“Everything that I did in my day I did because I had to do it,” Tamara, a 52-year-old Colonial Heights resident, says. “You have to get up. You have to go to work. You have to fix dinner. You have to wash clothes. ... I had no motivation to do anything. I did it because I had to do it.”
After living that way for a year or so, Tamara says she started to suspect she might have sleep apnea, a condition the National Institutes of Health defines as a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.
According to the NIH, people with sleep apnea stop breathing for a few seconds to minutes and these pauses may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. ... As a result, the quality of your sleep is poor, which makes you tired during the day.
Tamara had read about the symptoms, among them fatigue, daytime sleepiness and, as she puts it “being able to fall asleep at the drop of a hat.” Her husband also said she’d been snoring loudly — also a sign of sleep apnea — and that she stopped breathing off and on during the night.
Roy was familiar with sleep apnea, having been diagnosed with it himself last summer. The 63-year-old, retired from a career in the U.S. Army, says he’d always had trouble falling asleep — sometimes staying awake for an hour or more, just “thinking, thinking, thinking” — but Tamara had noticed he was also snoring and having breathing pauses.
Encouraged by his wife and his physician, Roy underwent a sleep study and was diagnosed with obstructive sleep apnea.
What is a sleep study?
Sleep studies are tests that record what happens to your body during sleep. The studies are done to find out what is causing your sleep problems. ... Sleep studies are usually done in a sleep lab. But sleep studies also can be done with portable equipment you use at home. (WebMD)
Dr. Richard Parisi, MD, a sleep medicine specialist with Sleep Clinics of America, says obstructive sleep disorder, in which “the throat collapses intermittently overnight,” is the most common problem he diagnoses and treats in his practice.
It’s most common in those who are overweight, he says, but family history and the shape of a person’s airway are also factors. In kids, tonsils and adenoids are often to blame and surgically removing them often takes care of it. Left untreated, however, sleep apnea can lead to serious medical problems.
“Oxygen levels decline when you’re not breathing and blood pressure increases every time you have one of these pauses for breathing,” Dr. Parisi says. “That combination of things increases the risk of heart disease, including heart arrhythmias like atrial fibrillation, and strokes are more common. Diabetes [risk is] increased to an even greater degree in those with sleep apnea.”
Fortunately, there are effective treatments.
“It’s treated in a multitude of ways,” Douglas Puryear, MD, a sleep medicine physician with Pulmonary Associates of Richmond, says, adding that treatment may be as simple as “positional therapy,” instructing a patient to sleep on his or her side, which can help keep the airway open.
Other treatments include weight loss, dental devices that help keep the jaw forward and airway open, and continuous positive airway pressure treatment, commonly known as CPAP.
What is CPAP?
Continuous positive airway pressure therapy (CPAP) uses a machine to help a person who has obstructive sleep apnea breathe more easily during sleep. A CPAP machine increases air pressure in your throat so that your airway doesn’t collapse when you breathe in. (WebMD)
After he was diagnosed with sleep apnea, Roy and his physician discussed CPAP and decided it was the best treatment option for him. Still, Roy says, he was “frustrated” and “upset” about having to sleep in a mask, hooked up to a machine, when he’d always been in pretty good health.
Suleman Iqbal, MD, a sleep medicine physician with Sleep Centers of America, understands these feelings.
“Part of it is psychological and part physical,” he says. “The nature of having to strap a mask to your face with blowing air all night. At one time, you’re [just] in your pajamas. Now, it’s a CPAP machine ... with a tube that connects to your face. It can be uncomfortable, but over the last year the machine’s have become much more quiet — like a fan — and masks that patients wear are much more comfortable as well.”
Still, he adds, “Nothing’s going to change the fact that you have to sleep with a mask on your face.”
Some patients also might find using CPAP embarrassing, he says, particularly single people.
“Married couples often do better with it,” Dr. Iqbal says. “The patients sleep with it and see how much better they feel [and] get over that pretty quickly, once they realize how much it helps them. They come off blood pressure medications, diabetes is better controlled. They’re willing to tolerate it because their overall health and daytime energy levels are improving.”
It took just one night for Roy to become a believer in CPAP therapy. When he woke up the morning after using the machine for the first time, Roy says he “felt like a different person.” He was motivated, he had energy, and it hadn’t taken him hours to fall asleep.
“When I put that mask on, I was knocked out right away,” he says. “It was like a sleeping pill to me.”
Over the next few weeks, as Roy started feeling better and better, Tamara started thinking maybe she should do something about her sleep apnea, too. She’d been losing weight, which she was told might alleviate the problem, but says she wanted a “quicker fix” because of the risks associated with sleep apnea and heart disease.
