Thanks Mark. I don't know what kind of sleep apnea I have, but the CPAP does the trick for me. I don't have any residual concussion symptoms. The only exception is occasionally I will bump my head and the headaches will come back for a week and then disappear. I haven't been to ENT for years and will keep in mind what you said.

I'm glad to hear you already discuss sleep apnea as an issue for concussion recovery. It was such a huge deal to me wish I had known that from the beginning would have said me a terrible year.

Brian

Brian--what kind of test did you do to determine the apnea? In hospital or one of the home tests? Also, what kind of symptoms were you battling while you still had PCS?

CPAP success usually means Obstructive Sleep Apnea. Continuous Positive Airway Pressure devices use air to blow the obstructions out of the way. It usually requires a sleep lab test to get a CPAP prescribed. Sometimes, an at home test will be done first if your insurance company is cheap and needs pre-auth. Then, a sleep lab test is done to test out the effectiveness of a CPAP. Many go straight to the sleep lab and get a CPAP fitted during the night after observing OSA. There are many permutations of how the system works depending on insurance and local preferences.

Years ago, before I had my surgeries for OSA, I used a CPAP. The insurance is often crazy! They wanted me to rent a machine (not state of the art) for a month at a time for a few months. While I can see that they don't want to pay for machines that might not help people, my doctor actually told me to just go online and buy one outright -- it was cheaper than one month of the rental, and it was a much better machine! My out of pocket cost was much less, and it was mine to keep. I just brought it with me to the lab to have it calibrated to my pressure needs. After I had my surgery, I didn't need it anymore, and I was able to give it to a friend who didn't have insurance at all.

I'd love to see that research. There is nothing about TBI or PCS that would cause OSA. But, OSA can make PCS much worse. So, someone with mild OSA can be much more symptomatic since the PCS brain is much more sensitive to oxygen levels.

CSA can be caused by neck issues that lead to inflammation that interrupts blood flow to the autonomic nervous system that controls breathing. That was my problem. Once I learned sleep postures to prevent causing neck inflammation, my CSA came under control and was rare. This lead to a stability in my PCS symptoms. No more zombie days.

One of the difficulties with CSA is very few pulmonologists ever see a true case of CSA. Plus, CSA often coexists with OSA. Treating the OSA can reduce CSA to a manageable level so the OSA diagnosis appears to be proper. I had CSA without any OSA but the pulmonologist was determined there was nothing wrong unless it was OSA if he was not able to trigger a CSA episode. My wife counted 16 CSA episodes in one hour. The take home test was worthless because the system did not record properly. Trying to schedule a second test was problematic.

Every time I tried to get a sleep test, the doc wanted to test for OSA only. It can be difficult to get a proper diagnosis if the problem is CSA.

I will try to remember the name of the researcher. I believe it began with an 'R,' but I can't rely on my memory anymore...

I found at least 4 different studies that identified sleep disorders after TBI. Some of the conclusions about OSA resulting from TBI are not fully supported by the studies. OSA was discovered in the course of sleep studies in response to complaints about daytime sleepiness and insomnia. They used the vague status of 'no prior sleep disorder' complaints to suggest the OSA did not predate the TBI. Absent the additional insomnia and sleepiness complaints, it leaves the issue of prior OSA as an unknown.

But, sleep apnea, whether OSA or CSA is still worthy of consideration.

I have recommended many times that a bedside or other recording pulse-oximeter system as worthwhile to start the process toward getting a diagnosis, whether positive or negative.

I know he mentioned Johns Hopkins during our discussion, and there is a researcher named Rao at Hopkins who has written some things on TBI and sleep, according to a quick PubMed search. Not sure if this is the guy he was referring to.

I did the home test. My main long lasting symptom was headache although I had that "foggy" feeling, light sensitivity. The headache was from the concussion not sleep apnea. A common apnea symptom is headache.

I love my CPAP!

Riggs: i went through similar testing and also have really poor sleep. Were you actually able to sleep in the sleep center for a reasonable amount of time? I had trouble with all the wires so unsure how accurate that data is.