Sleep Apnea: Getting Enough Air?

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So, imagine instead of going to bed every night, you decide to sleep in your swimming pool. You tread water in your pool, waiting to fall asleep. As you drift off to sleep, you start sinking to the bottom of the pool. You stop breathing for a few seconds. Your brain signals you to wake yourself up by gasping for air. A few minutes later, you drift again, gradually find yourself under water, unable to breathe, waking yourself up for another breathe… You do this for eight hours every night, maybe even 30-50 times every hour. The next day, you are exhausted, tired, sleepy, foggy-brained and irritable.

This is called Sleep Apnea, a serious sleep disorder where a person stops breathing during sleep. Spouses may complain of loud snoring, forgetfulness, daytime sleepiness but most people are in denial or are unaware they have it. Roughly 18 million Americans suffer from sleep apnea and as many as 90 percent are not diagnosed.

“I am so upset – he won’t do anything about his sleeping problems! When he wouldn’t even bring it up with the doctor — and I know this is because he doesn’t want to use the machine — he came home and started saying I was the one who has the problem sleeping. He said he sleeps just fine.”

Are you AT RISK for Obstructive Sleep Apnea?

Okay, so men are more likely than women, being over 40 years, being overweight with a neck size greater than 17 inches in men and 16 inches in women, large tonsils, large tongue, chronic sinus issues, acid reflux and family history puts you at risk!

What are the signs and symptoms?

  • Wake up with a very sore or dry throat
  • Snore loudly
  • Occasionally wake up with a choking or gasping sensation
  • Sleepy during the day with lack of energy
  • Feel sleepy while driving
  • Have morning headaches
  • Feel restless during sleep
  • Forget things easily, memory issues
  • Moody, irritable, depressed
  • Decreased libido
  • Wake up frequently in the night

Why is it IMPORTANT to Treat Sleep Apnea?

UNTREATED sleep apnea can lead to serious conditions like high blood pressure, atrial fibrillation, diabetes, heart attacks, stroke and heart failure.

UNDIAGNOSED sleep apnea in children with sinus issues, allergy issues, large tonsils, deviated septums is frequently misdiagnosed as ADHD.

UNDERLYING sleep apnea is linked to major depression, chronic headaches, memory loss, impotence and obesity.

Take an excessive sleepiness quiz! (Epworth Sleepiness Scale)

Choose 0 for never dozing; 1 slight chance; 2 moderate chance; 3 high chance of dozing

  1. Sitting and Reading [ 0   1    2     3 ]
  2. Watching TV [ 0   1    2     3 ]
  3. Sitting inactive like a theater or meeting [ 0   1    2     3 ]
  4. Passenger in a car for more than an hour without a break [ 0   1    2     3 ]
  5. Lying down to rest in the afternoon if circumstances permit [ 0   1    2     3 ]
  6. Sitting and talking to someone [ 0   1    2     3 ]
  7. Sitting quietly after lunch without alcohol [ 0   1    2     3 ]
  8. In a car, while stopped for a few minutes in traffic [ 0   1    2     3 ]

RESULTS: 0-5 Lower Normal ; 6-10 Higher Normal; 11-12 Mild Excessive; 13-15 Moderate Excessive; 16-24 Severe Excessive Daytime Sleepiness

(Talk to Your Doctor If You Score High to Severe Excessive Daytime Sleepiness!)

Did you know there are different Types of Sleep Apnea?

Obstructive sleep apnea (OSA): The back of the throat gets blocked when the soft tissue in the back of the throat collapses during sleep.

Central sleep apnea: The brain fails to signal the muscles to breathe, due to injury to the brain’s center that controls breathing.

 

So your Sleep Study (polysomnogram) says you have Obstructive Sleep Apnea?

Treating obstructive sleep apnea may involve lifestyle, weight loss, medications, equipment, surgery, or appliances.

  1. Weight Loss. Your risk for obstructive sleep apnea is higher if you are overweight with a body mass index (BMI) of 25 or more or obese with a BMI of 30 or higher. Neck Circumference in males >17 inches and women >16 inches.
  2. Avoid alcohol and sleeping pills. It relaxes the muscles in the throat leading to apnea and may prevent the person from protecting his/her airway from waking up.
  3. Sleep on your side. 
  4. Stop Smoking. It causes swelling the upper airway making both apnea and snoring worse.
  5. CPAP (continous positive airway pressure) and BiPAP devices.
  6. Dental appliances
  7. Surgery- Nasal surgery for septum correction, Uvulopalatopharyngoplasty (UPPP) for removal of the soft palate and Mandibular maxillar advancement surgery.
  8. INSPIRE- an implantable pacemaker-like device (small pulse generator) placed under the skin in the upper chest. One wire detects breathing from the lung, another wire sends an impluse to the hypoglossal nerve stimulating airway muscles in the neck keeping them open. It can be remotely programmable to turn it on before bed and turn off after waking up.
  9. Expiratory Positive Airway Pressure (EPAP)– it uses disposable adhesive valves that are placed over the nose when you sleep and have a high compliant rate. Upon inhalation, the valve opens and helps the airway remain unobstructed. Then with exhalation, the airflow is directed into small channels, which creates pressure and, again, keeps the airways open. 

Your Sleep Apnea Effect Others too

People with sleep apnea are up to ten times more likely to have a motor vehicle accident as a result of sleepiness, sometimes with fatal results. Focus and memory issues can affect your work and may impact lives if you work with children, in the health field or drive a vehicle. Obstructive sleep apnea also affects relationships, family and friends. Being chronically tired makes it hard to socially engage and being depressed leads to failed relationships.  Because of the loud, bothersome snoring, spouses or bed partners might choose to sleep in separate bedrooms. For men, untreated sleep apnea can also lead to problems with impotence also affecting sexual intimacy.

Better sleep quality can help reverse and repair your brain, heart, mood, weight issues, invigorating your mind-body-spirit. Imagine a life full of energy, bounding happiness, sharp memory and the best of health. It is my hope that reading this blog and understanding the importance of sleep will encourage you to get the medical help that you need. Wishing you a restful night and sweet dreams!

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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

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