctor about the possibility of sleep apnea.

    Treating Sleep Apnea - CPAP

    The most common treatment for OSA is a machine that provides what's called Continuous Positive Airway Pressure, or CPAP. The continuous pressure keeps your airway from becoming obstructed.

    Once you're diagnosed with sleep apnea, the doctor will likely send you to a medical-equipment provider, who will fit you with a CPAP mask to wear while you sleep and give you a custom-programmed CPAP machine. Not everyone can tolerate CPAP and FMS can make it harder, especially if you have head, face or jaw pain. CPAP can also make it harder for some people to fall asleep.

    My personal experience with CPAP, however, has been very positive. I get better sleep, and I actually find the machine to be somewhat soothing. My daytime fatigue dropped off significantly and my energy level came way up as soon as I started using it.

    If you find it hard to adjust to CPAP, talk to your doctor or equipment provider to see if they can help you. You may also want to consider other treatment options. Leaving sleep apnea untreated is a poor option, both because of the impact on your FMS and because of the associated serious health risks -- remember, some of them can kill you.

    Treating Sleep Apnea - Other Options

    Other sleep apnea treatments include:

    [*]Losing weight. While it's easier said than done, it can greatly improve the condition.[*]Dental devices. If jaw position is responsible for the obstruction, wearing a device to bed can be effective.[*]Surgery. This may be the only treatment option for some people who can't tolerate CPAP; however, be sure to take into account that surgery carries serious risks, FMS can slow your recovery rate, and surgery can cause your symptoms to flare up. Here's more information on possible sleep apnea surgeries from About.com Sleep Disorders Guide Brandon Peters: Surgery Options for Obstructive Sleep Apnea⁷

    General anesthesia and sleep apnea can be a dangerous combination. Read Sleep Apnea & Surgery⁸

    Living With Sleep Apnea & Fibromyalgia

    Sleep apnea and FMS can be a tough combination to live with, both because poor sleep makes FMS worse and because FMS makes CPAP especially hard to use. However, with proper treatment from your doctor and diligence on your part, it's possible to feel better and minimize sleep apnea's impact on your life.

[pacmanx1]

It's a lot to read but here's part ot it:

OSA in depression

Compared to the large number of studies investigating depressive symptomatology in OSA patients, far fewer studies have focused on the screening for OSA in a primarily depressed study population. In one of the few investigations of the prevalence of OSA in a depressed cohort, Reynolds et al. found, in a small sample of 17 older patients with major depression, that 17.6% also had an OSA syndrome, compared to 4.3% of 23 healthy elderly controls [38]. This suggests that OSA might be an important confounding factor for studies on mood disorders in general, as its presence is not routinely determined in either research studies examining mood or clinical settings. However, many more studies are required to assess the prevalence of OSA in primarily depressed patients, particularly as it can be suspected from existing studies that OSA is greatly underdiagnosed in this patient population.

Clinically, this is of particular concern, as sedative antidepressants and adjunct treatments for depression may actually exacerbate OSA. Notably hypnotics prescribed to treat depression-related insomnia might further decrease the muscle tone in the already functionally impaired upper airway dilatator muscles, blunt the arousal response to hypoxia and hypercapnia as well as increase the arousal threshold for the apneic event, therefore increasing the number and duration of apneas [39,40]. These effects might differ depending on the patient population and the severity of OSA. Older depressive subjects are of primary concern: both, frequency of OSA and depressive symptoms increase with age, as do prescription and consumption of sedative psychotropic medication. Pharmacologic treatment of depression and depression-related insomnia in this age group should therefore routinely consider the potential presence of a concomitant OSA.

Finally, as Baran and Richert point out, the diagnosis of a mood disorder in the presence of OSA has its very own challenges [41]. Considering the DSM-IV definitions [<A href="http://www.annals-general-psychiatry.com/content/4/1/13#B42">42], it could either be viewed as a mood disorder due to a general medical condition, or classified as an adjustment disorder with depressed mood, due in particular to EDS and its debilitating consequences on the patients' daytime functioning. The identification of pathophysiological features that allow distinction between OSA and depression might assist with such diagnostic issues.

http://www.annals-ge.../content/4/1/13

Edited June 10, 2010 by pacmanx1