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Respiratory Disorders (Expert Forum)
sleep apnea and other considerations
Answered by
MN
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sleep apnea and other considerations
by bluedylan, May 05, 2008 01:03PM
Hello, I am a 30 year old male who is 60 pounds overweight, however I do exercise for 30 minutes per day at a target heart rate of 150-160. I have an ex smoking habit of about 12 yrs, 1 pack per day. My cholesterol is 153 and triglycerides are normal.
For about 6+ months I've been experiencing a constant very heavy, tight feeling in my chest that does not get worse with exercise. It feels sometimes like it keeps me from getting a deep breath easily. Sometimes I just feel breathless at rest.
I also have had symptoms of chronic lightheadedness and nausea, and feeling like I may faint (but my blood pressure is normal during these episodes). These symptoms have become quite debilitating and disabling.
Sometimes i may wake up at night feeling like I'm having trouble breathing, or rather, a trouble sense of breathlessness, but I never hear wheezing; I have even rarely awoken with severe sinus tachycardia of 160+, which was non-sustained, once I caught my breath.
I saw a doctor who had got me a chest xray, echocardiogram, and a regular stress test. These, and my thyroid/liver, etc. were normal.
But, I have seen a new doctor recently and he has noticed from his new labs, and my old records that my hemoglobin is consistently high-normal for the past 3 years, (i believe he said it was 16.7...I forget if that was right).
He thinks this is a sign of oxygen deprivation at night and thinks I have severe sleep apnea.
Would you agree that these lab results and other signs point to severe apnea?
Are there other considerations to make as well, given the troubling chest symptoms I have? The new chest Xray and EKG were normal, just the hemoglobin a bit high as usual. (i live at an elevation of 800 feet and don't smoke anymore).
I will be having a sleep study soon, but I wanted to just see if this seems as cut and dry to you?
And importantly, are these other considerations to make given my symptoms?
Thank you.
For about 6+ months I've been experiencing a constant very heavy, tight feeling in my chest that does not get worse with exercise. It feels sometimes like it keeps me from getting a deep breath easily. Sometimes I just feel breathless at rest.
I also have had symptoms of chronic lightheadedness and nausea, and feeling like I may faint (but my blood pressure is normal during these episodes). These symptoms have become quite debilitating and disabling.
Sometimes i may wake up at night feeling like I'm having trouble breathing, or rather, a trouble sense of breathlessness, but I never hear wheezing; I have even rarely awoken with severe sinus tachycardia of 160+, which was non-sustained, once I caught my breath.
I saw a doctor who had got me a chest xray, echocardiogram, and a regular stress test. These, and my thyroid/liver, etc. were normal.
But, I have seen a new doctor recently and he has noticed from his new labs, and my old records that my hemoglobin is consistently high-normal for the past 3 years, (i believe he said it was 16.7...I forget if that was right).
He thinks this is a sign of oxygen deprivation at night and thinks I have severe sleep apnea.
Would you agree that these lab results and other signs point to severe apnea?
Are there other considerations to make as well, given the troubling chest symptoms I have? The new chest Xray and EKG were normal, just the hemoglobin a bit high as usual. (i live at an elevation of 800 feet and don't smoke anymore).
I will be having a sleep study soon, but I wanted to just see if this seems as cut and dry to you?
And importantly, are these other considerations to make given my symptoms?
Thank you.
Doctor's Answer
by National Jewish, May 09, 2008 06:59PM
, May 09, 2008 06:59PM
The elevated hemoglobin, albeit a mild to moderate elevation, for one who effectively lives at sea level, may be an important clue. Yes it could result from nocturnal hypoxia, due to sleep apnea, but it could also reflect the presence of acquired abnormal hemoglobin or be consistent with chronic carbon monoxide (CO) poisoning. Many of the symptoms you have experienced could also be due to obstructive sleep apnea or to CO poisoning.
You might want to search your memory to note if there have been periods of diminished symptoms when on vacation, away from both your home and your car and place of employment.
You should proceed with the sleep study, have your hemoglobin evaluated by hemoglobin electrophoresis and have a carbon monoxide blood level checked. Despite the allegedly normal stress test, these symptoms could also be coming from your heart, due to small blood vessel disease and/or cardiac arrhythmias.
You might want to search your memory to note if there have been periods of diminished symptoms when on vacation, away from both your home and your car and place of employment.
You should proceed with the sleep study, have your hemoglobin evaluated by hemoglobin electrophoresis and have a carbon monoxide blood level checked. Despite the allegedly normal stress test, these symptoms could also be coming from your heart, due to small blood vessel disease and/or cardiac arrhythmias.
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