About three years ago I was diagnosed with obstructive sleep apnea. Sleep Apnea occurs when the airway is obstructed and you cannot breathe while sleeping. This causes a brief and unconscious waking up (This is a called an apnea). If you have enough apneas, sleep will become very fragmented. The most common symptom of Sleep Apnea is extreme daytime sleepiness.
For the last three years I have had a Continuous Positive Airway Pressure (CPAP) machine to treat my sleep apnea. The machine works by blowing air into my nasal passage. The positive pressure of the airflow inflates the airway much like a balloon so that it will not collapse and obstruct my breathing.
Over the last month or so I started to question my sleep apnea therapy. My CPAP machine is set to a fixed pressure based on one crappy night of sleep in a sleep lab three years ago. The CPAP machine I got was not too smart; it recorded every four hours that I used the machine and the total amount of time it has run. I don’t have any other data to look at for how effective my therapy is other than how do I feel. Some mornings I feel great other not so.
At the start of December I decided to try a new approach and get more information about what is really going on when I sleep. I purchased a new DeVilbiss Travel Auto Positive Airway Pressure Machine (APAP). The APAP machine works on the same principle as the CPAP except that it has sensors and can automatically adjust to the minimum effect pressure. I can collect lots of information from the APAP machine to that with my doctor.
My experiment for December:
- Baseline my sleep for a week with the new machine
- Stop taking Sudafed and see if my sleep is impacted
Baseline sleep for one week with new machine
My sleep didn’t look too bad during the baseline. Here are some of the cool graphs I extracted from the monitoring software.
Apnea Hypoapnea Index(AHI) – Number of Apnea and Hypoapneas per hour
Apnea Index (AI) – Number of Apneas per hour
Stop taking Sudafed and see if my sleep is impacted
I have been taking Sudafed daily for the last 10 years for nasal congestion. It has been nearly impossible to get off the stuff. I have not made it more than a few nights without it for the last 10 years. I have researched what the side effects of Sudafed are. But I could not find any conclusive information on the long term side effects. I am making an educated guess that over time the body becomes resistant to the effects of the drug. However the symptoms that it relieves are likely to get much worse when Sudafed is stopped after long term usage.
I have experienced a full 1.5 weeks of sleep without Sudafed. The first 4 days were pretty horrible, I experienced stuffy nose, dry eyes and lack of energy.
From my experiment I determined:
- I need about 15 minutes more sleep per day than I did when taking the Sudafed
- My AHI/AI numbers increased but are still in range of effective therapy
Other observations
I have noticed in the nightly report my snore index has increased significantly without Sudafed. The snore index is related to the vibrations (not audible) that are sensed by the machine. I believe the algorithm used by the APAP detects snore vibrations prior to actual snores and increases pressure until the snore vibration stops. The system makes a similar correction to bring the pressure down. When it lowers the pressure and starts detecting snore vibrations it will raise the pressure to minimize snore vibrations. The real advantage of an APAP is the constant search for the minimal effective pressure. The snore index is the primary feedback the system has on how you are responding to therapy.
Here is a snore index chart for a typical night taking Sudafed.
Here is a snore index for a typical night with no Sudafed. Notice that there is a significant increase in the snore index events without Sudafed.
Conclusion
I don’t really want to use Sudafed again and correlate the results of my experiment with and without Sudafed. However I can say that Sudafed seems to help sleeping with Sleep Apnea but its effect is not significant and the long terms risks of Sudafed are probably not worth taking.
I have been without Sudafed for a little over a week and feel pretty good now. The first 4 days were very difficult. I recommend that if you quit Sudafed you start on a Friday and hopefully by Tuesday morning the worst of it is behind you.
Please remember these are my results, they may not match yours. Please consult with a professional before altering your sleep therapy.
Later this year I want to experiment with playing the didgeridoo. I have read that several studies have shown it to reduce sleep apnea.
The nightly snore index has been improving significantly. I averaged about 10-40 snores per night in December. Through January and February my snore index is usually under 10 per night.
