Despite our perceptions, restful sleep is not a luxury to be enjoyed when our busy schedules allow. Rather, it’s a vital aspect of our physical, emotional, and cognitive well-being. The fact is that if we don’t get restful, recuperative sleep on a regular basis, the adverse health consequences can be significant. Unfortunately, that’s the reality facing people with sleep apnea—a disorder that causes them to stop breathing for short periods of time during sleep. According to Naeem Lughmani, MD, sleep medicine specialist at The Toledo Clinic, patients with obstructive sleep apnea (OSA), the most common form of the disorder, typically have a smaller airway to begin with. When they sleep, the muscles in the back of their throat relax, further reducing the size of the airway. As a result, they snore. What’s worse, they can’t get enough air with each breath, so their oxygen level drops and their body reacts as if it’s drowning, producing high levels of adrenaline. With this adrenaline surge comes an increase in blood pressure, heart rate, and muscle tone—essentially a “fight or flight” response—and then the person awakens.
This pattern can repeat over and over again throughout the night, depriving the individual of restful sleep, yet he or she is often unaware that it’s even going on. Very often, a family member or bed partner notices the problem before the sufferer does.
Symptoms commonly associated with sleep apnea include waking in the morning feeling tired, excessive daytime drowsiness, irritability or moodiness, difficulty concentrating, attention issues that increase the risk of accidents, and decrease in memory and cognitive function.
“Apnea deprives the individual of REM sleep, which is associated with psychological well-being, as well as delta sleep, which is when the body produces growth hormone and heals itself,” Dr. Lughmani explains. So, both your psychological and physical health can suffer if you don’t achieve these sleep states or enter them only partially.
Another significant concern is that the lack of oxygen and increase in adrenaline can lead to high blood pressure, heart arrhythmias, a greater risk of stroke and other cardiovascular issues, and elevated blood sugar that’s difficult to manage. Research has also shown that apnea can have an adverse effect on the immune system.”
Furthermore, sleep apnea can be the underlying cause of health issues that may seem unrelated. For example, Dr. Lughmani notes that waking frequently to urinate at night can actually be a sign of sleep apnea. He explains, “When the individual’s airway collapses and he or she struggles to get air in, a negative pressure is created in the chest. That negative pressure creates a vacuum that draws more blood to the heart, causing it to swell up. In response, the heart signals the kidneys that there’s too much water in the body, so they in turn begin to produce excess urine.”
Examples of other conditions that, according to Dr. Lughmani, might warrant an evaluation for sleep apnea include insomnia, depression or other mood disorders, focus problems such as ADHD, hypertension that’s difficult to treat (requiring more than two medications), heart arrhythmias, congestive heart failure, and prior stroke. “If you already have any of these problems, you should consider the possibility of sleep apnea because proper treatment of apnea can help in managing all these conditions,” he explains.
The good news is, sleep apnea can be treated effectively so that sufferers can once again enjoy healthy, restorative sleep. In fact, a retrospective study revealed that people who have sleep apnea that is being treated do just as well as people who don’t have the disorder.
Sleep apnea is diagnosed through a sleep study, conducted by a sleep specialist. Once the problem has been diagnosed, treatment typically involves the use of either continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) to keep the patient’s airway open during sleep. As the name implies, the former delivers air at a continuous pressure through tubing connected to a mask, while the latter delivers two levels of air pressure—a higher level during inhalation and a lower level during exhalation. Dr. Lughmani states that there are many different forms of CPAP/BiPAP technology and different ways of delivering air pressure, so if the patient is having difficulty with one form, there are always other options to try.
“Patient compliance and follow-up are crucial to success with CPAP or BiPAP, and oftentimes there are simple solutions to problems in using the technology, such as adjusting the air pressure, replacing an old mask, or tightening loose straps. And if one type of equipment makes the patient feel claustrophobic, which is a relatively common problem, we can try another type or we can use various techniques to desensitize the patient to the claustrophobia,” he adds.
For patients who can’t tolerate CPAP or BiPAP, Dr. Lughmani notes that there are surgical options as well as dental devices for treating sleep apnea. However, they are not as effective. Also, because obesity is a major risk factor for sleep apnea, weight loss often yields significant improvement in symptoms.
Dr. Lughmani further emphasizes that there are different forms of sleep apnea, including obstructive sleep apnea (OSA); central sleep apnea, which occurs when the brain fails to send the proper signals to the muscles that control breathing; and complex sleep apnea, which combines elements of OSA and central sleep apnea. “Whatever the cause, if you are experiencing any of the symptoms of sleep apnea, it’s important to see a sleep specialist for a proper diagnosis and appropriate treatment plan. Getting started with treatment will not only help you sleep and feel better, but it might also prevent serious health complications from developing in the future,” he points out.❦