Beating sleep apnea: we have the technology
This past week, March 27 - April 2, was National Sleep Awareness Week. [National Sleep Foundation] In addition to reminding people that getting a good night's sleep is essential to good health, the event serves to raise awareness about sleep disorders.
Last year, at age 28, I was diagnosed with obstructive sleep apnea. Since it is hard to explain, I'll use the National Sleep Foundation definition:
"Obstructive sleep apnea is a disorder in which breathing is briefly and repeatedly interrupted during sleep. The word 'apnea' literally means 'without breath.' Apnea is defined as a cessation of breath that lasts at least ten seconds. Obstructive apneas occur when the muscles in the back of the throat are not able to keep the throat open, despite efforts to breathe. This causes blockages in the airway and breathing interruptions, or apneas. Obstructive apneas can result in two problems: fragmented sleep and lowered levels of oxygen in the blood. The combination of sleep disturbance and oxygen starvation can result in multiple problems, including automobile accidents, hypertension, heart disease, and mood and memory problems . . . Although the connection between sleep apnea and heart disease is not entirely clear, we know that people with cardiovascular problems such as high blood pressure, heart attack, congestive heart failure, cardiac arrythmia and stroke have a high prevalence of sleep apnea." [National Sleep Foundation]
One recent study found that sleep apnea actually enlarges the heart, and makes it pump blood less effectively:
"Compared to the control subjects, the hearts of the sleep apnea patients were significantly enlarged on the right side and had thickened walls between the pumping chambers. The hearts of sleep apnea patients also pumped less blood per beat, and the velocity of wall motion was slower for both the left and right compared to the control subjects. The sleep apnea patients also had higher blood pressure and faster heart rates than the control subjects. The severity of the heart abnormalities was correlated with the severity of obstructive sleep apnea." [Science Daily]
I began experiencing symptoms of sleep apnea at around age fourteen or fifteen. I knew something was wrong, because I started having concentration and memory problems, and would get extremely tired all of a sudden at inappropriate times. It got worse as a got older, and eventually, sleep became a completely unpredictable aspect of my life. It became extremely hard to get up in the morning, and I would often oversleep, despite setting several alarms. And I would wake up with a sharp pain in my temples - similar to a really bad hangover - even when all I had drunk before going to bed was a glass of water.
One morning, when I was working in Midtown Manhattan, my chest started pounding, and I thought I was having some kind of heart problem. I told my boss I was sick, hopped in a cab, and told him to take me to the nearest emergency room. The triage doctor told me my heart was beating a little irregularly, but that he couldn't tell me what was causing it. "And you said you don't have any serious medical problems, right?" "Not that I know of."
It never occurred to me until recently that a sleep disorder could cause everything from memory and concentration problems to an irregular heartbeat. After all, if I had a problem with sleeping, it seemed like I slept too much, rather than not enough. Over the years, several doctors asked if I woke up a lot during the night, and I would respond that I didn't. What I didn't realize is that the "waking up" that occurs with sleep apnea is not necessarily the kind of conscious waking up which you would remember the next day (like waking up and staring at the clock, trying to get back to sleep). Instead, an apnea is often an unconscious cessation of breathing, which your body adjusts to by gasping for air, or by rolling over. Therefore, the best way to gauge whether someone should be checked out for sleep disorders is probably not whether they think they wake up a lot, but by how awake and rested they feel in the morning.
While sleep apnea doesn't always involve conscious waking, it definitely can. Another symptom of sleep apnea is suddenly waking up with your heart beating rapidly, as if it is about to jump out of your chest. I'm sure that nightmares, Porterhouse steaks, and other sleep disturbances may cause this occasionally. But if you find yourself consciously waking up with your heart pounding on a regular basis, or even a fairly regular basis, you probably have obstructive sleep apnea. This used to happen to me now and then, and when it did, it would happen just 15 to 20 minutes after I had fallen asleep.
Another misunderstanding people often have is that sleep apnea is something that only extremely overweight people get. When I started experiencing sleep apnea, I was not overweight at all, and was actually in the best shape of my life, playing basketball for a couple hours every day (nowadays, I don't get around to playing basketball as much, and I could afford to lose a little weight, but I'm still far from what you would call obese). Having a wide neck (size 16 1/2 or larger), and/or having a narrow throat (one of the top sleep apnea doctors in NYC looked into my throat and said "wow, it's definitely tight in there") are risk factors which are right up there with being overweight.
The good news is that obstructive sleep apnea can almost always be treated with a Continuous Positive Airway Pressure (CPAP) machine, which pumps air into your throat to keep it from closing up. The mask definitely bears some resemblance to Darth Vader's, but my CPAP has changed my life completely.
The moral of the story is that if you aren't getting good sleep, don't make the mistake I made, and spend fourteen years saying "oh well, I guess I just don't sleep well." Read up on sleep apnea and other sleep disorders, and talk to your doctor.
National Sleep Awareness Week page [National Sleep Foundation]
Sleep Apnea - The Basics [National Sleep Foundation]
"Sleep Apnea Treatment Benefits the Heart" [Science Daily]
"Dream Machine" [Calgary Herald]
"Air Mask Therapy Best for Sleep Apnea: Experts" [Forbes]
UPDATED 4/4/06:
Reader KB from Georgia writes to point out that custom-made oral appliances are another option for sleep apnea sufferers who do not like wearing a CPAP mask (and given their claustrophic nature and other drawbacks, there are a lot of people in this category).
