Regional
(2008-06-30)
Listen Now:
GREELEY, CO
(KUNC) -
null
The average person will spend more than 194-thousand hours of their life sleeping. But not all of those hours are restful - especially if you suffer from a sleep disorder. KUNC Commentator Dr. Marc Ringel joins us this morning for a little pillow talk.
It was love at first sight. Well, not actually at first sight. More like at first breath. I'm talking about my CPAP machine. CPAP stands for continuous positive airway pressure. All night, every night, this device blows air into my nose in order to keep my upper airways from collapsing when I inhale.
With sleep, muscles in the throat and nose can collapse and flap around to make the racket we call snoring. When floppy tissues shut the airway all together you have apnea, meaning no breath. The brain sometimes responds to the low oxygen level that comes with apnea by waking a person right up. More often, the breathless spell is just enough to move the sleeper from a deep REM dream-state to a shallower stage of sleep.
Whether they wake up completely or just spend too little time in REM sleep, people who suffer with sleep apnea do not get really restful sleep. They are fatigued and tend to fall right off to sleep day and night. Because they enter slumberland so easily and may not reach consciousness during any of the dozens of times a night that their snoozing is interrupted by apnea, people with sleep apnea often characterize themselves as sound sleepers. I did.
Daytime fatigue and diminished alertness are the most direct effects of being deprived of normal sleep. A host of other complications can result indirectly from lower oxygen levels, under the general heading of physiological stress. Heart rhythm disturbances and difficult-to-control hypertension are just two of the frequent complications of sleep apnea.
I've been describing obstructive sleep apnea, meaning that breathing is stopped by blockage of the airway. There are other kinds of sleep apnea that can result, for example, from weakness of the muscles that move the lungs and from decreased breathing drive as the result of drugs or of certain types of strokes. So, when a significant sleep disorder is suspected, it's important to make a specific diagnosis because the different types of sleep apnea require different types of treatments.
The large majority of sleep apnea does turn out to be obstructive. Middle aged men who are overweight are especially at risk for this malady. Facial muscles, including the ones that support the upper airway, slacken with age and these tissues thicken with weight gain. As for why men are more susceptible to sleep apnea than women, that may have something to do with hormones.
If you have daytime sleepiness, your partner complains of your snoring and especially, if she's heard you stop breathing while snoozing, ask your health care provider whether you ought to get a sleep study. The study isn't bad. You show up in the evening at the lab, carrying your own blankey, teddy bear, and hot water bottle. A technician attaches all sorts of sensors and wires to your head and body. The devices are surprisingly comfortable and unobtrusive. Then it's lights out in a comfortable bed in a comfortable room while the technician monitors and records brain waves, air flow, muscle tone, heartbeat, etc. A doctor will review the polygraph (that's what they call lie detector tests too because that examination also depends on simultaneous monitoring of multiple physiological variables) and make a diagnosis.
If you do have obstructive apnea, you might be able to get over it by losing enough weight. Surgical treatments that remove some of the excess tissue in the nose and throat sometimes work. Most of us get CPAP machines. We'll be fitted with either a nasal pillow, a soft silicone rubber appliance that is held against the nostrils firmly enough to make an airtight seal, or with an airtight face mask for mouth breathers. The technician will have measured just how much pressure it takes to hold the airway open on inhaling and the air compressor will be set to that level.
Most people learn to tolerate the CPAP apparatus very quickly. In my case, by the morning after going to sleep with CPAP for the first time, I felt more rested than I had in months. My wife loves my CPAP machine as much as I do, because I stopped snoring the first night. She calls the device my aqualung because it really does sustain my life, not to mention my marriage.
© Copyright 2012, KUNC
