Mild to Low Moderate Sleep Apnea and AF

Hello Everyone,

I received the results of my sleep study and am considering next steps. I was told by my sleep doctor that I was a difficult case to treat because my numbers were borderline mild to moderate. The large majority of abnormal respiratory events were hypopneas (a decrease in breathing opposed to a full stop, if I got that right) and during those events I was only mildly desaturated. He would not recommend therapy, except for the fact that I am a former Atrial Fibrillation patient, who recently (3 months ago) received an ablation, which so far has been successful. He pointed to the fact that there weren't a lot of data/studies to help understand how mild/moderate sleep apnea affects atrial fibrillation. As a patient, I'm torn. I want to do everything I can to lower my risk of AFib recurrence, however I would like to avoid unneeded therapy. I thought that I would share my case here and ask for any advice.

Thank you in advance,
Que

BTW: happy to share more specific sleep study data as needed

Do you know if you have issues sleeping on your side? My sleep Dr. was adamant about me using a CPAP machine, but figured out the I was doing just fine sleeping only on my sides. So I just sleep on my side.

I self diagnosed myself with mild apnea using a tachogram from my Polar monitor per this Power Point presentation: <[hrv.wustl.edu] (Polar tachogram described in more detail here: <[www.afibbers.org] ) A longer description of my self diagnosis is here: <[www.apoe4.info]

Overbreathing during sleep and all the time is an issue with apnea. To deal with this I now pay attention to always breathing through my nose, including during sleep and exercise. I sleep with my mouth taped shut (so I don't overbreathe at night) using this tape <[www.amazon.com]. I sleep with a device that goes around my chest with pads in back so I don't sleep on my back - also bad for overbreathing & sleep apena <[www.snoremart.com] Positional apnea is common.

I also started doing Buteyko breathing exercises to increase my serum CO2 levels. I plan to write a more organized post on this later, but here goes.

CO2 in the body is not just a waste gas like I learned in school. CO2 that we breathe out is like water. Too much, we die, too little we die and optimization of quantity is important. A Russian doctor, Buteyko, developed and studied a technique about this as a part of their space program.

It is necessary to allow hemoglobin to release oxygen, so if you are over breathing (which most of us are), your cells are not getting an optimal amount of oxygen (Bohr effect). CO2 is an arterial and vaso dilator. It relaxes the muscles, and is most likely the biochemical reason people feel how they do in a meditative state. <[www.buteykoscotland.co.uk]

When you delve into it, increasing oxygen to all the body systems can impact all those systems positively and dramatically – this can include autoimmune and many other systems.

Buteko correlated what he called the "control pause" or CP with serum CO2 level. You'd like a CP of >40 seconds and ideally over 60 seconds. Mine started out at 14 seconds and is now 17 or 18. Here is a video, too: [www.buteykodvd.com] and more description [www.buteyko.com] The most important one is measured right after you wake up - morning CP or MCP as it tells you whether you were overbreathing at night.

Your "out of air feeling" is caused by the brain sensing high CO2 levels - not low O2 (though there is a low O2 sensor - just doesn't come into play much). The level that this kicks in can be increased over time, with training.

The easiest way to get higher CO2 levels is to use a "Frolov" breathing trainer. It looks like a sippy cup, but it stores some of your exhaled breath, so your next inhale has more CO2 and less O2. This is a knock-off that I have, made in USA (ignore the weight loss BS) <[www.amazon.com] (ignore the reviews from people who don't know about Buteyko and increasing CO2 with this device). and I have a book on its use: <[www.amazon.com]
Some online instructions: <[www.aviva.ca]
<[www.zik20.com]
<[www.dov237.com]

Buteyko exercises are not easy, but the Frolov device is much more accessible.

Taping your mouth shut sounds a lot worse than it is. Some of the Buteyko exercises push you into the “need for air” zone. This is less fun, but you do get used to it.

You can also learn to perform even HIIT exercise, breathing through your nose. John Douillard preaches this, though he doesn’t look at it from the CO2 angle [www.google.com] [www.amazon.com]

Mercola talks about his own experience applying it to HIIT here: <[articles.mercola.com][/url]

My summary: apena causes a huge amount of stress; this technique may be a way to address the apnea. I plan to repeat the cortisol test in the near future.

Resources:

This guy is an expert:
[www.amazon.com]

This set has the above book + DVD’s & sample mouth tape:
[www.amazon.com]

I ordered mouth tape here:
[www.correctbreathing.com]

A good intro here: by Artour Rakhimov: [www.curezone.org]
The full version of this book is probably the most detailed reference: <[www.normalbreathing.com]
his website: <[www.normalbreathing.com]

Patrick MeKeown: <[www.buteykoclinic.com]

Alexander Stalmatski brought Buteyko to the west: <[www.amazon.com]

George