Snoring vs Sleep Apnea / Night Owl

denverpilot

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The other thread on snoring and sleep meds made me decide to ask questions.

I snore. My wife snores. About every person in both our families as far back as we can remember, snores.

Now lets throw in here that I've never been a good sleeper. Once I'm out, I'm out and nothing but WWIII will wake me. I even have an extra loud alarm clock that's only marginally effective if I haven't gotten enough sleep.

If I get eight hours, no problem. We all know what a challenge that can be. I'll wake easily on my own.

I'm also a big time night owl. Ever since I can remember I'd much rather be awake at night than during the day. Obviously this is inconvenient at best.

None of this is "changing". The experts always say if you're seeing differences in your sleep patterns or whatever, they can be a sign of underlying medical conditions. This stuff is life-long for me.

One of the crazy things about working with Jesse in Nebraska this year on my IR was that due to his work schedule, we flew almost exclusively in the afternoon and well into the night. I thought this was GREAT! The joke that "no prop should turn before noon" by Jeb Burnside on the Uncontrolled Airspace podcast, hits me just right.

So I cope. Early mornings and I rarely get along, but can be tolerated for brief bursts. In one job many years ago, I was required to be there in time for a 5AM start. During that year, I was continually drained and found myself with little brainpower and no energy for weeks on end. The sleep cycle never really adjusted forward on the clock. I ran on 4-5 hours of sleep for a year with 12+ hour weekend catch-ups that would make things worse.

When I was a kid, no one had ever heard of sleep apnea. Now it seems every fourth person I meet is using a CPAP machine.

Since this is about aviation medical issues, I'll stare that I never fly "tired" and I've cancelled flights for fatigue. Not a lot, but I've read how well the poor girl who was in the right seat of the Colgan flight slept in the days leading up to her and her passenger's deaths.

So naturally, my mind wanders to thinking about whether or not one should do a sleep study. The Internet has a way of convincing you that you have every disease on the planet.

I know a number of people here use a CPAP and have been diagnosed with obstructive sleep apnea. I've also read that many of you "always felt tired" or had other symptoms. I don't. My body just doesn't like sleeping at what most others would call "normal" times.

Before someone jumps on the "exercise more" bandwagon, I'll say that heavy exercise has an effect. I can utilize it to make myself more tired for short periods of time. Maybe even a month. But the cycle rebounds and I'm up at 2AM again in short order.

I've had jobs my whole life where being alert at 2-4AM is often useful. Bosses seem to figure out I'm not so useful at say, 6-7AM most days, but they can call me at midnight and know I will be fine with a request to fix something at 2AM, without even batting an eye. So they usually have a love-hate relationship with my natural rhythm.

I guess what I'm wondering is this... My GP has no answers. He'd probably order a sleep study for me if I asked. He's a screwball marathon runner who believes what works for him, works for all of his patients and recommends his neurotic non-stop motion as the fix for everyone. Heck, he may be right. I would certainly drop where I stood into a deep sleep if I ran as much as he does. Or my body would condition itself and I'd be a wide-awake night-owl with an emaciated body, slamming in 5000 calories a day just to exist. Haha.

So I'll ask. What would you do? Get a sleep study? Ask someone to hit you over the head with a frying pan at "bed time"? Become a midnight novel writer? (Oh wait, I already do that on PoA! Grin...) Take up a new line of work where graveyard shifts are commonplace?

Let's throw another one out there... If something is going on in a few days that's so damn cool I *must* be a morning glory, I can always fake it for a few days. I've even done the trick of getting a nap in, waking up at 2AM and starting the "day" from there.

Is there a "night-owls anonymous" group? Should I be standing up front saying, "Hi, I'm Nate and I'm a night owl. The last time I went to bed after midnight was three weeks ago. I've been sleeping ever since." A little 12-step action?

Mount some 747 landing lights to the ceiling in the bedroom and put 'em on a timer that can't be overridden? (Pretty sure Karen wouldn't like that.)

