GP telling me it’s menopause when it’s sleep apnoea

[Polkadotdash]

I need help as I’m really down a hole with this.
Despite having no symptoms of menopause and regular periods my GP is ignoring my diagnosis of sleep apnoea and insisting that the menopause is the cause of my exhaustion.
I’m on a waiting list for a CPAP machine but it’s likely to be a year before I get one. I’m currently going through a really bad phase of nightmares and choking at night. I saw my GP this morning to ask what I can do. She diagnosed me with menopause (again) and said it was hormones and that I should try to tackle the insomnia. No matter what I said she wasn’t listening. I feel like I’ve been going around this loop for years and years and keep getting told it’s menopause. I thought that the sleep study results would change this but no. I stop breathing on average 52 times an hour during REM sleep. I have no memory of this, I don’t fully wake but obviously I’m not rested.
Im so exhausted. I can’t keep up with normal life and I fall asleep two or three times during the day. I’ve been on iron tablets, anti depressants and b12 injections for years to try to combat my exhaustion but obviously it’s not going to be fixed if I can’t get proper sleep. What can I do to get through to them that this isn’t the menopause, it’s something else?

OP keeps pestering the poor GP, who is clutching at straws because OP clearly won’t accept the response of “suck it up and wait your turn”.

Would HRT improve the sleep apnoea? Is that what the GP means?

Except the response wasn’t ‘suck it up and wait your turn’ it was ‘your problem is hormonal’. Would you rather I accepted menopause meds I don’t need so that I wasn’t ‘wasting’ NHS time and appointments? Would I not be being very unreasonable then?
In your head I just went into the Gp and went ‘whah. I’m tired. Get me to the top of the waiting list’. I think after a decade of pussyfooting around this issue and 4 years of anti depressants I’m done doing everything to suck it up. I need help.

And I’m not ‘pestering my GP’. I last saw one in May 2022 to discuss sleep apnea. Or is more than one GP appointment a year pestering?

You have sleep apnoea, memory issues, fatigue, vivid dreams and exhaustion......but you don't have any symptoms of the menopause? Erm.....I hate to break it to you...🤦🏻‍♀️ !!

The sleep apnea has been going on for 9 years causing the exhaustion, memory loss etc. unless if cause you think that not having more than 90 seconds consecutive REM sleep for 9 years wouldn’t mess up my cognitive function?
Thats my point. It’s a misdiagnosis because the symptoms are similar to some of those experienced during the menopause. But no one wants to hear that. Treating me for menopause will not stop my throat collapsing at night.

so hospital disposed you, but GP won’t treat you? Crazy. I’d be asking to see another GP, then making a complaint.

But it might help!

You've asked your GP for support while you wait for follow up for your official diagnosis, and they've said you should look at treating symptoms of the menopause.

Clearly the menopause symptoms you're experiencing are compounding your existing sleep apnoea. I'm not saying you wouldn't have had it anyway, I'm saying you've got it both barrels.

Whether you like it or not accepting you're experiencing menopause symptoms and treating them will likely help you.

But hey, you know best.

Regards,
@FarmGirl78
Biomedical Scientist

OK, what do you actually want the GP to do (bearing in mind that the GP can't affect the speed at which you get CPAP). Don't just say "I want help". What exactly do you want? There is no alternative to CPAP.

I don't think you understand what CPAP is. I'd suggest you google it. It's not available via primary care, it's equipment that has to come via the hospital. GPs can't get CPAP. You can see every GP in the country and none of them can get CPAP.

I imagine the poor GP is trying to think of other things that are worth trying while waiting for the CPAP. It's difficult but she's trying her best, given that she has no authority over the hospital or the speed of the CPAP. In return for this, OP is complaining and other posters are slagging off the GP.

OK, you're absolutely sure you're not menopausal. 100% sure. I'm just going to tell you my experience.

I have ADHD, depression, anxiety and spine issues. I've had these issues either for life or in the case of my spine 15 years. Menopause came along and affected every single one of my pre existing conditions. Literally left me the shell of who I was. I didn't realise that it could do that. I wasn't functioning at all, I couldn't leave my bed, I was on a one way path to the afterlife. I'm now on HRT, and I've done a full 180° my depression has eased, my anxiety is a little better, my ADHD is more manageable, and my back pain has eased up a little.

There are studies that show that sleep apnea symptoms can reduce by up to 50% when women take HRT, and 25% if ERT is taken. This is why the Dr suggested it. Sleep apnea is affected by Menopause. All you can do while you wait for a machine is give HRT a chance.

Menopause isn't just hot flushes, mood swings and stopped periods, it can display in a multitude of ways, and affects women in a multitude of ways.

Regarding the cpap machine, go to PALS and explain the situation to them, tell them how hard it is and how desperate you are, they can advocate on your behalf.

