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Bob*
was in his early forties, enjoyed a variety of hobbies and loved his job as
a documentary filmmaker. Although Bob made it a priority to get at least eight
hours of sleep each night, he couldn't figure out why he always felt so tired.
At times he seemed to have no energy at all – he was too exhausted to play sports
and would often fall asleep while reading or watching TV. He tried going to
bed earlier at night, but it didn't help.
After months of feeling tired and irritable, Bob decided to see his doctor. "I was so sick and tired of being tired," he says.
Bob was referred to a sleep clinic for overnight testing and a diagnosis of sleep apnea was quickly confirmed.
What is
sleep apnea?
Sleep apnea is a disorder that causes your breathing to stop repeatedly while
you sleep. These breathing pauses or apneas usually last 10 to 30 seconds
and can happen many times throughout the night. The most common type of sleep
apnea is obstructive
sleep apnea which happens when the upper airway or throat gets blocked during
sleep. Often, the blockage happens when the soft tissue in the back of the throat
collapses and closes during sleep.
Relaxed throat muscles, a narrow airway, a large tongue or extra fatty tissue
in the throat can also block the airway. One in five adults has mild sleep apnea
and one in fifteen adults have at least moderate sleep apnea. Kids
can also get sleep apnea; obstructive sleep apnea affects one to three per cent of children.
| Why sleep is so important
Sleep, along with a healthy diet and exercise, is one of the overlooked keys to good health, says Dr. Najib Ayas, assistant professor in the Division of Respiratory Medicine, University of British Columbia. When sleep is disturbed over long periods of time it can negatively affect your health and feelings of well-being.
Sleep needs are different for each person – some need eight hours to feel properly rested while others need nine or more hours to feel refreshed. The right amount of sleep is whatever leaves you feeling rested and alert. While most people can follow simple steps to sleep better – going to bed at the same time each night, avoiding big meals, alcohol and caffeine before bed – people with sleep apnea must seek treatment from their doctor to get proper sleep.
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Sleep apnea is serious
Untreated sleep apnea can contribute to many problems, including difficulty with learning and memory, poor job performance and depression.
Evidence is now emerging about two of the gravest consequences of untreated sleep apnea:
- Increased risk for traffic accidents
Tired, drowsy drivers with untreated sleep apnea are less alert and less able to concentrate behind the wheel. Research
published in the New England Journal of Medicine suggests that people with sleep apnea are two to seven times more likely than healthy persons to have a traffic accident.
- Link between untreated sleep apnea and cardiovascular disease
Sleep apnea can also increase your risk for high blood pressure, heart attack and stroke.
In sleep apnea it's believed that the sudden and repeated drops in blood oxygen levels can increase your blood pressure and strain your cardiovascular system, which, in turn, can lead to heart attack and stroke. A recent study showed that there is a significant link between moderate to severe sleep apnea and stroke,
independent of other known risk factors.
Dr. Ayas says further research needs to be done to better understand the underlying
relationship between sleep apnea and cardiovascular disease and stroke. A
number of interrelated risk factors for sleep apnea – obesity, diabetes, high
blood pressure, alcoholism and smoking – are also known to increase the
risk for heart disease.
The bottom line is to see your doctor if you think you might have sleep apnea. "It's so important for people with sleep apnea to get treatment," stresses Dr. Ayas.
"Many of the people we see at our clinic are ticking time bombs on the verge of having a major heart attack or stroke." Your doctor can also suggest other lifestyle changes to reduce your sleep apnea symptoms and risk for other diseases.
Fortunately, there is easy, effective therapy available for sleep apnea.
"so important for people with sleep apnea to get treatment"
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CPAP — a therapy that works
After Bob's diagnosis of sleep apnea his doctor recommended Continuous
Positive Airway Pressure (CPAP) therapy. CPAP works by delivering a steady
stream of air through a special mask to keep your airway open during sleep.
A machine gently blows pressurized room air to the mask through a flexible tube.
The constant flow of air pressure from the mask prevents your airway from collapsing
when you breathe in.
Bob tried using the mask for a few weeks but found it uncomfortable and difficult to use. Before long, the mask ended up on a shelf in his closet. Sadly,
Bob continued to struggle with his symptoms for several more years until he got the support he needed to make his CPAP therapy work. He credits his wife of seven years Juanita*, with helping him to manage his sleep apnea and follow through with his CPAP therapy.
Learn the signs and symptoms of sleep apnea
Sleep apnea is sometimes called the snoring disease because snoring
is one of the symptoms. But snoring by itself doesn't necessarily mean that
you have sleep apnea. You can take this sleepiness
test to see if you're at risk.
If you have any of the following signs, see your doctor:
- daytime sleepiness
- loud snoring followed by silent pauses
- gasping or choking during sleep
- morning headache
- irritability or mood changes
- poor concentration or memory loss
- lowered sex drive
- falling asleep while driving.
Family members or bed partners often pick up on the signs of sleep apnea first. Many people with sleep apnea don't know they're snoring and gasping for breath at night. In fact, they may even think they're sleeping well!
Bob's wife Juanita recalls her frustration in trying to cope with her husband's snoring and his sometimes-irritable moods that came from lack of sleep. "I would move to the couch and still hear his thunderous snoring even though he was sleeping down the hall. I felt frustrated and stressed about not being able to get enough sleep myself."
At his wife's urging Bob finally decided to ask his health provider to help adjust his CPAP mask so it fit more comfortably. He bought a newer model mask with a quieter unit and a built-in humidifier, which helped to reduce the dryness in his throat and nose. After a couple of weeks Bob was able to use his CPAP machine all night. He says the difference was truly remarkable. "I felt fantastic, more alert. I stopped getting colds all the time. I was a much happier person."
If you have any of the signs and symptoms listed above, see your doctor. The sooner your doctor confirms a diagnosis of sleep apnea, the sooner you can begin therapy. Like Bob, you will feel better rested, more energetic and reduce your risk for serious health problems.
| What about lifestyle changes?
In addition to using his CPAP therapy regularly, Bob also lost 15 pounds,
bringing his body weight down to a healthy range. Obesity is a key risk
factor for sleep apnea. Being overweight significantly increases your
risk because having extra fatty tissue around your neck can put pressure
on your airway during sleep.
Other risk factors include alcohol and tobacco use and having a family
history of the disorder. If you have sleep apnea and you are overweight
ask your doctor or other health professional for help in creating a weight
loss plan for you. The most important lifestyle changes for people with
sleep apnea are:
- lose weight if you are overweight
- don't smoke
- sleep on your side instead of on your back
- stick to a regular sleep schedule
- avoid caffeine, alcohol and sleeping pills.
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*Names changed to protect privacy
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This article was prepared by 