Anyway... Thoughts? Any other secret night-owls out there in PoA land? Anyone ever beat it for a significant period of time, say... at least a year where you were in bed every night before midnight?

To throw some levity in here, dad is the opposite. If you try to reach him after 9PM you'll never get him. He's usually up at 04:30 at the latest. Pin drops wake him up.

Oh... And on the very few occasions I've had where I had no job or vacation for extended periods of time (weeks), the cycle doesn't really change.

There's a reason there's a lot more than average number of night hours logged in my logbook. ;)

What say you? Night owl? Early bird?
 
My schedule is all over the place. When I get really busy with work sometimes I'll skip sleep for a night or two. Sometimes I'm getting up every day at 6am and other times I'm staying awake until 6am.

Honestly it doesn't matter for me. I can flip my schedule in any which direction without much pain. The biggest problem is that if I can't figure something out -- I'm not the kind of person that just goes to bed and sorts it out the next day. I stay up until I've fixed it. As a result my schedule always tends to drift back to late night stuff.
 
I've never considered myself to be a night-owl or early riser. The problem I have is that my circadian rhythm seems to run on a 25-26 hr clock. When there's no external schedule to keep it seems I tend to get tired and fall asleep an hour or two later each night and wake a correspondingly later time each morning.

As to the snoring vs sleep apnea, it's my understanding that the two are nowhere near synonymous. You might be able to learn more about your sleep habits simply by leaving something that records sound running overnight. I think that continuous or intermittent snoring without cessation of regular breathing would indicate that you don't suffer from SA, but if the recording includes any indication of irregular breathing it might be a good idea to check further. A doctor might even be able to interpret such a recording.
 
Getting diagnosed with sleep apnea may ground you. I had a history of it, and had even had surgery to correct it, and got my 3rd class medical deferred until I had a new sleep study with no apnea and also completed the FAA maintain wakefulness test (sit for 8 hours in a recliner in a darkened room, staring at a wall, after a urine test for caffeine or other stimulants, hooked to an ekg machine to make sure you stay awake). Even after that, I had to have a letter from an ENT doc stating the surgery had resolved my apnea before I got cleared. Delayed my first solo flight by a couple months and cost me several thousand dollars for the tests.

If I had not been able to demonstrate a lack of symptoms, I believe it requires a special issuance and possibly a "logged" cpap machine where you have to submit proof you are using it every night. One of the local AME's can maybe comment more, I luckily did not end up going that route.

Just something you might want to know before you go and seek a diagnosis.

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Snoring is a symptom of sleep apnea, but not everyone who snores has OSA. If you notice, or your wife notices, that you wake up suddenly with a gasp - that's a pretty good indicator. Close your throat and try to inhale for about 10 seconds and then open your throat - you just simulated an apnea. A sleep apnea diagnosis requires a certain number of those per hour, I can't remember the number. These apnea events force you to 'wake up' even though you won't necessarily be conscious, and they mess with your O2/CO2 blood chemistry.

Being tired all the time is pretty normal due to stress and odd work and home schedules. Others, like you, just seem to have different biorythms or something. But being exhausted like you just pulled an all nighter, every single day, is another sign of OSA.

As far as I know, the only way to find out is with a sleep study. The SI is a pain to get the first time, but it's a very simple renewal.

I think there are diets or other schedules that people use to combat jet lag, something like that might help change your wake/sleep schedules if you need to.

As for me - I like getting up early, and I have no idea why.
 
If you are really wanting to know, then the sleep study will probably be the best way to go. However, they are not always conclusive. I have had two and the results were mixed simply because it has always been difficult for me to sleep well in anything other than my own bed.

Having said that, I had been having problems being tired during the day; feeling like I didn't get a good nights sleep. Ended up being diagnosed with sleep apnea and had the surgery. Wow, what a difference that made. No more being tired; no more heavy snoring. Felt great.

Started gaining weight and ended up with a recurrence of mild sleep apnea diagnosed after another sleep study. Lost a bunch of weight and the sleep apnea is gone again. No more snoring and sleeping great.

Diet and exercise plays a big role in your sleep habits.
 
