To Sleep: Perchance to Dream

First: credit where credit is due.  Thanks to the Bard, William Shakespeare, for providing the title for today’s blog.  Anyone recognize it from Hamlet’s soliloquy?

Although I’d planned to write about my odd experience with the threat of heart disease in next week’s blog, people have already started asking what heart disease has to do with Chronic Kidney Disease. The American Association of Kidney Patients has an easily understood, comprehensive article about just that. In a nutshell, “Individuals with kidney disease are at a high risk of developing hardening of the arteries resulting in heart attacks, heart failure and strokes.” I’d recommend reading the entire article at: http://www.aakp.org/aakp-library/heart-disease-and-kidney-disease/

In addition, although I am not astute enough to completely understand the studies I read about women and EKG testing, there does seem to be conclusive evidence that the female heart IS more sensitive to the EKG (just as Dr. Waram told me) and could provide a false positive for heart disease. Phew!  I feel like I dodged a bullet on that one.

So, what is today’s blog topic? Sleep!  If you remember, I’d had a sleep study just before the EKG panic but never got to write about sleep apnea and CKD.  You should know that I’d spent over four years trying to convince my nephrologist that I was tired because the CKD prevented me from producing enough red blood cells and he spent the same amount of time trying to convince me that wasn’t why I was always so tired.

In retrospect, it’s surprising that neither one of us ever considered sleep apnea.  It wasn’t until one of my many daughters was diagnosed with OSA that I started wondering if I could have it.  Of course, then I spent some time wondering if I were going to consider myself a victim of whatever health problem anyone I knew had. Once I got beyond that, help was on the way.

I found a study at http://www.medscape.com/viewarticle/538872 which clearly links sleep apnea and hypertension. Dr. John J. Sim makes the connection very clear:

“We think there may be a causative factor here; that sleep apnea may be causing direct glomerular injury,” Dr John J Sim (Kaiser Permanente, Los Angeles, CA) told renalwire . “We already know that sleep apnea causes hypertension and that hypertension causes kidney disease.”

If some degree of causality can be shown, it’s possible that treating sleep apnea may slow the progression of kidney disease, the authors speculate.

This is an older study from 2005, but it seems to lead the way to further proof that sleep apnea  does affect CKD. It’s also the only one I could understand {sometimes I do wish I were a doctor} which even mentions glomerular injury.

I think we need a definition of sleep apnea – also called obstructive sleep apnea or OSA – before we go any further, preferably a non-medicalese one. The simplest definition I could locate is from Yahoo! Health: “Obstructive sleep apnea is a condition in which a person has episodes of blocked breathing during sleep.” I should add the episodes usually last 10 seconds or longer.

During those episodes, you wake yourself up by gasping or snorting in an effort to start breathing again.  Now that I understand exactly what is happening, it’s sort of scary.  I hadn’t realized this could be serious.  But, being me, I’m not going to let it.  Hence, the sleep study. 

You don’t just walk into a sleep center to request one of these.  My family doctor, the ever vigilant Dr. H. Zhao of Deer Valley Family Practice, referred me to several pulmonologists – lung and respiratory tract specialists. I chose Dr. Loreman of Central Arizona Medical Associates and was glad I did since I found her personable, informative and easy to engage in a specific discussion about my health. Her suggestion?  A sleep study.  Off I went to make my appointment with Valley Sleep Center.

While they did a terrific job of monitoring my sleep patterns during different sleep states, I was unimpressed.  I don’t know what I expected, but they hooked me up, sent me to sleep, then woke me up to put on a CPAP and sent me back to sleep.

According to WiseGeek.com, “A CPAP machine has a small box connected to tubes through which air flows. The tubes are connected to a mask worn on the face. Straps around the mask fit it to the face over the mouth and nose. For those with sleep apnea, the CPAP is used at night during normal sleep.”

A CPAP was recommended for me. I am not thrilled and made it clear I’d like to try an oral {sometimes called dental} device to see how effective that is before I agreed to the CPAP.  I have reservations about being hooked up to a machine.  Those are my personal reservations.  Many, many people are perfectly comfortable with the CPAP.

There are several different types of dental appliances, so I’ll have to tell you about them at another time.  I don’t know anything about them yet. I had to postpone my appointment with this dental specialist since I had the emergency appointment with the cardiologist at the same time {see next week’s blog}. But before this appointment, there is one of   the two cataract surgeries.

Looks like my body is catching up to my chronological age.  It was bound to happen.  I just didn’t expect it all to happen in one month!!!!

Until next week,

Keep living your life!

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2 CommentsLeave a comment

  1. Hello! Do you use Twitter? I’d like to follow you if that would be ok. I’m undoubtedly enjoying your blog and look forward
    to new updates.

    • Absolutely, Salvador. It’s WhatHowearlyCKD. I’ll look for you there.


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