Last Saturday was a pretty horrible day. I had no energy and a nasty headache that would not go away whatever I tried. Out of desperation in the evening I put some Olbas oil by my pillow, hoping it might clear my head by the morning. To my surprise, I woke up with a clear head and much better energy. My wife also remarked that she hadn’t noticed me snoring, which is unusual.
The lack of energy on the Saturday had really bothered me. When you’re contemplating further loss of mobility and really want to make the most of what you can do right now, the thought that you might lose some of those precious remaining days is quite frightening. Sunday night came and I tried the same trick with the oil… and it didn’t work 😕
Me being me, I started brainstorming and researching. “Causes of low energy” - I picked out the possible causes that seemed most compatible with my experience and put them in order of what seemed most likely. Top of my list was sleep disturbance from respiratory problems that might include mild sleep apnea.
I started digging into sleep apnea specifically. First of all, how can I tell if that’s what is wrong?
The NHS told me symptoms include making gasping, snorting or choking noises while sleeping, loud snoring and feeling tired, moody, with a headache during the day. That all sounded plausible. I checked with my wife whether the description fitted — it did. Then she reminded me that I use the Sleep Cycle app and it records the sounds you make when you snore. We had a listen and quite a giggle! Oh dear! (She also reminded me that she’d brought up my snoring years ago when we first met and that I’d chosen not to do much about it at the time… also “oh dear!”).
So… it seemed a plausible explanation, but I wanted to know a little more. For instance, why does it vary day-to-day? I found this: Night‐to‐night variability of obstructive sleep apnea:
Obstructive sleep apnea shows a considerable night‐to‐night variability.
I’ve suffered from allergic rhinitis as long as I remember. I wondered if sleep apnea can be related to allergies. In Allergies and Sleep, the author writes:
Sleep problems are common in people with allergic rhinitis … Obstructive sleep apnea (OSA) … is linked with allergic rhinitis. OSA occurs when the muscles of the throat relax and fail to hold the airway open during sleep. … Nasal congestion, which causes the upper airway to narrow, increases the risk of both snoring and OSA among allergic rhinitis patients. The good news is that reducing nasal inflammation may reduce symptoms of snoring and OSA as well as daytime fatigue and sleepiness, according to at least one study.
That one study, Rhinitis and sleep apnea, states:
Rhinitis alone is associated with mild OSA, but commonly causes microarousals and sleep fragmentation. Reduction of nasal inflammation with topical treatment improves sleep quality and subsequent daytime sleepiness and fatigue.
This really started to sound worth investigating. Next I looked into the question of what I could do about it. I’m awaiting a referral to a respiratory specialist as it happens, but in the meantime maybe there was something I could try. I read a lot but still hadn’t turned up much that was immediately actionable. However, a couple of days later we had a device fitted to the bed which will raise and lower the mattress — to assist me when my core gets weaker. Even at its flattest, it still introduced a slight incline to the bed. We slept a night on this and I was amazed to see in the morning that my “snore time” was just 1 minute. My wife wasn’t keen on the slope so we’re reserving that device for when we really need it, but the following night I just added an extra pillow with much the same effect. The results (via Sleep Cycle App) speak for themselves — Thursday and Friday were the two nights in question, both logged 1 minute of snore time:
Of course I’m really hoping it’s not a fluke or some other explanation — only time will tell.
Later on I thought to check whether this has been a steady problem or appears to have been getting worse. Here’s the long-term chart:
I have a little more than 2 years of data. It’s not totally clear but it does look like the problem got significantly worse towards the end of last year. Since I suspect my ALS symptoms began before 2018, it does look possible that my respiration is starting to be affected — something I was hoping to avoid for some years to come. However I’ll wait to see what the specialist has to say, in the meantime I shall be sleeping propped up, after popping an anti-histamine and with the Olbas oil deployed! Sweet dreams!