Symptom Spotlight: Melanie's Updates on Sleep Apnea and Constipation
Live from Stage 4 | Episode # 0 30| 5/26/2026 | Symptoms Spotlight
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Hosts
Abigail Johnston lives in Orlando, Florida and has been an attorney since 2002. In 2017, while tandem breastfeeding her boys (then 1 and 3), Abigail was diagnosed with de novo Stage IV Metastatic Breast Cancer (MBC) and soon thereafter discovered that she has a genetic mutation that predisposed her to developing cancer at ATM. Since her diagnosis, Abigail has focused her efforts on patient advocacy and supporting those people in the MBC Community through her experience and training, virtually and in person. She currently serves as the Director of Mentorship, Legal Clinics and financial services at Project Life, a founding member of the PIK3CA Pathbreakers, and volunteers with a variety of organizations including the MBC Alliance, FORCE, METAvivor, and many others. Connect with Abigail via her blog at NoHalfMeasures.blog.
Melanie Sisk was a wife, mom of two young boys, and working full-time as a Registered Nurse when she was diagnosed with Stage 1A Breast Cancer at the age of forty-three. She completed her recommended surgery and radiation and was on endocrine therapy. Melanie thought she had put cancer behind her because she did everything right. However, she was diagnosed with Metastatic Breast Cancer at the age of forty-seven. Due to her metastatic treatment protocol and disease, she retired from her nursing career. Melanie has dived into advocacy work with an urgency to do what she can, while she can. She helped to start and moderate a local support group in her area of North Carolina called Piedmont Triad METsters. She is a trained volunteer with Cancer Services, Inc. and a Peer to Peer Support Group Leader and Light Up MBC State Captain for METAvivor. She is a Living Beyond Breast Cancer 2023 Hear My Voice MBC leadership alumna and a mentor with Project Life. She also serves on the MBC Leadership Committee for Surviving Breast Cancer. She is also a part of the new initiative, PIK3CA Pathbreakers.
Summary
In this Symptoms Spotlight update, Melanie Sisk returns to share two unexpected personal experiences that happened after recording earlier episodes on sleep and constipation.
Sleep Apnea Update: A friend noticed Melanie's snoring at a cancer conference and encouraged her to get tested. After a simple at-home sleep study, Melanie was diagnosed with obstructive sleep apnea, averaging 12 events per hour without realizing it. She and Abigail discuss the symptoms to watch for, including daytime fatigue, morning headaches, dry mouth, and difficulty thinking clearly. All of which can easily be mistaken for cancer treatment side effects. Melanie shares how easy the at-home test was and encourages listeners to talk to their primary care physician if they suspect sleep apnea.
Constipation Update: After recording the constipation episode, Melanie's CT scan revealed she was significantly constipated. She had been experiencing nausea, vomiting, and abdominal pain — symptoms she assumed were from her targeted therapy. A gastroenterologist diagnosed her with chronic constipation with diarrhea breakthrough, a condition she hadn't considered even as a nurse. A colonoscopy-style clean-out and a new daily routine resolved her symptoms entirely.
The episode closes with an important message: don't assume every symptom is caused by cancer treatment. Primary care physicians and specialists like gastroenterologists play a vital role in managing the full picture of your health.
Sleep Apnea
Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts during sleep. The most common form — obstructive sleep apnea (OSA), which is what Melanie was diagnosed with — occurs when the throat muscles relax and block the airway, causing breathing interruptions (called "events") throughout the night.
Common symptoms include:
Loud snoring
Gasping or choking during sleep
Waking up with dry mouth or headaches
Daytime fatigue and sleepiness
Difficulty concentrating or thinking clearly
Irritability
Treatment options include CPAP machines (which keep the airway open with continuous air pressure) or oral mouthpieces that reposition the jaw to prevent airway blockage — both of which Melanie mentions in the episode.
Chronic Constipation with Diarrhea Breakthrough
Chronic constipation with diarrhea breakthrough (also called overflow diarrhea or paradoxical diarrhea) is a condition where a large buildup of stool becomes impacted in the colon, and liquid stool from higher up in the digestive tract leaks around the blockage and passes through — causing what appears to be diarrhea.
It's paradoxical because the person is actually severely constipated, yet experiencing loose, watery stools. This is why it's so easy to misdiagnose or misunderstand — as Melanie experienced firsthand.
Why it's confusing:
The diarrhea masks the underlying constipation
Nausea and vomiting can result from the backup in the digestive system
Abdominal pain and cramping are common
Patients (and sometimes providers) may treat the diarrhea symptom rather than the root cause — constipation
Common causes include:
Certain medications (like the targeted therapy Melanie is on)
Reduced physical activity
Dehydration
Neurological changes from cancer or treatment
Treatment typically involves clearing the impaction first (as Melanie described with a colonoscopy-style clean-out), followed by a consistent regimen of fiber, hydration, stool softeners, or laxatives to prevent recurrence.
It's a great example of why Melanie's message resonates — a symptom that looks like one thing can actually be caused by something completely different underneath.
Key Topics:
Recognizing the signs of constipation beyond straining
Over-the-counter remedies and natural solutions
The role of movement in digestive health
Avoiding the pendulum swing between constipation and diarrhea
When to seek help from your medical team
