Sleep: We often take it for granted. We don’t realize that so many things can go wrong with it. Today, we are happy to present our reply to our first letter sender: Sleepy Suzy. Let’s help Sleepy Suzy get some sleep.
Ask the Doctor
Dear Doctor Florendo,
I am having some trouble with my sleep. Sometimes, I wake up in the middle of the night unable to breathe. Sometimes this is accompanied by chest pain, sweating and palpitations. I also wake up in the middle of the night with numbness in one arm or a leg. I have taken different types of vitamins including Vitamin B and C, with no improvement. What is wrong with me?
Reply to Letter Sender
Dear Sleepy Suzy,
Many doctors may give you different explanations for this phenomenon. Sleep disorders can often go undiagnosed. One of things we need to consider is a breathing disorder during sleep. Sleep is a major trigger for hyperventilation. When you hyperventilate while awake, numbness in the arms and difficulty of breathing may happen. When one is sleeping however, the presentation may be the numbness of one arm or leg only. The difficulty of breathing and/or chest pain, may wake you up too. This is often accompanied by other symptoms which I will describe shortly.
HYPERVENTILATION DURING SLEEP
Hyperventilation during sleep has been widely documented. Scientists do not yet know what causes it. It has been noted to occur with sleep apnea.
Hyperventilation causes an imbalance in the concentration of the oxygen and carbon dioxide in the body. This imbalance causes blood vessels in the arms and legs to become smaller. This restricts the flow of blood in the arms or legs, thus causing arms and/or legs to become cold and numb. This imbalance also causes the airways to become smaller giving you the impression that you have a difficult time to breathe.
Besides sleep, there are other things which can also trigger hyperventilation. Click here to read about these triggers.
If you happen to hyperventilate during your sleep you may experience one or more of the following upon waking up:
- Dry Mouth
- Itchy Eyes
- Nasal congestion often without mucus
- Back Pain
Patients who also have this problem may complain of occasional leg cramps during rest or sleep. They are noted to snore many times although not always. Rarely, they experience sleep paralysis. If the problem is severe enough, it may contribute to sleep apnea which results in poor energy levels and sleepiness throughout the day.
The condition can be quite scary. Patients sometimes feel like they are going to die. Although no one has died from this disorder, progressive long term changes that may occur with it can be linked to hypertension, asthma, and chronic fatigue syndrome. This can be a chronic problem.
NORMAL LABORATORY RESULTS
Common laboratory tests such as blood counts and ECG’s are usually normal. When there are slightly abnormal results, such as mild anemia, they cannot explain the plethora of symptoms. Sleep studies may reveal hypocapnia during sleep but the costs of undergoing this test is quite prohibitive. Unfortunately, the cut-offs for studies which can theoretically detect this problem have not yet been set, making many of them useless.
DRUGS, VITAMINS NOT EFFECTIVE
Unfortunately, no vitamin has been effective in treating hyperventilation. There are no known prescription drugs to treat this disorder as well. Devices which are designed to shut your mouth during sleep such as specially made pillows or orthotic devices may help. They have limited use however, as the body tends to seek out a deeper breathing pattern during sleep.
TESTING FOR HYPERVENTILATION
Today, we have tests for hyperventilation at our clinic. These tests include an assessment of your use of breathing muscles, simulation of hyperventilation, and a thorough documentation of your symptoms. If you are positive for all these tests, there is a more than 90% possibility that hyperventilation is part of your problem. It is important that your doctor knows how to test for hyperventilation. If in doubt, I suggest you see someone who specializes in hyperventilation and dysfunctional breathing.
MAY BE PART OF A BIGGER SYNDROME
Hyperventilation during sleep may be an indication of Dysfunctional Breathing, otherwise known as Chronic Hyperventilation Syndrome. As many as 20% of the population may be suffering from this problem. This problem goes undiagnosed because it is unfamiliar to many physicians. To make things worse, its symptoms mimics those of other problems. This causes it to be missed and diagnosed as something else.
The British Thoracic Society recommends the use of Breathing Retraining as the treatment of choice for Dysfunctional Breathing. It is believed that breathing retraining can correct the oxygen and carbon dioxide levels in the body, reversing many symptoms. Among the breathing retraining programs available, I personally recommend the Buteyko Method. The Buteyko Method is easy to learn. It also does not require the purchase of expensive equipment. You may read more on the Buteyko Method here.
Breathing Retraining Works!
Breathing retraining is supported by clinical studies, which is why it has been recommended by the British Thoracic Society. I have seen breathing retraining work for many of my patients too. They have the same complaints as you do, oftentimes even worse. They get relief as early as 1 week upon initiation of their treatment. Besides improving sleep, they experience other positive changes with their health as well.
I have listed other things you can do to deal with hyperventilation. Click here to read it.
I’m looking forward to seeing you soon.
Dr. Charles Edward Florendo
This article was written by Charles Florendo
is a certified family physician with training in interventional wellness. He is probably the first hyperventilation and dysfunctional breathing specialist in Southeast Asia. He has taught breathing retraining to patients and healthcare workers in Africa, United States, and the Philippines. He holds an advanced certificate in Buteyko from the Buteyko Breathing Association (UK). He is presently the medical adviser of the at Buteyko Clinic International and a consultant at Mary Chiles General Hospital (Philippines) and the Clinica Salutare (Philippines) and the Biobalance Wellness Center (Philippines). He lives in Manila, Philippines
Disclaimer: This article is based on the personal opinion of the author and does not constitute medical advice. Trademarks and copyright of names and logos of organizations, corporations, or products belong to their respective owners. The mention of any particular product or service does not constitute their endorsement by any particular entity. The author is not affiliated with the Global Initiative for Asthma,nor the British Thoracic Society.
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