Seems like the consensus from those living with it is a constant sense of tiredness. I definitely don't experience that.

I'd spend eight hours fidgeting in the "test recliner" just fine on a normal sleep night, I'm sure. In fact, being stuck in a recliner with nothing to do would be annoying as hell. Ha.

I would be dying to grab the Kindle and finish the damn Civil War trilogy by Selby Foote that's taken me half a year to read. Only 100 pages more to go. I guess it'll probably be finished in 2013. (I think I know how it ends, but don't spoil it for me. ;) )

Did y'all know U.S. Grant used to stuff roughly 20 cigars to smoke in all of the pockets of his uniform on the morning of any large battle? I didn't.

And that Lee was constantly riding to the front to rally troops who would break out in a chorus of "Lee to the rear! Lee to the rear!" trying to convince their beloved commander to retire rearward and that they'd fight for him if he only would get out of there? Dedication. Wow.

Never worked for any leaders worthy of that, myself. I wouldn't exactly say any of them ever came anywhere near the front lines, but if they did, nobody would be telling them to get out of the line of fire, that's for sure. :) :) :)
 
I have been one of those "night owls" since I was a kid. I'm now 52. Mornings and I have never seen eye to eye. Fortunately, for the past 10 years I've worked exclusively at night. I sleep much better during the daytime than I do at night. Unfortunately, that arrangement appears to be coming to an end soon, and I will likely be compelled to start work at 8 a.m. some days. EIGHT a.m.!! Does the world really function at that hour? Most of my (day-oriented) friends say, "Oh, how nice!" Like hell. It will suck.

I guess I can look forward to cancelling more flights due to fatigue, since when I arise at 6, no matter what time I tried to go to bed, I am exhausted for the rest of the day.
 
Seems like the consensus from those living with it is a constant sense of tiredness. I definitely don't experience that.

I'd spend eight hours fidgeting in the "test recliner" just fine on a normal sleep night, I'm sure. In fact, being stuck in a recliner with nothing to do would be annoying as hell. Ha.

I would be dying to grab the Kindle and finish the damn Civil War trilogy by Selby Foote that's taken me half a year to read. Only 100 pages more to go. I guess it'll probably be finished in 2013. (I think I know how it ends, but don't spoil it for me. ;) )

Did y'all know U.S. Grant used to stuff roughly 20 cigars to smoke in all of the pockets of his uniform on the morning of any large battle? I didn't.

And that Lee was constantly riding to the front to rally troops who would break out in a chorus of "Lee to the rear! Lee to the rear!" trying to convince their beloved commander to retire rearward and that they'd fight for him if he only would get out of there? Dedication. Wow.

Never worked for any leaders worthy of that, myself. I wouldn't exactly say any of them ever came anywhere near the front lines, but if they did, nobody would be telling them to get out of the line of fire, that's for sure. :) :) :)

Go to bed! What the heck are you telling us about the Civil War at 4:27 am?! Seriously, you sound like many people who just enjoy nights more than days. Me too... If you have been like this your whole life, you probably don't have a problem. Many people also snore and don't have sleep apnea. I snored until I lost 70 pounds. If you are overweight, losing it might help. It did for me both times I lost 70+ pounds. If you really want to drive yourself nuts, go to webmd.com and starting looking up all those aches and pains we all get. You'll spending all of your waking hours in a doctor's office.

You better get to sleep or Santa is going to fly over your house and leave you nothing!
 
Eight hours in a recliner?? I'd sleep just to stave off debilitating boredom!!

In the dark! What are they thinking. Anyone will sleep without interaction.

I'm down by 10pm, up before 4 am. 12 hr from the time I leave home in the morning until home again. I get a couple of 1hr naps during the day commuting, another person drives. No problems.

While on active duty it was normal to have long work days with 14-18 hr long flights.

When I sleep, I sleep soundly. Always been a snorer, all my brothers the same.
 
Eight hours in a recliner?? I'd sleep just to stave off debilitating boredom!!