Sorry but I’m not.
Lots of conditions present with similar symptoms. A headache could be dehydration, a head injury, a brain tumour, needs for glasses, ear infection, etc etc. You can’t just say ‘you’re definitely menopausal because you are exhausted’ in the same way as you can’t definitely say ‘well your periods have stopped because your menopausal’ when you’re actually pregnant. Do you see the difference?
Ive no idea why you’re so sure I’m experiencing the menopause when my blood test results indicated hormone levels to show I am not experiencing the menopause but my sleep study indicated I am experiencing sleep apnoea.
Are you my GP by any chance?

I know what it is! The OP says the GP won’t acknowledge her diagnosis.

Thanks everyone for your thoughts. There is some useful stuff in amongst the comments.

Unless you've had your blood tested every couple of days for a few months you can't role out being peri-menopausal. Depending at what point in your cycle you tested it would be possible to say "Yes, you've definitely been through the menopause". But that doesn't mean you aren't peri.

As for being your GP, you have ignored them so I don't expect you'd take advice from me either. You seem to think people are trying to prove you wrong or win a non existent argument when it's actually people giving you well meaning, experienced advice. Your health that is making you so very miserable could improve if gave the advice a chance but hey ho, your choice.

I've just been put on a two-year waiting list for the sleep clinic for my apnoea. I am on hrt, my sleep's improved but I still wake about twice a night.
My GP recently gave me lansprazole tablets to see if the choking in the night is caused by reflux.

I've been through the cycle of the menopause and been diagnosed with sleep apnea.

There are some similarities between the two but it is not the same. With the menopause, my sleep was awful. Struggled to fall asleep, and then would wake up regularly until I was wide awake at 4am and couldn't get back to sleep. I was exhausted but it was not surprising.

Now that I've made it to the other side, I sleep amazingly again. That means falling asleep with no problem, wake up regularly but going right back to sleep, and sleeping until 7am. However, despite sleeping well for 8h plus, I wake up feeling totally jetlagged. I just want to go to sleep all through the day and because I can't, it's a constant battle. I yawn non stop all through the day even out on a walk getting fresh air.

OP, you know that the way you feel is due to your sleep apnea. No medication to help with the menopause would stop it and hrt isn't for everyone anyway.

I totally get your desperation. 1 year is a very long time when you feel as you do. I hope they said that so not to raise your expectations but that the wait will in reality be much shorter.

She’s on the waiting list for CPAP. Did you miss that? It doesn’t matter what the GP does, she has to wait for the CPAP.

Thank you so much. This is really helpful to hear from someone who has experienced both conditions. I hope you can get your apnoea treated soon.

Two years is awful. Fingers crossed you get seen sooner than that.

Perimenopause can cause huge sleep issues. If you still have regular periods you can still be Perimenopausal.

Many people only have one or two symptoms. For example I have never had a hot flush. My main symptoms were rage and lack of sleep. I put up with this for 7 years totally unnecessarily.

At 52 you will be Perimenopausal it is inevitable. The role of oestrogen in our brain function is huge and lack of proper brain function can lead to other issues. I would accept the HRT if I were you while you are waiting for an appointment.

Blood tests should not be used after 45 years old to diagnose perimenopause according to both NICE and BMS. They are not reliable as hormones fluctuate so much during this time.

The menopause and sleep apnea are two totally different things. The menopause can trigger osa but not cause it. Getting treatment for the menopause doesn't stop the process of menopause nor cure sleep apnea, especially in people who are not overweight.

There is a lot of assumptions made about osa and the test to decide whether to be referred is too basic and targeted. I was given the test and deemed not to meet the threshold for referrals because I don't fall asleep uncontrollably during the day but that's because I fight it with all my might because I can't afford to fall asleep. I didn't meet the typical sufferer. I'm fit, skim, don't snore. Don't drink or smoke.

I finally got referred after a few very distressing episodes of waking up feeling like you do when you've been under water too deep and feel you won't make it back to the surface on time. That and my watch showing serious dips in blood oxygen. It's thanks to a different GP who told me to answer the questions as if how strongly I felt like sleeping rather than falling asleep that got me the referral and the test indeed showing that I suffer from sleep apnea.

I suspect there are a number of menopausal women struggling with sleep who have undiagnosed osa but put it down to the menopause and never get tested.

Going to the GP was indeed pointless as there is nothing for treatment than a CPAP machine but I totally get your utter sense of helplessness. Waking up day after day feeling like you've had no quality sleep at all is alienating.

You are much better off sleeping 4h with 2 of it being deep sleep than sleeping 8h with only 10mns of it if that.

Try your community health team. Hubby has COPD and our area allows anyone with a diagnosis to self refer. Worth a shot….