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June 6, 2013

In great shape, but sleep apnea exists?

 

Can a healthy 200 lbs bodybuilder have sleep apnea?

Q: I don’t get it, thought in order to have sleep apnea you had to be old, over weight and ugly, not in that order… I went to the Doc about restless leg syndrome and she said we need to do a sleep study and see just how bad you got it. Well I got it worst than I thought. I walked in to the waiting room at 8:45 pm and 5 other guys were sitting there cracking jokes about how their wife’s don’t put out any more and waiting to be escorted back to our rooms.

Well here I am 200lbs bodybuilder sitting there waiting my turn and the nurse walked out and said your father will be in good hands so you can go home now… Well, I’m here for a study, and this black lady towers over me and asked is this a joke, because I’m not in a joking mood, I thought to myself you’re going to die.. She came back out to the waiting room and gave me a long look, “your with me”.. So I’m sitting in this chair in my room and she walks in with a 1000 wires and starts gluing them on every inch of my body and talking about uncomfortable..

So at 1:45 she put me to bed and said I can see everything so not make a move unless I tell you too. This room is dark and so quiet that I can hear my ears ringing from the years of racing I guess.. … finally the adrenine level comes back down and I fall asleep. She comes running in, wakes me up and tells me we’re putting this mask on you before you die,, OK.. I asked is this going to help my restless legs, she said “baby this going to save your life”. So here I am, can’t stand to have anything touching me while I sleep and I’m told I have to have it.. can you help me with any advice on how I’m going to live with a mask on my face….. Poor Poor pitiful me…

Dr. Smith: First of all, 60% of sleep apneics are NOT obese. I have treated many slim females, and in fact, had 2 come in today with sleep-disordered breathing. I always tell them it’s nothing they have done at all, it’s just the luck of their genetics. It’s why I take a “uvula shot” with all my new patient photos.

Secondly, put to bed at 1:45??? That place is very poorly run. I have never heard of that kind of delay. Anyway, each sleep center has their protocol for placing a PAP machine during a study, regardless of what the orders were from the MD. You received what we call a “split study”, and they decide on this sometimes due to your insurance, but most times due to a drop in your SpO2 below a certain level (usually 80%) for a given amount of time (usually 10 minutes).

However, some centers are less than scrupulous, and all they want to do is sell you a PAP machine, so without knowing your center, it’s hard to say. This is the reason I have written letters to the sleep centers I send patients to, stating “Under no circumstance are you to place a PAP machine on my patient”. So, my name and about 4 ENTs in the area are on the walls in the sleep centers, warning the techs not to do this to our patients. They have been sleeping in their own beds for quite some time with their disorder, and the chances of them dying on their watch are not real good, especially since they are connected to 18-24 wires, and everyone would know if they are about to code.

Now to your specific study. It is now accepted that you will be sold a PAP (and insurance will cover), if your AHI (or RDI) is 15 or higher OR if it is 5 or higher, with accompanying comorbidities, such as hypertension, sleepiness, etc.. Be sure to ask them for a copy of your analysis. If you would like me to take a look at it and give you some advice, I do this regularly, so you can fax it to 972.255.5693, and I will gladly discuss your results with you.

Sleep Dallas Contact info: 1800-More-Sleep (1800-667-3753)

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