It's not 8 hr at once. Every couple hours you have to kick back with no tv , and the lights dimmed for something like 20 min. This gets repeated every couple of hours for a total of 8 hours.
 
Eight hours in a recliner?? I'd sleep just to stave off debilitating boredom!!

Yeah, not fun. No TV, no reading, just stare at a wall. Had to wean myself off caffeine for 2 weeks prior also. I was worried that if I went cold turkey on my morning coffee I would doze off just from boredom.

Still not sure how that proved I'm medically fit to fly a plane on any given day, but hey, I got my medical and I'm not complaining.

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It's not 8 hr at once. Every couple hours you have to kick back with no tv , and the lights dimmed for something like 20 min. This gets repeated every couple of hours for a total of 8 hours.

If I recall correctly it was 4 sessions, 2 hours each in the chair, with a 15 minute break in between.

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If I recall correctly it was 4 sessions, 2 hours each in the chair, with a 15 minute break in between.

Sent from my SCH-I535 using Tapatalk 2

there are diff protocols, but most that I'm aware of are either 20 or 40 min in the dark, every couple of hours. You must have gotten a different version.
 
How much does the wakefullness test cost?

Can't remember. I live in a town with a lot of GA and Center controllers. FAA doesn't always require it, but it is OK to do it preemptively. The sleep tech told me that DOT requires truckers to take it annually and also said the only two people he's seen that failed were truckers.
 
How much does the wakefullness test cost?

When I did it in Plano in 2010, it was about $1100. And that included lots of the doc's time going over the results. Dr. John Debus was a good find.
 
Can't remember. I live in a town with a lot of GA and Center controllers. FAA doesn't always require it, but it is OK to do it preemptively. The sleep tech told me that DOT requires truckers to take it annually and also said the only two people he's seen that failed were truckers.

I drove trucks for several years, and I've never even heard of the maintenance of wakefulness test outside of aviation.

I've heard that they're using neck measurements to require some drivers to do sleep studies these days, but despite being overweight myself, mostly due to my time in the trucking industry, I've never had to do anything like a sleep study or maintenance of wakefulness test.
 
I drove trucks for several years, and I've never even heard of the maintenance of wakefulness test outside of aviation.

I've heard that they're using neck measurements to require some drivers to do sleep studies these days, but despite being overweight myself, mostly due to my time in the trucking industry, I've never had to do anything like a sleep study or maintenance of wakefulness test.

Don't know how DOT decides who gets it, that's just what the tech told me.
 
How much does the wakefullness test cost?

It was about 1 AMU. The place I did it had never heard of doing it for the FAA and said they do it for truckers usually.


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Nate, ask for an overnight home recording sleep saturation study. That is INCAPABLE of rendering a diagnosis, but can be suggestive. It's in certification "middle ground". Just make very sure the office does not code it as sleep apnea.

The agency is discussing, however, demanding such screening based on BMI so beware if you are 29 or above.
 
The agency is discussing, however, demanding such screening based on BMI so beware if you are 29 or above.

Argh! IMO, the BMI scale is pretty far off for us tall guys. Bruce, last time you saw me I'd have had a BMI around 39.55, which would put me not overweight (and I am), not obese (and I probably was that too), but MORBIDLY obese.

Currently, I'm at about 36.5. Lowest I've been in the last 8 years was 32.5.

For my height (6'4"), the supposed "normal" range is 152-205 pounds. I recently came across a pic of myself from 1993 where I'd have weighed about 175... You can see my ribs! I also remember from back then that I had so little body fat that I could see the blood vessels in my arms. 152 would be unhealthily low!

Even the high end of that, I'd be pretty darn skinny. At a BMI of 29, the upper end of the "overweight" range, I'd be 238. That probably sounds like a lot for the shorter folks, but for someone of my height, 238 is pretty skinny. So now we're going to have to submit to sleep studies for the medical? Grrrrrrrr. :mad2:

Please keep us posted on this... Thanks!
 
