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Dead in bed syndrome or sleep apnea ?

Discussion in 'Diabetes Soapbox - Have Your Say' started by rytham2, Jun 9, 2015.

  1. rytham2

    rytham2 Type 1 · Member

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    It so happens I am a type 1 diabetic diagnosed at 15yrs of age.
    I used to like running, swimming, rugby. So I was quite fit really.
    It was in my later years when things started changing for me, and 1 was that I kept dying in bed, Yes I couldn't believe it was happening.
    My wife would be telling me in the mornings that it was weird as she really thought I stopped breathing, and was panicking a little what to do.
    She says she would shake me a little for some response, but nothing, then suddenly I would take a sharp breath and start breathing again.
    This was happening quite frequent, and I just laughed it off, saying I do have a habit of holding my breath.
    Any how when my diabetic check came up and I hadn't been for 2yrs with moving house, the nurse went through her routine of a new diabetic check up.
    After which the doctor came to see me. He stated that blood pressure very low and heart rate slow.
    I was put on a meter for checking the heart, and while asleep my heart would slow down too much, and stop for 10-20 seconds.
    They thought the meter was faulty and so brought me into hospital. (Only by the Grace of God it jumpstarted again),
    I was to be fitted with a pacemaker to keep my heart at a steady pace, but my answer was I didn't want it, I had asked God to take me in my sleep.
    The nurses response was "Your not dying on my ward", "Your having a pacemaker"
    Never had heart stop since. Been 10yrs nearly and soon to have the battery changed in my bionic heart. I'm 66 now.
     
  2. Celsus

    Celsus Type 1 · Well-Known Member

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    Good story Rytham2, and certainly happy to hear you are still among us and going well with your pacemaker!

    "Dead in Bed Syndrome" is though a term referring to sudden death in young diabetic patients without any history of long-term complications. Autopsy is typically negative. Frequency data on this condition from studies in the U.K. and the Scandinavian countries concludes that such deaths occur in 6% of all deaths in diabetic patients below age 40 years. The frequency may also be expressed as 2–6 events per 100,000 patient-years. So fatally serious for the victim and family/relatives. The causes are by definition unknown, but a plausible theory is a death in hypoglycemia, since a history of nocturnal hypoglycemia is noted in most cases. (but mind you, not in all...)

    The situation you personally describe above is actually not specific diabetes related but actually linked typically to a heart condition. It has even a special name for it by itself: "Sleep Apnea". Interested can read more about it here:
    http://www.helpguide.org/articles/sleep/sleep-apnea.htm
     
  3. Brunneria

    Brunneria Other · Moderator
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    Blimey - glad you are still with us!
     
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  4. Fi2000

    Fi2000 Type 2 · Well-Known Member

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    I was diagnosed with sleep apnea 2 years I ago. In my sleep I stopped breathing 56 times a hour. I now sleep with a CPAP machine to keep my airways open.
     
  5. RuthW

    RuthW Type 1 · Well-Known Member

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    Yes, but Celsus, it could be linked to diabetes, if it is due to some kind of autonomic damage. Is that the term? You know, basically damage to the nerves which govern various bodily functions/organs.
     
  6. PatsyB

    PatsyB Type 2 · Well-Known Member

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    Very Very scary....to think some one can pass away in their sleep like this and at any age
     
  7. Celsus

    Celsus Type 1 · Well-Known Member

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    Hi Ruth,
    Are you considering the OP subject of "dying in bed" syndrome or the sleep apnea, which was his real problem? :)

    Its true the prevalence of obstructive sleep apnea even in young and lean T1s with and without cardiovascular autonomic neuropathy has been shown to exist in multiple studies.
     
  8. RuthW

    RuthW Type 1 · Well-Known Member

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    I am suggesting that he may not have had sleep apnea. He didn't mention snoring, which is the usual accompaniment to that, and they didn't treat him with a CAP machine. My hubs had sleep apnea, and the same pattern of stopping sleeping. They gave him a machine and then an operation on his nose! But all his other tests (blood pressure, FB, cholesterol, etc are so perfect it makes me a bit jealous, esp since he is actually obese!)

