Shift work disorder?

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ratski

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My wife brought up sleep apnea this morning. I do snore. I'm going to try better sleep hygiene, then look into getting a sleep study.
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Better sleep hygiene is important, but if you have sleep apnea, getting treated is more important.
There is a good FREE app on the iphone done by a teacher/mentor of mine called "Best Sleep Hygiene".
This guy has forgotten more about sleep that I'll probably ever be able to learn.
He is one of the gurus in Dental Sleep Medicine.

No one dies in their sleep "naturally".
Sleep apnea puts an amazing strain on your cardiovascular system.
It can also cause significant oxygen deprivation.
To give you an idea, my son in law was going as long as two minutes (witnessed) without breathing.
His O2 levels were dropping below 68% at night.
If you go into the hospital with an Oxygen level below 68%, they might sliding a tube down your throat and having a machine breath for you.

Those are not good things.

OK, so you have several of the signs and symptoms. Snoring is a biggie.

Here are a few others to consider.

Have you ever awakened gasping for air?
Has you wife ever noticed you gasping while sleeping or has she noticed you not breathing for a while?
Do you have to get up one or more times while sleeping to go to the bathroom?
Is there any history of Sleep Apnea in your family?
Do you have High Blood Pressure?
What is your Neck size?
What is your BMI?
Do you have night sweats?
Do you have your tonsils?

Here is a short screening test called the Epworth Sleepiness Scale.
Answer each question very honestly and then have your wife answer them about you.
You'll be surprised at the difference.
Don't answer them by saying "yeah, well of course that happens, I'm on shift work." That isn't the point.
After you answer the questions, add up the numbers.
A score of 10 or more means you probably should have a Sleep Study.
Either a study in the sleep lab (PSG) or what is called an OCST (Out of Center Sleep Test) that is done at home.

Don't take this lightly. I'm not trying to give medical advice or a diagnosis over the Internet, but you have signs and symptoms of a problem.
If the problem is present, get it treated.
A lot of people who haven't treated the problem are dead or disabled (strokes, heart attacks)

You are in OKC? There are some very qualified docs up there. If you are diagnosed and a CPAP isn't your cup of tea, consider a dental appliance.
A word of caution if you decide on the Oral Appliance. There are a lot of DDSs who really don't know what they are doing with these.
It isn't as easy as some make it sound.
One of the best in the OKC area is Robert Talley in Norman.


Epworth Sleepiness Scale
How Sleepy Are You?

How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling tired?
This refers to daily life in recent times, if these things have not occurred recently, try to work out how they would have affected you.


Apply the most appropriate number for each situation
0--No chance of dozing
1--Slight chance of dozing
2--Moderate chance of dozing
3--High chance of dozing

1. Sitting and Reading
2. Watching TV
3. Sitting inactive in a public place (i.e. a theater or a meeting)
4. As a passenger in a car for an hour without a break
5. Lying down to rest in the afternoon when circumstances permit
6. Sitting and talking to someone
7. Sitting quietly after a lunch without alcohol
8. In a car, while stopping for a few minutes in traffic


Hope this helps.

Dave
 

BadgeBunny

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I scored 24 Dave!

I can remember a time when I used to fall asleep at stoplights ... as well as just about every other time listed there (and a few others that no normal person would fall asleep during :lookaroun). My problem wasn't sleep apnea, it was exhaustion. If you are burning the candle at both ends (and you could very well be if you are not sleeping well because of pain issues), you need to get that resolved. A number that high is dangerous to your long-term health. Probably your short-term health, too. How's your gout? Are you still hurting bad??
 

dennishoddy

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I scored 2.

Lying down to rest in the afternoon when circumstances permit.

Rarely. Yet my wife says I snore, and quit breathing for short periods of time.

I've never been a napper, or fall asleep when becoming inactive. Done an afternoon nap that I can still count on one hand.
 

ratski

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I scored 24 Dave!

If you seriously scored a 24, and haven't not been seen for the possibility of a sleep related disorder, you really SHOULD address this with your MD.
If you bring it up with him/her and tell them that you took an Epworth Screening and got a 24 and they have no real concern or understanding of the significance of the number (very likely with a lot of MDs), then ask them for a referral to a sleep specialist.

A number this high is very significant.

Dave
 

cvrx4

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I started out on days. I worked 6 am to 230 pm. I had a thirty minute commute. I had to be up around 5 am everyday. I hated it, I was always tired. I would almost fall asleep at my work station around 9am or so. I would have to yell at myself on the way home and more than once almost ran off the road. I would get home and try to take a nap before my wife got home but when she woke me up around 530 pm all I wanted to do was go back to sleep. It caused real issues in our marriage I was always tired.

My director asked me to pick up a night shift one night to cover for someone that was gone on vacation. I LOVED IT. It was easu for me to stay up all night and then drive home the next morning. I have never once fallen asleep on night shift and I have gotten less sleep. I have been on nights for over 8 years now. I have had ample oppurtunity to go back to days in a supervisory position but have not done it. My wife worries if I ever go back to that schedule. The only real issue is going to sleep at nights I am off and if I have to do something around 9 or 10 am. Other than that I am good to go. It just feels more natural to me. I am not sure why.
 

mapcon1941

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I work 12 hour rotating shifts as well. I notice that a high percentage of coworkers have related health issues ie. diabetes and high blood pressure. I guess it goes with the territory. I also have sleep apnea and the CPAP was/is a life saver. The sleep study sucks, but would be worth it if you are are diagnosed then treated. There is also a drug called Nuvigil or something along that spelling that will help you be awake during the day when you are on nightshift and try to live a normal life. I take it very little, and only when necessary, but it does help.
 

ratski

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I work 12 hour rotating shifts as well. I notice that a high percentage of coworkers have related health issues ie. diabetes and high blood pressure. I guess it goes with the territory. I also have sleep apnea and the CPAP was/is a life saver. The sleep study sucks, but would be worth it if you are are diagnosed then treated. There is also a drug called Nuvigil or something along that spelling that will help you be awake during the day when you are on nightshift and try to live a normal life. I take it very little, and only when necessary, but it does help.

Diabetes and High blood Pressure are both directly related to the presence of Sleep Apnea.

The "in Center" sleep test can be a bit much for some folks, but there is also the availability of an Out of Center Sleep Test.
The one that I use in my office is about the size of an ipod that straps onto your wrist.
There are a few leads on your fingers and one that goes near the area of your throat and chest.
You put it on your wrist, get the leads fixed right and push a button.
The machine says "good night" and that is is.
You sleep in your own bed at your own time

Dave
 

tRidiot

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Ratski's right... sleep apnea is a huge problem and very dangerous for sudden death while sleeping. This was likely a significant contributing factor in the death of the "Minister of Defense," for those of you NFL fans who might recognize that nickname.


My problem was always not being able to convince them to go for the testing, or those who did, couldn't get them to wear their sleep apparatus. Had several patients die in their sleep that I am convinced this was a factor. :(
 

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