By: Dr. Sreelatha Naik, MD, Geisinger Sleep Medicine
Is snoring, gasping or choking keeping you or your bedmate from getting a peaceful night’s rest?
When a person has sleep apnea, let’s face it: They aren’t the easiest of bed partners. Treating this common condition not only eases annoyances, but it can prevent a range of serious health issues.
Many cases do go untreated — simply because not everyone has someone to wake them up and tell them to quit snoring already. So they have no idea they’re living with a medical condition that could easily be treated.
Most patients seek treatment because a bed partner or roommate notices snoring and disrupted sleep. Many patients are referred to us by cardiologists, neurologists and other specialists who recognize some of the effects of sleep apnea, such as heart disease and stroke. Recognizing the symptoms early can help you get treatment before the related health issues go from bad to worse.
Signs of sleep apnea
Although you may not know you have this condition — since you’re sleeping (or nearly sleeping) when it happens — there are some clues to watch for:
Do you wake up feeling tired no matter how much sleep you’ve had, and then feel sleepy during the day? Dozing off in a meeting might be funny to your coworkers. But dozing off while driving is dangerous. While sleep apnea is a common cause of sleepiness, a sleep provider may find other causes of insufficient sleep, like narcolepsy.
If your very loud snoring has been waking up your bed partner, they’ve probably mentioned it a few (hundred) times. It might be time to talk to a sleep specialist.
Gasping and choking
Feeling short of breath when you wake up or suddenly waking yourself by gasping for air or choking? The likely cause is sleep apnea.
Waking up frequently, feeling restless at night and dealing with insomnia are symptoms for many women with this condition.
Cognitive and mood changes
Signs you might not expect include memory problems, anxiety, depression and loss of interest in sex.
Feeling bad when you wake up
Morning headaches and waking up with a dry throat and mouth or a severely sore throat are all signs to watch for.
Types of sleep apnea
There are two major types of sleep apnea: obstructive and central.
The most common of the two types, obstructive sleep apnea, is caused by a complete or partial blockage of the airway. Risk factors include being male, over 40 or overweight, and having a large neck and tonsils. People with gastroesophageal reflux (GERD), a family history of sleep apnea and nasal obstruction are also at risk.
Central sleep apnea occurs when the nerves that control the breathing rhythm fail to transmit signals to your breathing muscles. Those who are using certain opiate medications, have had heart failure or have had a stroke are at risk.
What happens if you have sleep apnea?
Recognizing the type of sleep apnea and getting the proper treatment is very important because it may cause a range of problems such as heart disease, stroke, poorly controlled diabetes, difficult-to-control blood pressure, sleepiness and even traffic accidents. Untreated sleep apnea is also a major cause of hospital readmissions, including for diseases such as COPD, and is a major cause of death from all causes."
Resulting health problems include:
· Heart failure
· Arrhythmia, such as AFib or heart flutters
· Heart attack
· High blood pressure
· Cognitive issues
Your treatment options vary depending on how severe your symptoms are and the type of sleep apnea you have.
A CPAP machine, which delivers air through a mask worn over the nose or mouth to keep the windpipe open when you sleep, is the most effective form of treatment for obstructive sleep apnea. Alternate treatments, such as dental devices worn during sleep to reposition the tongue and jaw, as well as nasal devices, have shown variable success.
Some people find a CPAP machine uncomfortable There are many reasons for this, including having a more complicated breathing problem than obstructive sleep apnea. That’s why you need to follow up with your sleep physician for regular monitoring if you’re on a CPAP. Advanced technology allows sleep physicians to track your breathing using an internet-based system while you’re using the CPAP at home.
Luckily, many other treatment options exist for obstructive and central sleep apnea. Tell your sleep provider if you have difficulties with CPAP so they can find a better approach for you.
Surgical therapies to treat sleep apnea have traditionally included tonsillectomies and other surgeries that open the nasal or throat passages. A newer means of treating obstructive sleep apnea is an implantable pacemaker device called hypoglossal nerve stimulation, or the Inspire® device.
For central sleep apnea, there’s a similar pacemaker-type apparatus called phrenic nerve pacing, or the Remedē® System. Lifestyle changes, like losing weight, changing your sleeping position and practicing good sleep habits, can help too.
Geisinger offers these and other therapies as well as offering a sleep medicine fellowship to train new physicians on the latest approaches and technologies. Our program is truly cutting-edge.
A multi-pronged approach
Given the advances in sleep medicine, managing sleep apnea and sleep disorders has become a multidisciplinary process. After your initial visit with a sleep specialist, you may be referred for ENT (ear, nose and throat) surgery, oral maxillofacial surgery or psychological treatment to improve your sleep health — which should lead to better health overall.
Work with your sleep provider to determine the right therapy for you. Why put up with another night of snoring? Everyone deserves a good night’s sleep.
For the latest health and wellness tips and advice, visit geisinger.org/balance.