Are you sleepy during the daytime despite getting 7 or 8 hours of sleep during the night? Do you snore so loudly that others have difficulty sleeping in the same room? Do you wake up with a headache or parched mouth? It’s possible that you have sleep apnea and don’t know it.
Sleep apnea is a condition that interferes with breathing during sleep. It is potentially life threatening, since breathing literally stops more than 20 times each hour for anywhere from 10 seconds to 2 minutes at a stretch. You may wake up gasping for air during these breathless intervals but then fall back to sleep, unaware that anything happened. As a result, you don’t remember that your sleep was disturbed. But your body does. People with sleep apnea are often so tired during the day that they find it difficult to stay awake, even when driving or socializing. As my patient Andy found, untreated sleep apnea can interfere with all aspects of your life, and ignoring it may lead to disaster.
Diagnosing the Problem
Many people are tired and sleepy at some point during the daytime, so that fact alone isn’t enough to diagnose sleep apnea. And although loud snoring is often a symptom, it’s not always present; and not everyone who snores has sleep apnea. Some additional symptoms include:
- Frequent need to urinate during the night
- Daytime irritability and/or mood swings
- Difficulty concentrating or focusing
Most of us experience these sorts of symptoms from time to time, but they are more common among sleep apnea sufferers. I can also tell you that the disorder is more common in men than women, especially overweight, middle-aged men.
Sleep apnea can be treated, but it must be identified first. Because it’s tricky to pin down, the best way to properly diagnose it is by visiting a sleep-testing center, which your doctor can recommend, or by using a home sleep tester.
One thing you do not want to do is ignore the situation and try to tough it out. Sleep apnea is associated with high blood pressure, low levels of testosterone, blood sugar management difficulties for diabetics, and a greater likelihood of strokes, as well as an increased risk for heart disease. Furthermore, sleep apnea interrupts normal sleep cycles that include dreaming and rapid eye movement (REM) sleep, making you vulnerable to psychological and emotional difficulties.
Understanding Sleep Apnea
There are three types of sleep apnea: obstructive, central, and mixed. Obstructive sleep apnea is the most common and the most serious. In this condition, tissues in the throat temporarily block air intake. This happens because our muscles relax when we sleep. That allows the uvula (the appendage hanging in the back of the throat), the tongue, or tonsils to block the airway.
In central sleep apnea, a part of the brain fails to send the necessary information to the muscles that breathe for you at night. Central sleep apnea is most often found in people age 60 or older, and it is far less common than obstructive sleep apnea.
Mixed sleep apnea, the third type of the condition, combines features of both obstructive and central sleep apnea.
Treating Sleep Apnea
Once sleep apnea is identified, a number of treatments are available, including the following:
Weight loss: Losing weight can improve overall health dramatically. I’ve had patients who lost as little as 10 pounds get relief from sleep apnea, while reporting less joint pain, too.
Sleeping on your side: A change of sleeping position from back to side may help keep the airway open and ease sleep apnea symptoms.
A continuous positive airway pressure (CPAP) machine: The CPAP is a very effective device, although the mask aspect intimidates some people. A CPAP keeps the airway open by relaying pressurized air through a mask that fits snugly over the nose. Most people find that they can sleep very well with the mask, even though it does take some getting used to.
If you try a CPAP and have problems, work with your physician or sleep technician on making adjustments. If one machine or mask isn’t working for you, ask for a different one. It’s important that the mask fit properly, so don’t settle for one that leaves gaps between the seal and your face.
Hormone and neurotransmitter evaluations: Insufficient hormones, especially testosterone in men, increase sleep apnea. In addition, low levels of the neurotransmitter serotonin, known for promoting feelings of well being, have been linked to sleep apnea. Blood tests can help determine if you need supplemental hormones or additional serotonin. A doctor familiar with natural hormones can give you a prescription for testosterone cream. Serotonin levels can be raised by taking 100 to 300 mg of the amino acid 5-HTP (5-hydroxytryptophan, available at most health food stores) at bedtime.
An oral device: Oral devices, which reposition the jaw to minimize obstructions, may be helpful for anyone with obstructive sleep apnea who can’t tolerate the CPAP due to claustrophobia or other issues.
Surgery: Surgery involves removal of tissue that may obstruct breathing. It is effective for about half of the patients who try it. A second, more aggressive surgery is another option for those who do not get relief initially.
Prescription medication: Prescription drugs, such as Nuvigil or Provigil, that promote alertness may help sleep apnea patients stay awake during the day. Keep in mind, though, that these drugs, like all medications, have side effects that may include:
- Sleep difficulties
- Feelings of anxiety or nervousness
- Back pain
- Allergic reactions, like swelling of the face, lips, or tongue
- Stuffy nose
Given the choices, I recommend numbers 1, 2, and 3 (if appropriate) first; and many people will benefit from using a CPAP machine while they’re working on weight loss.
Clearly, sleep apnea is a disorder that requires attention. If you suspect you may have the condition, I urge you to seek treatment because this is not something that goes away or improves with time. It can have serious consequences for you and others if not treated. And I can tell you that every single patient of mine who has been treated for sleep apnea reports feeling dramatically better afterward, despite initial reluctance. So take my word for it, this is one condition you can get under control safely and easily, and I’m here to help.