Sleep Apnea and Migraines

Well it’s official. I do have Obstructive Sleep Apnea. Last weekend I had a sleep study and got the results on Wednesday. The doctor was very thorough in explaining the results and I was honestly “blown away” to receive a positive diagnosis. Every single test I’ve ever had for any health problem that might explain Migraines has always turned up negative. I didn’t expect this one to be any different. But there it was on paper: multicolored lines showing every time I stopped breathing or failed to breathe deeply enough to maintain healthy blood-oxygen levels. I couldn’t deny the results. The bigger shocker was when the doctor told me she thinks I’ve had it all my life. I assumed it was showing up just because of my weight gain over the last 5 years. Apparently I have (1) a small jaw, (2) a large tongue, (3) large tonsils, and (4) a history of grinding my teeth since preschool which are all anatomical markers that put me at risk. She said she thinks it’s genetic. Holy cow!

For years I avoided discussing my sleep problems with doctors because I stubbornly refused to admit that I might have to use a CPAP in order to get a good night’s sleep. I saw the use of a CPAP as “being hooked up to a machine” — as evidence that I was severely ill. In my mind, it was tantamount to “life support”, a fate less preferable to death itself. Trust me, I’m not there now. Breathing is vital and I’d sure like to be doing it while I sleep…especially if it really is a Migraine trigger.

I refused to see my sleep problems as anything but a side effect of the Migraines themselves. I reasoned that if I could just stop getting Migraine attacks, I would sleep fine, wake up refreshed with plenty of energy to exercise, thus losing weight as well. I refused to consider or discuss the possibility that it might be the other way around. I rationalized my weight gain in the same way. It wasn’t until I faced the hard reality that all my hoped-for treatment options had failed that I decided to open my mind to the possibility that I did not know everything there was to know about Migraines. In fact, my health problems might not be due to Migraines alone.

I didn’t want to admit I might be an overweight, out-of-shape woman with a serious health problem that needed treatment. I am now ashamed to admit I was quite a snob about the whole issue. I made the mistake of equating my identity with my disease. My lifelong identity has been wrapped up in the belief that “I have migraines”. What if it isn’t true?

What if something else caused or made the Migraines worse?

What if that’s only part of the story?

Now that I have been diagnosed with Obstructive Sleep Apnea, I still don’t know which condition caused the other or if they are simply co-morbid. I might not ever know. I don’t even know if treating the Obstructive Sleep Apnea will help reduce my pain. But…I am about to find out. Tonight I go back to the sleep lab for a titration study where I will be fitted with a mask and the pressure adjusted so that I have less than 5 apneas (stop breathing) or hypoapneas (failure to breathe deeply enough) each night. (Once I’m getting better sleep and my brain works more efficiently, I will post a blog about the basics of Sleep Apnea for your benefit).

My husband is trying so hard to contain his excitement, but I can tell he has a lot of hope for this treatment. He has been forced to watch helpless on the sidelines for 23 years while I suffer through attacks and failed treatments, many of which were worse than the disease itself. Not to mention that my foghorn-like snoring keeps him awake at night and gives my kids lots of jokes to tell at my expense. A few days ago he said something I hadn’t thought of. He mentioned that if this works, I will have to go “back to the drawing board” to identify triggers. If lack of oxygen during sleep turns out to be such a significant trigger, we may find that other things I assumed to be triggers are no longer true. Wow…getting rid of a trigger…what a concept.

I’m the skeptical one. There have been so many treatment failures that I just can’t bring myself to get too excited about this one. I have also been the one getting an education on Obstructive Sleep Apnea. I know that there may be an adjustment period in getting used to the CPAP mask and machine. I also know that I may need extra sleep once it starts working to give my body time to recover from “sleep debt”. I’m no “Pollyanna”. I’m going into this with my eyes wide open and reasonable expectations. I’m in for an adventure along my journey. I’ll keep you posted along the way.

In the meantime, here are a few links about Sleep Apnea that have been my “school” for the week:
American Family Physican – Obstructive Sleep Apnea
American Sleep Apnea Association
American Sleep Association
Sleep Apnea – Diagnosis
PubMed Health – Obstructive Sleep Apnea
Your Sleep – American Academy of Sleep Medicine
MedScape – Upper Airway Evaluation in Snoring and OSA
Vitamin D for Sleep

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