“Another motivating factor for me to do it was I kind of already knew I had it and we have a 10-year-old and a 15-year-old, and I was afraid of the damage it could do to my heart in the process,” she says. “I really didn’t want to wait until I lost the weight. ... I wanted to be healthy for them as well as myself.”
These days, both Roy and Tamara are using CPAP and sleeping and feeling much better. Like her husband, Tamara saw an immediate improvement in her energy level. She started exercising, something she was always too tired to do before, and has lost 20 pounds. Her goal, she says, is to lose enough weight to be able to stop using the CPAP machine altogether.
“It just makes me an all around better person,” she says. “It makes me feel more enthusiastic about daily life activities and gives me ambition, drive and motivation to do things.”
Asked what she would say to others who are considering seeking treatment for sleep apnea, Tamara says, “I would say if they want to feel better during the day, if they want to have energy and be motivated, to definitely do it. My only regret is I didn’t do it sooner.”
Lack of sleep nothing to snore at
The Centers for Disease Control and Prevention says insufficient sleep is a “public health epidemic” affecting 50 to 70 million adults in the U.S. According to Dr. Parisi, the average American adult gets six to six-and-a-half hours of sleep each night, but actually needs seven or eight.
“Most people are sleep deprived,” he says.
The CDC also links the sleep deprivation to numerous medical conditions — among them high blood pressure, diabetes, depression, cancer and obesity.
“Sleep is important for lots of physical reasons,” Dr. Parisi says. “There are other body functions that are linked to sleep cycles: hormone levels, metabolism, centers in our brain that regulate food intake. All that is connected. So, people who do not get sufficient sleep are more likely to eat more during the day [and] seek out fatty and high-carbohydrate foods. Weight gain is a very common consequence of sleep loss.”
Lack of sleep also has been linked to an increased risk of accidents, both on the job and on the road.
The National Highway Traffic Safety Administration estimates “drowsy driving” accounts for “more than 100,000 crashes a year, resulting in 40,000 injuries and 1,550 deaths.” In keeping with this, WebMD reports, “Reducing your nighttime sleep by as little as one and a half hours for just one night could result in a reduction of daytime alertness by as much as 32%.”
“We keep learning more and more about the effects of sleep loss,” Dr. Parisi says. “Very significant things happen. First of all, the most obvious: [you are] less alert during the day when driving and working. It affects work productivity, mood, creativity, memory. There are also physical consequences.”
What are some consequences of sleep deprivation?
- Decreased performance and alertness
- Memory and cognitive impairment
- Occupational injury
- Automobile injury
- Poor quality of life
- High blood pressure
- Heart attack
- Heart failure
- Psychiatric problems
- Attention Deficit Disorder
- Mental impairment
- Fetal and childhood growth retardation
- Injury from accidents
- Disruption of bed partner’s sleep quality
- Poor quality of life
Dr. Puryear traces the sleep deprivation problem back to a very famous invention: the light bulb.
“Insufficient sleep is probably the most common sleep disorder in the U.S.,” he says. “What caused it? The light bulb. Before the light bulb, people went to sleep when it got dark and had big families.”
‘Beauty Sleep’... Is there anything to that?
Most people have probably heard someone say, “I’ve got to get my beauty sleep.” Is there anything to that notion? Local physicians say there is.
“Proper sleep makes one feel better, and if you feel better, whether you look better or not, you’re going to think you look better,” Dr. Puryear says. “Some people get puffiness around the eyes and more lines around the face. That will take away from one’s physical appearance.
“People you run into — they look tired, bags under their eyes, eyes droopy, yawning — that takes away from our general appearance, as opposed to bright, chatty, energetic looking.”
But, he adds, “If you sleep more, are you going to wake up looking like a supermodel? Probably not.”
According to Dr. Parisi, the concept of beauty sleep might actually be based in science.
“There’s really some ... scientific evidence to that,” he says. “It turns out that sleep is important for healthy connective tissue. The connective tissue in our skin that makes it more elastic and prevents wrinkling and sagging is related to sleep. That may be the mechanism for the value of beauty sleep.”
What is REM sleep and what happens there?
Dr. Parisi says there are “two general sleep stages” — REM and non-REM — that are cycled through during sleep and both are essential to getting a good night’s rest. REM, or rapid eye movement sleep, is when “most of the dreaming occurs,” he says. “Non-REM sleep is also known as quiet or deep sleep. Non-REM sleep is actually the majority of the night in adults — about 75 percent of sleep.”
“They both have different functions. Different parts of the brain are involved in different stages. In general, you can say that non-REM sleep is more important for physical regeneration, recovery overnight. That’s the stage where growth hormone is produced and your body recovers from physical injury. REM sleep may be more important for mental regeneration, for memory consolidation, for mood.”