We can all remember our parents telling us how important it is to sleep. Most of us can vividly remember the cry of a cranky toddler who has not had his or her nap and lets the world know it. Unfortunately, as adults we manifest the effects of not having enough sleep a lot more dangerously then the crying toddler. As adults not getting enough sleep means having an increased risk of heart attack and stroke.
Many obstacles get in the way of us having healthy sleep. To name a few: we have deadlines that need to be met, work longer hours, have “insomnia ,” travel for a living and are constantly in different time zones, and/or we have a disorder like Obstructive Sleep Apnea. Whatever the reason, the problem of sleep deprivation must be corrected. This is exactly what sleep physicians do—they get people sleeping.
Recently the American Academy of Sleep Medicine and The Centers for Disease Control and Prevention (which help support the development of the current guidelines) have recommended that adults get at least seven hours of sleep each night. Getting only six or less has been associated with a decrease in performance, increased risk of heart attack, stroke, diabetes, and obesity.
Although there are many causes of not getting enough sleep, today we will focus on the epidemic of undiagnosed sleep apnea which accounts for anywhere 75% – 85% of cases.
What is Sleep Apnea and how many people does it effect?
Estimates suggest that sleep apnea affects more than 18 million people in the United States. Sleep apnea is when breathing partially or completely stops during sleep. The most common type of sleep apnea, Obstructive Sleep Apnea, is caused by blocked airways in the throat. A person with sleep apnea will awaken, partially or fully, when the brain doesn’t get enough oxygen. In most cases, the person is not even aware of. People with sleep apnea may be known as loud snorers and often the bed partners are the ones who bring them in to see a doctor. People with sleep apnea may have excessive daytime sleepiness, fatigue, insomnia, depression, or secondary hypertension.
What are the risk factors for Sleep Apnea?
- Increased BMI>25.Around half the people with obstructive sleep apnea are overweight. Fat deposits around the upper airway can obstruct breathing.
- Narrowed airway.You may have naturally narrow airways, or your tonsils or adenoids may be enlarged, which can block the airway.
- High blood pressure.
- Chronic nasal congestion.
- People who smoke are more likely to have Obstructive Sleep Apnea.
- A family history of sleep apnea.If you have family members with Obstructive Sleep Apnea, you may be at increased risk.
- Recent research has found an association between asthma and the risk of Obstructive Sleep Apnea.
In addition, patients who have Atrial fibrillation (also called AFib) should be screened for sleep apnea. There are many risk factors for developing AFib. These include being age 60 years of age or older, having high blood pressure, diabetes, or existing heart disease. Another risk factor that is little known and not completely understood is sleep apnea.
How is sleep apnea diagnosed?
Sleep apnea is diagnosed by an overnight sleep test. The study measures the number of times that a person either stops breathing during sleep or breathing becomes very shallow. It also measures the level of oxygen in the blood and monitors the brain and heart rhythm during sleep.
What are treatment options for sleep apnea?
The major treatment options are as follows:
- Lifestyle changes such as losing weight
- CPAP or BIPAP therapy
- Dental devices for sleep apnea
- Nasal dilators
- Surgical options of which there are many. Our patients have had a lot of success with the new Inspire therapy.
Dr. Thakkar is the founder and the medical director of Golden Gate Sleep Centers. She completed her Internal Medicine training at UCSF, Fresno, then a Sleep Medicine Fellowship at UC, Davis. She then served our Veterans at the VA in Sacramento / Mather. She remains part of the UC Davis volunteer Faculty in Sleep Medicine and has served as Medical Director of private practice Sleep Labs. Visit her website at goldengatesleepcenters.com or call (925) 820- 4472.