Robert Hayden, DC, PhD, FICC
I look for topics in current events, and sleep apnea is a recurring theme in the news nowadays. It is blamed for a long list of personal and societal problems. As research accumulates, it is being taken more seriously.
Sleep apnea is the term for a condition in which one either ceases breathing transiently or has very shallow breathing while asleep. These pauses may last anywhere from a few seconds to a few minutes and may occur up to 30 times in an hour. It is frequently associated with loud snoring or choking sounds, so anyone trying to sleep around this person will also have sleep disturbances. Imagine for a moment how rested one would feel after wrestling all night just to breathe.
This condition often goes unrecognized because it does not have a blood test or x-ray that identifies it. Many times a patient does not realize they have the condition. The only know that their chronically fatigued and are falling asleep in the middle of the day. If a patient calls this to the attention of a healthcare provider who is listening, there will be some probing questions to establish a history that contains the fingerprints of sleep apnea.
There are two kinds of sleep apnea to consider. Obstructive sleep apnea, the more common one, is associated with small upper airways that close or become obstructed during sleep. The other less common one is central sleep apnea which is related to the part of the brain that controls sleep or sometimes side effects of medications. Obstructive sleep apnea is associated with snoring, while central sleep apnea is not.
There is a common misconception that sleep apnea is caused by obesity. There are no good research data to support that assertion. About half of people who have sleep apnea are obese, but two thirds of Americans are obese anyway. If it happens in children, look for enlarged tonsils as a potential culprit.
If you have obstructive sleep apnea, you are likely to snore. You may be legendary for your snoring and never really know it. You will think everyone is making it up because you were in a stupor and unaware. However, when the neighbors begin turning on their lights in the middle of the night and your pets migrate to the other side of the house, you may use that as objective evidence that you have an issue.
You will be sleepy during the daytime, sometimes falling asleep at work. This is particularly bothersome if you drive for living, and the Department of Transportation is very aware of this situation and is trying to assess and control it in the pool of drivers under its jurisdiction.
If you have this condition, you may also experience morning headaches. You may awaken frequently for urination. You may have mood swings, personality changes, and irritability, so relationships may suffer. Concentration will be difficult, and thus learning will be more difficult or take longer. And, because you have struggled to breathe during the night, your mouth will be dry when you awaken, possibly with a foul taste. Dry mouth will also lead to halitosis (bad breath) and early decay of the teeth.
There may be a simple solution. Sometimes obstructive sleep apnea is the result of sleeping position. Side lying position for sleep should be optimal, while back sleeping will likely exacerbate the condition. You may want to try this and see if you rest better.
If you have changed your sleeping position and are still having these issues, make an appointment with your health care provider. Take with you a brief diary (maybe seven days) of your sleeping experiences. This will be helpful to establish the history of the condition. There will be a focused physical examination of your upper airways, including the mouth, pharynx, nose, sinuses, and tonsils if you still have them.
The definitive test for sleep apnea is a sleep study. Sometimes these are done in hospital or clinical settings. These are troublesome for patients because they are sleeping in a foreign place with wires and tubes on them. There is also significant expense that may run from $1800-$3000, depending on your location. Good luck getting insurance to cover that.
In our clinic, we use a home sleep study apparatus that will give us a good diagnostic test for under $200. There is a headset that you wear as you get into your own bed and sleep naturally in your own home. The headset is then mailed to the lab the next day and the data will be uploaded for analysis. The study is done on a cash basis so that complete privacy is assured. Insurance companies will not know you are having this study done. The results are faxed directly to us.
If treatment is needed, breathing machines can be obtained for home use. You would simply where one to bed and sleep with it to restore normal sleep cycles. It will make nearly miraculous differences in how you feel.
Moreover, sleep apnea is associated with high blood pressure, heart attack, stroke, and diabetes. It will increase the risk of congestive heart failure. It causes irregular heartbeats and increases significantly the chance of work-related or driving accidents. It also fuels obesity, and two-thirds of cancers are traced to obesity.
So if you are known for making legendary noises while asleep, think about having this assessed before it becomes more serious. Consider it very seriously. Or, if you prefer, sleep on it. Call me anytime if you have questions about this, because it can cost you more than a night’s sleep.