Breathing stops, ADD/Memory problems, chronic fatigue

[ill13632]

Hi!  I have central sleep apnea/asthma which started it seems 2 years ago with chronic fatigue and O2 levels of about 73% (my FEV1 scores are also 73%).  I'm worried my brain cells are dying and I'm having severe chronic fatigue, memory/ADD loss, headaches and sometimes vertigo.  I have a neu cyst in my clivus.  I've tried bipap with O2 but it doesn't work that well and I'm getting 0% stage 3/4 sleep.  What caused my sleep apnea, memory/ADD problem and what can I possibly do?  Thanks so much!

[ill13632]

Thanks so much!  Should I go to a neurologidt to treat my obstructive and central apnea?  I weigh about 183 and am tall so I don't know why I have this terrible disease that is destroying my career.  I can't focus like I used to when studying and I don't know if this is from sleep apnea.  
My blood sugar was high and I had low testosterone.  I heard that acetazolamide can help and tonsil surgery.  But one ENT said my tonsils were small (other said they were large and flabby) and that there would be intubation problems because of my base of tongue

[David Tinkelman, M.D.]

Having had this condition for two years, you may be aware that Central Sleep Apnea can be divided into hypercapnic (elevated carbon dioxide levels) and hypocapnic (reduced carbon dioxide levels) types. Hypercapnia occurs in neuromuscular diseases and in association with sleep-related hypoventilation. The apnea in this case is an extreme form of hypoventilation disorders that lead to hypercapnic central sleep apnea.  In either case apnea and resultant reduction of 02 levels is a serious problem, a very serious problem if oxygen levels in the range of 73% are sustained during sleep, that if not effectively addressed can lead to all the symptoms you describe.  You appear to be chronically sleep deprived and your vital organs, especially your brain, could be severely oxygen deprived.

In addition, the cyst of the clivus rarely, if large, could compromise air flow through the naso-pharynx and thus add an obstructive component to your sleep apnea.  In suggesting that bipap “doesn’t work that well” I’m not sure if you are saying it was properly used but ineffectual or that you were unable to tolerate the apparatus.  If the latter, you should work closely with members of the nearest advanced Sleep Lab to make it work for you.  Actually, in either case such consultation would be warranted.

Yours is a complex problem that warrants the expertise of a skilled sleep specialist to address two questions:  1) determination of the cause of your apnea and, 2) determination of the best, most effective PAP device and what it will take to enable you to use it effectively.

Sorry, but I cannot be more specific.

Good luck