From The Doctor’s Desk

Poor Sleep? Always Tired? It could be Sleep Apnea?

Sleep apnea is a serious sleep disorder that occurs when a person's breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night. The "apnea" in sleep apnea refers to a breathing pause that lasts at least ten seconds.

There are two types of sleep apnea: obstructive and central. Obstructive sleep apnea is the more common of the two. Obstructive sleep apnea occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. During an apneic episode, the diaphragm and chest muscles work harder as the pressure increases to open the airway. Breathing usually resumes with a loud gasp or body jerk. These episodes can interfere with sound sleep, reduce the flow of oxygen to vital organs, and cause heart rhythm irregularities.

In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Central apnea is named as such because it is related to the function of the central nervous system.

Symptoms

Chronic snoring is a strong indicator of sleep apnea and should be evaluated by a health professional. Since people with sleep apnea tend to be sleep deprived, they may suffer from sleeplessness and a wide range of other symptoms such as difficulty concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep while at work, on the phone, or driving. Left untreated, symptoms of sleep apnea can include disturbed sleep, excessive sleepiness during the day, high blood pressure, heart attack, congestive heart failure, cardiac arrhythmia, stroke or depression.

Why is it important to evaluate for Sleep Apnea?

Obstructive sleep apnea, or simply sleep apnea, can cause fragmented sleep and low blood oxygen levels. For people with sleep apnea, the combination of disturbed sleep and low oxygen may lead to hypertension, heart disease, life threatening arrhythmias, mood and memory problems, and possibly death. Sleep apnea also increases the risk of automobile crashes. Sleep apnea can be life-threatening and you should contact our office immediately if you feel you may suffer from it.

Evaluation

If you suspect you may have sleep apnea, the first thing to do is make an appointment with us. Bring with you a record of your sleep, fatigue levels throughout the day, and any other symptoms you might be having. Ask your bed partner if he or she notices that you snore heavily, choke, gasp, or stop breathing during sleep. Be sure to take an updated list of medications, including over the counter medications, with you any time you visit a doctor for the first time.

One of the most common methods used to diagnose sleep apnea is a sleep study, which may consist of a Home Sleep Test (HST) or Overnight Polysomnography (PSG) which requires an overnight stay at a sleep lab. In many cases, Home Sleep Test (HST) may be performed instead. This is a modified type of sleep study that can be done in the comfort of your home. It records fewer body functions than PSG, including airflow, breathing effort, blood oxygen levels and snoring to confirm a diagnosis of obstructive and/or central sleep apnea.

Treatment

The treatment of choice for obstructive sleep apnea is continuous positive airway pressure device (CPAP). CPAP is a mask that fits over the nose and/or mouth, and gently blows air into the airway to help keep it open during sleep. This method of treatment is highly effective.

Second-line methods of treating sleep apnea include dental appliances, which reposition the lower jaw and tongue, and upper airway surgery to remove tissue in the airway. In general, these approaches are most helpful for mild disease or heavy snoring.

Lifestyle changes are effective ways of mitigating symptoms of sleep apnea which m ay include weight loss, avoidance of alcohol prior to bedtime, avoidance of certain sleep aids or other medications at nighttime, smoking cessation, or positional sleeping if apnea only occurs while laying on your back.

The most important part of treatment for people with OSA is using the CPAP whenever they sleep. The health benefits of this therapy can be enormous, but only if used correctly. If you are having problems adjusting your CPAP or you're experiencing side effects of wearing the appliance, call us and ask for assistance.

Call us for more information or an appointment!