Sleep Apnea: Why sleeping without breathing is bad for your health
Sleep apnea is a sleeping disorder that can affect anyone. Recently it has received much attention. Nonetheless many people who have sleep apnea have yet to have the “who me” moment. The reason the moment is so elusive for so many is that they don’t have a strong feeling that they have any problems sleeping. In some ways it’s like high blood pressure. You can have a serious problem, but be completely unaware of it until you have your blood pressure checked. By the way, when WAS the last time you checked your blood pressure?
Who are most often affected by sleep apnea?
People with sleep apnea are most likely to be: men, overweight, over 60 years, those who consume alcohol or take sleep medicines, smoke, or have chronic rhinitis. Of course having combinations just makes it more likely.
In most cases, except for the telltale symptoms, which I will mention momentarily, the only way you might know you have sleep apnea is if someone has complained that you snore like a Saturn 5. In many cases the person sleeps through the apnea event without waking up or sensing that anything is out of the ordinary.
How can I tell if I have sleep apnea?
There are two types of sleep apnea, obstructive and central. I am going to address only obstructive apnea since it is the most common.
The most common symptom is daytime sleepiness. Recall that humans have very complex sleep cycles and these cycles must run uninterrupted for you to be fully rested and refreshed. Sleep apnea interrupts these cycles everywhere from 5 to 30 times per hour, which can turn 7 hours of sleep into just 1 or 2 hours of effective sleep, and this makes you feel tired and sleepy while you’re awake. The next most likely symptom, aside from someone telling you that you snore horribly, is waking up with a dry mouth or slightly sore throat. This symptom indicates you were breathing through your mouth most of the night.
What causes obstructive sleep apnea?
Sleep apnea occurs most often when a person is sleeping on their back. It occurs because when you are in that position, and as the muscles of the throat relax, the passageway for air flow begins to collapse. The diaphragm continues to contract but there is no air flow into the lungs. During exhalation what air is in the lungs is exhaled normally and during the next inhalation the collapse happens again. Eventually, a shortage of oxygen causes you to move slightly or turn your head, the muscle tone of the throat returns briefly and you breathe normally for several breaths. Then it happens all over again.
Is it really a big deal?
YES! A June 11, 2013, study published in the Journal of American College of Cardiology, found that in people (mean age = 53 years) with sever sleep apnea, i.e. occurring more than 20 times per hour, there was a 60% increase in the risk of sudden cardia death during sleep. In people with more than 20 episodes per hour, there was an 81% increase in risk, compared to those without apnea.
YES -number 2! In a presentation given at the May, 2013 American Thoracic Society 2013 International Conference, Ricardo Osorio MD, reported on his research, in progress, that showed a link between sleep apnea and Alzheimer’s disease. Dr. Osorio noted that the markers for Alzheimer’s disease improved once treatment for sleep apnea began. Dr. Osorio was also hopeful that treatment for sleep apnea might evolve into a form of treatment for Alzheimer’s disease.
YES – number 3! Sleep apnea has also been associated with increased risk for hypertension and liver dysfunction.
What is the treatment?
There are many treatments, but a complete description of each is beyond the scope of this article. So let me focus on the most common and reliable treatment. It is called, continuous positive airway pressure (CPAP). The method involves sleeping with a small CPAP mask over your nose or nose and mouth. The mask is attached to a CPAP machine that maintains a certain air pressure within your throat. The air pressure prevents the throat from collapsing when the muscles of the throat relax. Therefore it helps maintain a clear passageway for the flow of air as you sleep.
It is worth noting that some people, but not all, respond to changes in lifestyle such as stopping smoking or losing weight. These are certainly worth a try. Also, forcing yourself to sleep on your side might also be helpful. It turns out that when your sleeping partner kicks you and says turn over they are doing you a favor. You can try putting a pillow behind your back to keep from easily rolling over on your back.
So spread the word, sleep apnea is destructive to your health and very treatable.