Dental Sleep Medicine Program [Sleep Health Centers]
Last year, at age 28, I was diagnosed with obstructive sleep apnea. Since it is hard to explain, I'll use the National Sleep Foundation definition:
"Obstructive sleep apnea is a disorder in which breathing is briefly and repeatedly interrupted during sleep. The word 'apnea' literally means 'without breath.' Apnea is defined as a cessation of breath that lasts at least ten seconds. Obstructive apneas occur when the muscles in the back of the throat are not able to keep the throat open, despite efforts to breathe. This causes blockages in the airway and breathing interruptions, or apneas. Obstructive apneas can result in two problems: fragmented sleep and lowered levels of oxygen in the blood. The combination of sleep disturbance and oxygen starvation can result in multiple problems, including automobile accidents, hypertension, heart disease, and mood and memory problems . . . Although the connection between sleep apnea and heart disease is not entirely clear, we know that people with cardiovascular problems such as high blood pressure, heart attack, congestive heart failure, cardiac arrythmia and stroke have a high prevalence of sleep apnea." [National Sleep Foundation]
One recent study found that sleep apnea actually enlarges the heart, and makes it pump blood less effectively:
"Compared to the control subjects, the hearts of the sleep apnea patients were significantly enlarged on the right side and had thickened walls between the pumping chambers. The hearts of sleep apnea patients also pumped less blood per beat, and the velocity of wall motion was slower for both the left and right compared to the control subjects. The sleep apnea patients also had higher blood pressure and faster heart rates than the control subjects. The severity of the heart abnormalities was correlated with the severity of obstructive sleep apnea." [Science Daily]
I began experiencing symptoms of sleep apnea at around age fourteen or fifteen. I knew something was wrong, because I started having concentration and memory problems, and would get extremely tired all of a sudden at inappropriate times. It got worse as a got older, and eventually, sleep became a completely unpredictable aspect of my life. It became extremely hard to get up in the morning, and I would often oversleep, despite setting several alarms. And I would wake up with a sharp pain in my temples - similar to a really bad hangover - even when all I had drunk before going to bed was a glass of water.
One morning, when I was working in Midtown Manhattan, my chest started pounding, and I thought I was having some kind of heart problem. I told my boss I was sick, hopped in a cab, and told him to take me to the nearest emergency room. The triage doctor told me my heart was beating a little irregularly, but that he couldn't tell me what was causing it. "And you said you don't have any serious medical problems, right?" "Not that I know of."
It never occurred to me until recently that a sleep disorder could cause everything from memory and concentration problems to an irregular heartbeat. After all, if I had a problem with sleeping, it seemed like I slept too much, rather than not enough. Over the years, several doctors asked if I woke up a lot during the night, and I would respond that I didn't. What I didn't realize is that the "waking up" that occurs with sleep apnea is not necessarily the kind of conscious waking up which you would remember the next day (like waking up and staring at the clock, trying to get back to sleep). Instead, an apnea is often an unconscious cessation of breathing, which your body adjusts to by gasping for air, or by rolling over. Therefore, the best way to gauge whether someone should be checked out for sleep disorders is probably not whether they think they wake up a lot, but by how awake and rested they feel in the morning.
While sleep apnea doesn't always involve conscious waking, it definitely can. Another symptom of sleep apnea is suddenly waking up with your heart beating rapidly, as if it is about to jump out of your chest. I'm sure that nightmares, Porterhouse steaks, and other sleep disturbances may cause this occasionally. But if you find yourself consciously waking up with your heart pounding on a regular basis, or even a fairly regular basis, you probably have obstructive sleep apnea. This used to happen to me now and then, and when it did, it would happen just 15 to 20 minutes after I had fallen asleep.
Another misunderstanding people often have is that sleep apnea is something that only extremely overweight people get. When I started experiencing sleep apnea, I was not overweight at all, and was actually in the best shape of my life, playing basketball for a couple hours every day (nowadays, I don't get around to playing basketball as much, and I could afford to lose a little weight, but I'm still far from what you would call obese). Having a wide neck (size 16 1/2 or larger), and/or having a narrow throat (one of the top sleep apnea doctors in NYC looked into my throat and said "wow, it's definitely tight in there") are risk factors which are right up there with being overweight.
The good news is that obstructive sleep apnea can almost always be treated with a Continuous Positive Airway Pressure (CPAP) machine, which pumps air into your throat to keep it from closing up. The mask definitely bears some resemblance to Darth Vader's, but my CPAP has changed my life completely.
The moral of the story is that if you aren't getting good sleep, don't make the mistake I made, and spend fourteen years saying "oh well, I guess I just don't sleep well." Read up on sleep apnea and other sleep disorders, and talk to your doctor.
National Sleep Awareness Week page [National Sleep Foundation]
Sleep Apnea - The Basics [National Sleep Foundation]
"Sleep Apnea Treatment Benefits the Heart" [Science Daily]
"Dream Machine" [Calgary Herald]
"Air Mask Therapy Best for Sleep Apnea: Experts" [Forbes]
UPDATED 4/4/06:
Reader KB from Georgia writes to point out that custom-made oral appliances are another option for sleep apnea sufferers who do not like wearing a CPAP mask (and given their claustrophic nature and other drawbacks, there are a lot of people in this category).
Dental Sleep Medicine Program [Sleep Health Centers]
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