Question: My husband’s sleep apnea machine is collecting dust at the bottom of a closet. I seem like treating this was the rage a few years ago but now you hear nothing about it. Has something changed that I don’t know about? — Susan, of Lima
Susan! Maybe your husband needs to dust off his machine and contact his doctor for adjustments.
Sleep apnea is quite common, as common as type 2 diabetes. It affects more than 18 million Americans, according to the National Sleep Foundation. Risk factors include being male, overweight and over the age of 40. But sleep apnea can strike anyone at any age, even children. The rate of obesity is increasing, and so is sleep apnea.
What is sleep apnea? Sleep apnea is a condition that makes you stop breathing for short periods while you are asleep. There are two types — obstructive and central.
In obstructive sleep apnea, you stop breathing because your throat narrows or closes during sleeping. In central sleep apnea, you stop breathing because your brain does not send the right signals to your muscles to make you breathe.
Many people with sleep apnea do not know that they stop breathing when they are asleep. But they do sometimes wake up startled or gasping for breath. They also often hear from loved ones that they snore.
Sleep apnea may cause daytime sleepiness, restless sleep, waking up choking or gasping, morning headaches, dry mouth, or sore throat, waking up often to visit the toilet, waking up feeling unrested or groggy, trouble thinking clearly or remembering things. When you wake up, you may not move right away. Your muscles feel weak or you may without reason laugh, get excited or angry.
Is sleep apnea dangerous? It can be. People with sleep apnea do not get good-quality sleep, so they are often tired and not alert during the day. This puts them at risk for car accidents and other types of accidents. Plus, studies show that people with sleep apnea are more likely than others to have high blood pressure, heart attacks and other serious heart problems. In people with severe sleep apnea, getting treated with C-PAP machine can help prevent some of these problems.
Sleep apnea must be differentiated from narcolepsy. People with this condition are very sleepy in the daytime and sometimes fall asleep suddenly during normal activities. Insomnia is another condition that can cause daytime sleepiness. Other times medical conditions such as hypothyroidism can cause it. In hypothyroidism, the person does not make enough thyroid hormone and all organs slow down. Depression is the other condition that may cause sleepiness during the day.
There are a few things folks with sleep apnea may want to do:
• Stay off your back when sleeping.
• Lose weight if you are overweight.
• Avoid alcohol because it can make sleep apnea worse.
• Avoid smoking.
Several tests may be needed to pin down the cause of sleep apnea before the treatment is started. A “sleep study” is the most common test doctors use to find the cause of daytime sleepiness. For this test, you spend the night in a sleep lab at a hospital or doctor’s office. Sometimes these tests may be done at home.
How is sleep apnea treated? The most effective treatment for sleep apnea is a device that keeps your airway open while you sleep. Treatment with this device is called “continuous positive airway pressure,” or CPAP. People getting CPAP wear a face mask at night that keeps them breathing.
If your doctor recommends a CPAP machine, try to be patient about using it. The mask might seem uncomfortable to wear at first, and the machine might seem noisy, but using the machine can really pay off. People with sleep apnea who use a CPAP machine feel more rested and generally feel better.
There is also another device that you may wear in your mouth called an “oral appliance” or “mandibular advancement device.” It also helps keep your airway open while you sleep. But devices do not work as well as CPAP for treating sleep apnea.
In rare cases, when nothing else helps, doctors recommend surgery to keep the airway open. Surgery to do this is not always effective, and even when it is, the problem can come back. Other treatments can be losing weight, positional therapy, correction of the nose and removal of tonsils, dental appliances, jaw surgery and the pacemaker-like Inspire device.
CPAP therapy cannot cure. Sometimes it is challenging. Sometimes some people cannot tolerate, do not like the mask, have a sinus problem or a broken nose. They may have big tonsils that require surgery. Some others outright do not want to use it and deny that they have the problem.
The most important thing is communication with the treating physician who is an expert in sleep disorders. There are more than 50-60 different styles of masks available from different companies to fit the mask properly.
Please do not ignore it. Good sleep is especially important. Sleep apnea is mostly a treatable condition.
Be safe, take all precautions for COVID-19 and stay healthy.
Suman Kumar Mishr MD, Fellow of American College of Endocrinology, Cridersville.