Argh! IMO, the BMI scale is pretty far off for us tall guys. Bruce, last time you saw me I'd have had a BMI around 39.55, which would put me not overweight (and I am), not obese (and I probably was that too), but MORBIDLY obese.

Currently, I'm at about 36.5. Lowest I've been in the last 8 years was 32.5.

For my height (6'4"), the supposed "normal" range is 152-205 pounds. I recently came across a pic of myself from 1993 where I'd have weighed about 175... You can see my ribs! I also remember from back then that I had so little body fat that I could see the blood vessels in my arms. 152 would be unhealthily low!

Even the high end of that, I'd be pretty darn skinny. At a BMI of 29, the upper end of the "overweight" range, I'd be 238. That probably sounds like a lot for the shorter folks, but for someone of my height, 238 is pretty skinny. So now we're going to have to submit to sleep studies for the medical? Grrrrrrrr. :mad2:

Please keep us posted on this... Thanks!

Absolutely agree on the BMI for tall guys. I'm your height and there is no way I could weigh anywhere near the middle of that range. I have tried out a whole bunch of the 200 numbers. The lower I go, the more times I get sick, I don't feel well and all the fat pilots bully me

I wonder when BMI was last updated from the original work to develop it. Reminds me of the science behind the "you need to drink 8 glasses of water a day" myth. The researcher who did that work said years later that the work wasn't done to determine how much water you should drink a day, rather it was a determination of the average amount of water a person consumes from different sources of liquids and foods throughout a normal day.
 
Nate, ask for an overnight home recording sleep saturation study. That is INCAPABLE of rendering a diagnosis, but can be suggestive. It's in certification "middle ground". Just make very sure the office does not code it as sleep apnea.

The agency is discussing, however, demanding such screening based on BMI so beware if you are 29 or above.

If the FAA worked as hard on improving their system as they did disqualifying pilots ....... well never mind.

I understand their concerns about pilots falling asleep, but, and this is an honest question, other than the few times airline pilots have fallen asleep and over flown destinations is there any documentation of GA pilots falling asleep and killing themselves because they have sleep apnea?

We are all aware of what fatigue can do to our piloting skills as well as lack of oxygen, and so on. But is the sleep apnea focus a real problem or an implied one.

It appears to be a knee jerk reaction but if anyone has information on the facts the FAA is using I would love to be enlightened.
 
If the FAA worked as hard on improving their system as they did disqualifying pilots ....... well never mind.

I understand their concerns about pilots falling asleep, but, and this is an honest question, other than the few times airline pilots have fallen asleep and over flown destinations is there any documentation of GA pilots falling asleep and killing themselves because they have sleep apnea?

We are all aware of what fatigue can do to our piloting skills as well as lack of oxygen, and so on. But is the sleep apnea focus a real problem or an implied one.

It appears to be a knee jerk reaction but if anyone has information on the facts the FAA is using I would love to be enlightened.

Don't forget that FAA medical covers not only the pilot population, but the ATC guys too. Recall there has been a few more news stories about those guys napping on the job than pilots falling asleep.

You used the phrase "falling asleep". In my view being over fatigued and near sleep is a worse case and more dangerous. All sorts of bad things happening in this state. Greatly reduced reaction times, hallucinations, potential situational blindness. All not things you want an air traffic controller experiencing when this sector goes from sedate to excrement hitting the rotating air mover.

So the BMI thing might be a "broadbrush" approach, but consider the challenge of developing a protocol or standard that has to be simple the implement, and cover everyone who obtains an FAA medical.


Now what would be nifty is some form of incentive to get healthier. Perhaps pay for the AME visit if you dropped weight (in healthy manner), improved blood pressure, are on track for dropping an SI, etc.
 
I do agree that the incentive to drop 40 pounds could make this a sideways blessing.

One of the issues I see is that there are most likely pilots out there that know they have some level of sleep apnea but avoid the study and treatment because they do not want the hassle and added expense of the FAA imposed restrictions, making it a negative motivator. Using the BMI will just push more people out of GA because of the expense. I certainly don't have the answer to all of this so I will just try to look at it as an incentive to loose weight.
 
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