Do you suffer from daytime fatigue? Do you snore? If so, you may suffer from something called “obstructive sleep apnea.” This occurs in up to 10% of our population, but is thought to be one of those underestimated health conditions where a lot more people suffer from it, but just don’t know it yet (like diabetes). That is why I think it’s a good idea to make sure all my listeners learn about sleep apnea, to potentially help themselves or someone they love who may be affected by this disruptive ailment.
What is Sleep Apnea?
Sleep apnea is defined as pauses in air flow of greater than 10 seconds in length (hence the term “apnea”) during sleep. These pauses are caused by the collapse of the soft tissues in the back of the throat called the “pharyngeal” tissue. Sometimes the pauses are significant enough to cause a decrease in oxygen reaching the brain. This causes fragmentation in sleep, and patients are often very sleepy during the daytime as a result. Some report diminished functioning at work, along with the need to nap during the day. Patients may be so sleepy during the day, that they even fall asleep at the wheel of a car while driving—very scary.
People with the following conditions are more prone towards developing sleep apnea:
- The elderly
- High BMI (body mass index)
- Heavy alcohol consumption
- Sleep aid use
- Sleeping without dentures
- Increased neck girth (over 17 cm in men and 16 cm in women, if you feel the urge to get the tape measurer)
Symptoms of Sleep Apnea
As a physician, whenever a patient comes to me complaining of fatigue, I always ask about the following other possible symptoms of sleep apnea:
- Restless sleep
- Pauses in breathing during sleep (often reported by the significant other)
- Daytime napping or snoozing
- Headache upon awakening in the mornings
Diagnosis of Sleep Apnea
If your doctor thinks you may be suffering from sleep apnea, you will likely need special sleep testing using a home portable monitor or in the laboratory, where they measure your airflow, oxygen saturation, and breathing.
Consequences of Sleep Apnea
At this point, you may be thinking, “So what if there are a few pauses of air flow during sleep?” It doesn’t seem like a big deal, right? Well, sleep apnea can cause some pretty serious medical consequences, including:
- High blood pressure
- Heart failure
- Heart disease
- Automobile accidents
- Increased mortality, in general
Treatment of Sleep Apnea
If your doctor diagnoses you with sleep apnea, your main treatment consists of a special mask called a CPAP that blows air into your throat during sleep. I know what you’re thinking: Who in their right mind would be able to sleep with a big mask on their face, let alone one that blows air down your throat when you are trying to sleep? Patients often complain that it’s uncomfortable and takes some time to get used to it. However, they also tell me that they are able to regain their energy level and that it truly changes their lives as a result. Learning to fall asleep with the mask seems to be a very small price to pay for what they gain in return.
Weight loss is often the second method of treating sleep apnea and should really be the ultimate goal in every patient who is overweight and suffering from this condition. It’s really your only hope in curing the sleep apnea without having to wear a CPAP mask. Some patients no longer need the CPAP once they lose the weight and a sleep retest may be indicated once at least 10% of your initial weight has been lost.
In addition, it would be wise to avoid alcohol and sleep aids since both can exacerbate the condition. And don’t forget to wear your dentures to bed!
Take Home Message
Snoring and daytime fatigue are quite common symptoms. I cannot tell you how many patients I see who suffer from fatigue and snoring, and are also overweight. My little doctor antlers light up every time I see this combination of symptoms. Sleep apnea is underestimated, and your doctor may not think of it right away. If you have these symptoms, make sure to ask your doctor about sleep apnea.
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