    So, I'm suggesting the OP's doctors did a sleep test and determined that he needed a pacemaker (much more drastic than a CAP machine) because it was not your classic sleep apnea.

    And then I wondered whether the mysterious DIB might be related to autonomous nerve damage. So I found the posting very interesting! That was my train of thought
     
    #8 RuthW, Jun 20, 2015 at 2:40 PM
    Last edited by a moderator: Jun 20, 2015
  9. Celsus

    Celsus Type 1 · Well-Known Member

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    Agreed, both disease areas are very interesting, but (most often) not interrelated.

    With regards to sleep apnea, then you mainly have 3 types: obstructive, central, and a mix of the two.
    Obstructive sleep apnea (OSA) is the most common, around 80% of all cases. It is caused by a physical blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. Patients of this type are often overweight/obese. And yes, you see many T2s here for this reason (a physical blockage due to the overweight, not due to the T2 itself...) As OSA is due to a physical blockage, then one of the most frequent symptoms is laud snoring.

    In Central Sleep Apnea (CSA) the airway is not blocked, but the brain fails to signal the muscles to breathe. Reason why snoring is not necessarily observed at all. When CSA is caused by heart failure, the patient has slow blood flow as well as erratic breathing and consequently awakens due to lack of oxygen. You can not fix that with a continuous positive airway pressure device (CPAP). Apart from those patients, about half of those suffering from CSA can be managed on CPAP alone.

    OSA patient has a mechanical problem, one that almost always can be corrected by CPAP, potentially combined with weight loss and/or a surgical tissue adjustment. Treatment of the CSA patient is more challenging because the signal to the body to inhale is not being transmitted from the breathing center in the brain. So despite the difference in the root cause of each type, in all three, you can observe the same symptom namely that people with untreated sleep apnea stop breathing repeatedly during their sleep. As you mention the example about your own hubby, then many different root causes can be behind the sleep apnea. And depending on root cause, then the right treatment is different. Even children can suffer from sleep apnea, so its not just old, obese T2s. And for the OP, then luckily he reacted on his sleep apnea, which was actually a symptom due to his serious heart condition. Or rightfully, as often is the case with us lazy men, it was his wife that was his saviour and sent him to the doctor to get the problem fixed! :)

    Ruth, I have also loads of statistics/studies to pull from if you want us to dive into the dead in bed syndrome.
     
  10. anna29

    anna29 Type 2 · Well-Known Member
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    We have had 2 threads with the same threads titled - dead in bed syndrome .
    This can be a bit misleading or tad confusing within the soap box thread forum .

    Hence why I have given this additional title to discuss or debate about possible other option(s) .
     
  11. Celsus

    Celsus Type 1 · Well-Known Member

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    Thanks Anna !
    As it turns out, this thread is actually about Sleep Apnea and nothing about Dead in Bed Syndrome, so suggest the title is updated accordingly. OP may involuntarily have used the 'dead in bed' as catch phrase, without knowing of the syndrome with same name.
     
  12. RuthW

    RuthW Type 1 · Well-Known Member

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    OK, Celsus, I didn't know CSA was common, so I thought it was a complication of his diabetes - damage to his autonomic nervous system. But according to what you say it is not a complication of his diabetes which causes heart failure, it is a result of an unexplained failure to signal in his central nervous system.

    And yes, I'm not surprised about his wife's involvement. I was always elbowing my husband to make him breathe. I didn't care how noisy the air pressure machine was at first. At last I could sleep without anxiety.
     
    #12 RuthW, Jun 20, 2015 at 10:48 PM
    Last edited by a moderator: Jun 24, 2015
  13. Kjosh

    Kjosh Type 2 · Member

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    Both my husband and I have sleep apnoea. I am diabetic as well, my husband stopped breathing 76 times an hour it's now down to 6 times an hour using Cpap machine, yes it's inconvenient and it takes some getting used to, but it gives peace of mind.
     
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