Saturday, June 8, 2013

Fainting , Diabetes , High blood pressure Sleep Apnea and the Vagus nerve




 Vagus nerve 
The vagus nerve is the longest most wide spread nerve in our body. This nerve supplies fibers to every organ except the adrenal gland.  Most of these fibers (80 % ) carry information towards the brain and some of these fibers are very sensitive to low blood glucose  and low oxygen levels resulting in a variety of symptoms .

 Common symptoms often associated with the vagus nerve.
   Heart rate - stimulation of the vagus nerve causes slowing of the heart rate and
                        severe stimulation can cause conduction blocks in the heart.
                               The patient discussed in a previous post had transient blocks in the electrical connection between the
                                upper and lower parts of his heart. 
    Sweating  -  especially facial sweating
   Gastrointestinal - Nausea

The patient discussed in a previous post had all of the above symptoms and testing revealed low oxygen levels of 78 %.  Click on the link below to review the case.

The patient above also had hypertension and pre-diabetes and his cardiology work up revealed episodes of slow heart rates including transient heart blocks occuring at night. Blood oxygen levels revealed 98 episodes of anoxia ( oxygen levels dropping to 78 %)  on the night tested. Normal oxygen levels are 95 to 99 % and values below 90% are considered abnormal.

He was diagnosed and treated for Obstructive Sleep Apnea and his oxygen levels and his symptoms have almost completely resolved with CPAP treatment.  He still has occasional mild symptoms of transient nausea and sweating that can be traced back to  an increased number of  night time episodes of apnea  3 to 4 /hour . ( normal is less than 5 ) the night before. The cause for the periodic increase in apnea ( usually for 2 nights ) has not yet been determined.  In addition , his BP is usually increased for 3 to 4 days during and after these periodic episodes.  His BP is nomally controlled  to 130 +- / 75 + - with a diuretic every other day. His Pre- diabetes has not progressed. .

Have Fun , Be Smart and do not overlook sleep apnea 
David Calder,MD


   
                       
                       
                       

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Your comments and questions are appreciated. David Calder,MD