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I have been struggling with what indications seem to point to is apnea.  An overnight pulse-Spo2 check indicates that O2 dropped to 89% 3.6% of the time.  Lower readings were small: 88% 1.2%, 84-87%, 0,6% of the time.  There was no rise in heart rate.  Most of the time my SpO2 was above 95% except for about 90 mins where it dropped to the low 90s and briefly below 90 as stated above.  This period was mediately after I took 2mg Lunesta and 3mg melatonin.  I suspect that the Lunesta lowered my breathing.  Please comment on that.

However, my wife informs me that I do stop breathing for a few seconds at a time.  I asked her for more info such as how long, but she always shakes me after a few seconds until I breath again.  According to some articles cessation of breathing is normal if less than 10 seconds an less than 10 times an hour.  I have instructed her to not disturb me until 10 seconds has passed. However, there should be 'breath-omoters' just like there are pulse oxyometers.  I am looking into that as well.  Please comment.

I would like some ideas and suggestions whereby I can further diagnose my condition.  If I have obstructive apnea, then that can be cured by changing my sleep position or something.  BTW, I am not overweight.  

What are the general cures regarding central sleep apnea?
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The gold standard is a diagnostic sleep study and titration in a lab. It would differentiate between obstructive, central, or complex sleep apnea or UARS. It would also determine if it is exacerbated, decreased or eliminated by sleep position, and if you are prone to centrals at higher pressures.

If you want to go with the assumption it is the garden variety obstructive sleep apnea, you could get a loaner data capable auto titrating cpap machine to use at home and the data would show what pressure would alleviate your episodes of reduced and/or stopped breathing. The machines are programmed that an episode has to meet certain criteria before it acknowledges them as events, so brief normal events are taken into consideration.

Some with mild OSA can be helped by raising the head of their bed a few inches, staying off their back, or stomach sleeping. Or by wearing a boil-and-bite mouthpiece that pulls the lower jaw forward. Or by avoiding alcohol and sleep aids. The danger is in having a false sense of security in these measures without knowing for sure.

Central sleep apnea is a whole different story. It is neurological in origin and could have any number of causes, and in my opinion too complicated to even consider self diagnosing or treating. If I was formally diagnosed with true CSA, I'd want to be under the care of the best neurologist and sleeping with a highly specialized machine designed to take over breathing when the brain doesn't send the proper signals.

The fact that you are not overweight lends to the probability that if you have OSA, it is likely due to the structure of your throat, thus longstanding. It is great you are looking for answers. Maybe your situation dictates you try self diagnosis first. It's just that it's not an exact science and trial and error can be time consuming. In the meantime, if you have sleep apnea, treament is delayed. And your poor wife must be frazzled if she has to stay awake in fear of you not breathing. Best wishes in your endeavor.
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Avatar_n_tn
Thank you for your comments.  I am guessing that by 'complex' you mean a combination of obstructive and central, right?  I'm not sure what you mean by 'decreased' or 'prone to higher pressures'.  

We agree that a sleep study is the standard diagnostic.  While it may establish the nature of my ails, they are expensive and so can be the treatments, neither of which I can pay for.

As to trying different positions... I can say that I tried to stay on my side last night, and I slept for 6 hrs with only 3mg melatonin.  This seems to indicate that it is obstructive.

The rent-a-CPAP seems like a good place to go from here.  I also tried to relax my jaw and I can see how that can obstruct my throat.  I was not away of a boil and bite aid: I was thinking of strapping my jaw closed with an elastic band.  (I saw a web site selling them for $60, I can make of for far less)

I am not sure I can agree that 'not knowing for sure' is a danger.  If these low cost approaches do not work, then I will have to eventually get into a sleep center.  but, for now I need to mitigate costs until I exhaust the possible lower cost solutions.  I do not drink any alcohol nor use any drugs other than the Lunesta.

