asthma

[ill13632]

thanks so much for your help!  my FEV1 was 73 and I have asthma attacks/shortness of breath at night even on symbicort (maybe it's better on Dulera)  
I feel better after I take some oxygen and I have sleep apnea where my O2 levels fall to about 70% at night  
do I need to try a different inhaler or be on oxygen during the day?  on those finger oximeters my O2 level is sometimes around 94% during the day but I thought 100% is normal?

[ill13632]

is it possible that a worm or parasite fluke could cause sleep apnea?  I think I've ruled out any heart damage and brain damage
I feel discomfort and some sort of blockage when I drink a smoothie

[ill13632]

I was going to a doctor for over a year and they never switched me off the symbicort even though my FEV1 scores were bad.  Nothing has worked to increase my FEV1, not prednisone, albuterol, singulair.
could this be the source of my memory problems and ADD?  my day O2 is usually around 94%.
thanks so much!!!

[ill13632]

I have been taking symbicort for over a year and my FEV1 was still 73 after this.  I'm trying dulera now but I still seem to have asthma attacks in small rooms.
has my brain been damaged by 75% O2 at night (from my sleep study)?  I'm having serious memory and concentration problems which may destroy my career.  
I have a brain cyst in my clivus and have mostly clear airway apneas (very irregular graph) and hypopneas and rarely obstructive apnea.  thanks very much!

[David Tinkelman, M.D.]

What you describe suggest much less than optimum control of your asthma.  It would be important to work with your doctor to provide an optimum medical regimen and, at the same time, explore the possibility that your asthma may flare on the basis of allergens or irritants in your home or work environment.  If your FEV1 is only 73% at best, your asthma is definitely out of control.  

That you mention nocturnal asthma as your primary problem suggests that it may well be related to sleep apnea.  A fall in oxygen saturation to 70% is a most serious problem and oxygen alone is almost certainly not adequate therapy.  You should definitely be evaluated with a trial of CPAP.  There could well be a secondary benefit to optimum CPAP usage in that there is medical evidence to suggest that nocturnal asthma may subside significantly when sleep apnea is controlled.

Neither oxygen nor inhaled medication, either alone or together, is likely to provide good asthma control.  Both sleep apnea treatment and attention to environmental factors will be required.  Your best bet would be consultation with a specialist with expertise in both asthma and sleep disorders.  Under no circumstances should you abide nocturnal oxygen saturations of 70%.

Good luck