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Sleep apnea and digestive problems?

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Joined: Fri Jun 30, 2006 5:32 pm
Posts: 88
Location: Connecticut
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Fri Aug 11, 2006 11:02 am Post
I'm wondering if anybody would know if Sleep Apnea can cause either digetive problems, or cause IBS (Irritable Bowel Syndrome) to act up with more episodes?

My husband has been having increased discomfort, especially with his IBS. He also sometimes seems to have symptoms of Gall bladder disease, although, he doesn't think that's what it is. I have not yet convinced him to have a sleep study done, although I'm positive he has sleep apnea, as I've watched him stop breathing in the night and then gasp to get air again. Along with twitching of his legs, feet, and sometimes hands and arms.

I am hoping he might attend the AWAKE meeting with me in 3 weeks, so that maybe someone there might help me to convince him that sleep apnea is not something to take lightly. He is definitely in denial, and is a hard egg to crack...hopefully this will change soon.

Thanks in advance for any help you can give me.
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Joined: Sun May 07, 2006 5:45 pm
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Fri Aug 11, 2006 11:41 am Post
As usual I have some studies at the ready. Not as good as usual, given a lack of matched controls... But there is a link between some forms of sleep disordered breathing and IBS:
http://www.chestjournal.org/cgi/content ... t/123/1/87
Interesting that UARS is far more heavily associated than OSA, and it is *inversely* correlated with severity fairly well (p<0.01, they claim). It's useful to skip to the results:
http://www.chestjournal.org/cgi/content ... 23/1/87/F2
it's remarkable how many of the UARS patients have IBS!

http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Citation
Indicates that IBS causes sleep fragmentation but I guess nobody bothered to see if this was related to apnea? If only I could get to the full article! Another one I found said that of 6 people they performed polysomnography on for IBS, 3 had apnea, vs. none of controls; but given the small sample size I would not worry too much about that. Unfortunately a lot of very interesting articles turned up by google scholar are inaccessible.

This seems to be an area of active research - and one that is interesting to me as I know people who have virtually all the symptoms that seem to be UARS - insomnia, bruxism, and IBS. I (personally) am researching UARS,and its associated symptoms aggresively. I have noted again and again that UARS has distinct symptoms vs. apnea, and further that doctors tend not to notice them... the academic community apparently agrees that UARS is underdiagnosed:
http://www.co-pulmonarymedicine.com/pt/ ... 44!8091!-1

(Incidentally... "functional somatic syndromes" as referred to there includes UARS).

One of these days I will have to write up my treatise on sleep medicine...



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Joined: Fri Jun 30, 2006 5:32 pm
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Location: Connecticut
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Fri Aug 11, 2006 1:13 pm Post
SleeplessJ,
Thanks so much for the information! you are truly an asset to these forums, with your ability to quickly find information and weed out the stuff that doesn't apply.

I can't pretend that I understood every word of what was written in those articles......LOL! :lol: But, I gleaned enough information to get the general idea of them. It makes for some interesting information and I surely appreciate the time you took to look this up for me.

I'm not exactly sure what UARS is, I know what it's an acronym for, but don't know physically how that is displayed...and what the difference is between OSA and UARS is. Would anyone like to explain that to me?

I DO know that I need to get my husband to a sleep center as soon as I can because since we got married (15 years ago) I've noticed that he stops breathing and gasps for air and snores, etc. He's also had some other "mysterious" symptoms, that have never been explained. One being that he's had on occasion some chest pains on and off.....nothing seems to explain why he'd have them. They weren't bad enough for him to want to go to the doctor or the hospital, so no input from them. He's described symptoms that sound to me like gall bladder issues, as I've had problems with my gall bladder in the past. He's had major heartburn....all of these things come and go so they disappear as quickly as they appear....Lately, he's been having more problems with IBS as I've mentioned, and feeling sick to his stomach. He's extremely moody, cranky when things don't go exactly as he thinks they should, and has admitted to feeling depressed for quite awhile; he can't seem to relax on his days off, and has to constantly be doing something. He never takes naps during the day, but will fall asleep on the couch in the evenings when the lights are low and he's watching tv. I know that some of these things could just be related to diet or whatever, but when I think about ALL of them together, over the years, and the fact that he probably has some sort of Apnea......it seems like the pieces fit together.

Well, wish me luck in convincing him to go for a study!

Thanks again SJ!



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Joined: Sun May 07, 2006 5:45 pm
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Fri Aug 11, 2006 2:53 pm Post
UARS.... UARS is a minefield. Some think it's a distinct syndrome:
http://ajrccm.atsjournals.org/cgi/conte ... 161/5/1412
Some say it's not (really just apnea 'lite')
http://ajrccm.atsjournals.org/cgi/conte ... 161/5/1413
(I love those two links as they were from the same issue of the same journal!)

Generically it's defined as the brain detecting the increased pressure required for respiration such that no apnea or hypopnea event occurs, but an arousal still does. So like apnea it originates in the throat trying to close, similar to apnea or hypopnea. Detecting that is very hard, though, as the patient will seem to keep breathing normally. The usual method of detection, the esophegal baloon is about as much fun for the patient as it sounds, and so nobody does it. It is argued that a lot of "spontaneous" arousals shown in sleep studies are really UARS events - indeed Guilleminault (et al) originally "invented" UARS to describe patients who seemed to have a far larger than normal number of arousals, and seemed to respond to CPAP.

And thus ironically testing CPAP is probably the best way to detect UARS.... My personal thinking is that what Guilleminault (et al) call UARS is clinically the same as what I call "hypopnea only" OSAHS. The "not a distinct syndrome" article does indicate that a lot of UARS diagnoses evaporate into OSAHS w/only hypops when different diagnostic methods/criteria are used... Anyway, It will definitely be discussed at length in my "treatise", if I ever write it, because there's a lot more to it.

As for your husband, with a history of heartburn he should be evaluated for GERD and related damage.

I would also think it fairly likely that he has... some form of Sleep Disordered Breathing. A lot of the symptoms sound, well familiar. It's certainly worth an evaluation. With a history of observed apneas, it's almost a slam dunk for a doctor to order a sleep study, without even getting tangled up in the web of UARS symptoms.

I'm somewhat curious... if you have ever looked at ADD? (I think in DSM-IV land, we're calling ADHD inattentive subtype... whatever) Some of the symptoms sound familiar - need for constant stimulation, moody, etc. I only ask because I was diagnosed with ADD as a teen, many years before my apnea diagnosis, and the treatments for ADD - stimulant medications - are also treatments for being sleepy. Indeed, provigil, everyone's favorite narcolepsy med, was recently approved for use in ADD. Don't know how well that would "go down" given his stomach problems, but something to look into.

And yes, ADD and Sleep Disordered Breathing have been shown to be linked, as if it wasn't obvious to every fuzzy-headed apnea patient that they can't concentrate! Another topic for the 'treatise', I guess :-)



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Joined: Thu Aug 24, 2006 7:29 pm
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Location: ohio
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Fri Sep 01, 2006 8:57 pm Post
I don't know how much this will help answer your question, but here goes. I was dx with sleep apnea March,2006. In 1998 I was dx with IBS and start of colon disease and also gallstones which prompted the removal of my gallbladder. I had digestive problems before I had it removed and even since.
I don't know how long I have had sleep apnea but I have a pretty extensive medical char of various disorders and illnesses.
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