It seems that CSA be only be determined at a sleep center.  Since obstructive  accounts for 85% of the cases, it seems prudent to explore remedies for OSA first.

From what I have read... overweight are far more likely to get OSA than those who are not.  I do not believe that my condition was 'longstanding'.  (I am taking that to mean that I have had it a long time)   It seems to me that I was sleeping just fine as I did not have the observable side affects such as difficulty to stay awake at work, etc.  This all changed after I returned from the Philippines, or possibly after a bout with 'walking pneumonia' which I was diagnosed as having a week after I had returned.

True, I am one to rely on myself, and in this case I want to be a part of the solution and not be dependent on others for the answers.  Often these others have a financial interest not in my favor.  Medicine in America has become so expensive that even a small ailment can ruin a families finances.  This is in part to society being conditioned to expect the best medical attention that money can buy.  Unfortunately, it is more often than not their money doing the buying, but others either from high insurance premiums or from the tax payer.  I do not wish that burden on anybody.

Again, thank you for taking the time to respond.
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Avatar_n_tn
Yes, sometimes circumstances determine we've got to make our own way, and it appears you are doing your homework and making informed choices.

Some apneas can contain more than one type within an event, and some people can have events each of one type, but with both types occuring in different events. There are technical definitions of what constitutes complex apnea and mixed sleep apnea, but I was really just pointing out some cases are outside the standard OSA. I've read that many machines you would rent will not differentiate centrals, but that some give better indicators in the data than others. I wish I could be more specific, that would be a research project.

By "decreased' I meant that some have fewer or less severe events on their side or stomach, even if not they are not eliminated. The reference to higher pressures was about how some people who originally were diagnosed with OSA start showing centrals when their cpap pressure reaches a certain point. This again would be the exception not the rule.

My comment about yours possibly being longstanding was just me thinking that if it is your throat structure at issue, it has not likely to have changed much as an adult, unless the issue is laxity of soft tissues. There are even some jaw structures (inset) that can contribute to narrowing of the airway. And often when we are young and strong we can amazingly compensate till there's a tipping point. Please don't take any of my comments as me thinking I know better than you what's going on with you. I was just dropping some things to consider (and possibly discard as irrelevant) as you go forward.

About chin straps, I'm using a homemade one myself. One key is for it to not push the chin inward. Mine goes from behind my jawbone gently pushing it forward to up under my chin holding it up tight. It has a slight stretch so I can push my mouth open if need be.

If you research the type of machine you do or don't want and what they are REALLY worth, you can find some great deals online. See if that is as economical as rental costs.  If from an online vendor, you would need a doctor's prescription (as well as with any rental). but I see used machines all the time being sold by private owners for a fraction of the new cost and often barely used. Watchouts: Best to make it local to check it out first. Does it matter if from a smoking home or one with pets? Has it been scented to camouflage an odor and the new odor even worse? Check the serial number for recalls. Google and learn how to access the machine's blower hours if any doubt that the user hours have been "rolled back".

Best wishes as you go forward. By the way, I know someone who has successfully done what you are doing.
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Avatar_n_tn
While sleep apnea can be complicated, I believe that it is basically obstructive.  My wife observed me for 45 minutes about 2 hrs into my sleep.  I appeared to stop breathing for about 3-7 secs, then turned a bit, then resumed breathing.  She counted this 4-5 times before I woke up.  This is under both the 10 sec/10 times an hour rule mentioned at some info sites.

Indeed, I do seem to sleep better on my side.  However, I have no control what position I assume during the night.  I usually end up laying on my back.  I have started to experiment with different head positions, and maybe I can find one that I can naturally lay in.  I definitely have an underbite allowing my jaw to sink into my throat.  I will try to fashion a strap as per the one you described.  Maybe that can help a lot.

I do not see a machine as a cure, nor do I like the idea of using one.  Traveling can become more complicated.  The problem is how to avoid the obstruction.   A strap is surely worth a try.

I do appreciate your comments, thank you.  
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