Recognizing Sleep Apnea
Always Sleepy, Never Rested
Recognizing Sleep Apnea
The problem with sleep apnea is that many people who have it don’t realize they do because, ironically, they are asleep when it happens. It can cause significant problems with our daily functioning – making us feel unrefreshed in the morning, fatigued throughout the day, and less able to concentrate and remember things like we should. It contributes to high blood pressure, heart disease, diabetes, and depression.
You are at risk for sleep apnea if you snore, have high blood pressure, have a larger neck size, or are overweight. Men are at slightly more risk than women, but it can affect anyone with the genes for it – it tends to run in families. Sometimes a couple will come into my office and the spouse will say “at times he will stop breathing for 15 or 20 seconds, I’ll get concerned, and then he’ll gasp and start breathing normally, but it keeps happening.”
There are two main types of sleep apnea – obstructive and central. In obstructive sleep apnea, there is a blockage in the airway that affects our breathing while we sleep. In central sleep apnea, the brain doesn’t send the signal to the lungs to keep moving air. In both cases, the body realizes it doesn’t have enough oxygen and sends a panic signal that partially wakes up the person, enough for the brain to send the signal to breathe or for the muscles to tighten up, removing the blockage and causing the “gasp.” Most of the time you are not conscious of these events at all, but sometimes you may wake up in the middle of the night “for no reason.” As soon as the person starts to breathe, the body relaxes and falls back into deeper sleep, and the cycle repeats. The problem is that the person never really gets good, restorative sleep – they are asleep, but it’s a very low quality sleep. This causes chronic stress on the body and leads to the problems mentioned above.
Fortunately, testing has become much simpler for this condition. We used to have to send people to a sleep center and have them stay overnight. Now, most people can be tested at home. If we see that there is sleep apnea then we begin treatment. The mainstay of treatment is always diet and exercise – losing weight and toning up the muscles can help reduce sleep apnea and sometimes fix it. The next step is CPAP – a machine that helps you breathe through the night so you can get deep sleep. In my experience, about 20% of people who use the machine feel it’s the best thing ever after the first night, 60% of people take a few weeks to get used to it, but eventually notice a real positive benefit, and 20% just can’t stand it. I strongly recommend sticking with it for at least a month, because once you start to feel it work, the reward makes it much easier to use. For people who just can’t get used to the breathing machine, there are other options, including a device that holds the airway open through the night or an implant that helps to keep the muscles toned so the airway stays open.
If you feel tired constantly, or if you are in need of a family doctor, don’t hesitate to call – we can help!