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You’re exhausted, even though you turned in early. Your partner complains about your disruptive snoring. Should you call your doctor? If the problem interferes with a good night’s sleep more often than not, you should talk to your doctor, according to Amit Khanna, MD, medical director at Lawrence + Memorial Sleep Center, and sleep medicine specialist with Northeast Medical Group. You may have a sleep-related disorder.
What is sleep apnea?
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Obstructive sleep apnea (OSA) is the most common sleep-related disorder. While you sleep, your throat muscles relax and narrow, blocking your airways so you aren’t taking in enough oxygen, causing short periods where you are not breathing followed by gasps for air. Another classic symptom is snoring. These repeated interruptions prevent the brain from entering the deepest, most restful sleep, often leaving people very tired, even though the clock says they had a full night’s rest.
“Untreated sleep apnea can increase your risk of serious complications, including hypertension, coronary artery disease, cardiac arrhythmias, type 2 diabetes, heart failure and stroke,” Dr. Khanna said.
Obstructive sleep apnea can contribute to memory and cognitive deficits, factors that can make it difficult to function throughout the day and may lead to errors in judgment. Motor vehicle accidents due to drowsy driving, for example, are two to three times more common among people with OSA.
What are the symptoms of sleep apnea?
“The most common symptom is excessive daytime sleepiness where patients have difficulty maintaining wakefulness or alertness at appropriate times during the day," Dr. Khanna said.
He notes that it is important to distinguish fatigue (a lack of physical or mental energy) from sleepiness (an inability to stay awake). People with sleep apnea may also snore or make wheezing, choking, snorting or gasping sounds during sleep, which can be frightening for parents, caregivers or bed partners. In some cases, people with sleep apnea may wake up with headaches or a dry mouth or throat.
What are the risk factors?
Sleep apnea is seen in all age groups, from infants to the elderly, yet the causes may differ. While men are at a much higher risk than women, the risk for women increases after menopause.
Other risk factors include being overweight, smoking, age, use of narcotics, heart disease or a history of stroke.
Treatments for sleep apnea
If you have been diagnosed with sleep apnea, your doctor may recommend that you lose weight, quit smoking, and avoid alcohol and heavy meals in the hours before bedtime. Sleeping on your side instead of your back allows the airway to remain open. Elevating the head of your bed may also provide relief.
Your doctor may also recommend bilevel positive airway pressure (BPAP) therapy or CPAP (continuous positive airway pressure) appliance, the “gold standard” for treating sleep apnea. This device consists of a blower that delivers a small amount of air pressure through a mask that fits over your nose to keep your airway open while you sleep.
Despite its effectiveness, patients may struggle with wearing the mask and stop using a CPAP. “It takes time and effort to get used to using a CPAP,” said sleep medicine specialist Vivian Asare, MD, associate medical director, Yale Centers for Sleep Medicine.
“Our support group meetings offer participants the opportunity to ask questions, trade helpful tips and share experiences that help people better understand and manage their sleep-related concerns,” she said.
Other nonsurgical treatment options include custom-fit dental appliances that move the lower jaw forward so that the tissues of the back of the throat relax and prevent the tongue from collapsing and blocking the airway.
For patients who cannot tolerate a CPAP or who have trouble with other treatments like oral appliances or weight loss, surgical treatment options include the Inspire upper airway stimulation device. Inspire is a small, electrical device implanted in the patient’s chest, like a pacemaker. Connected wirelessly to a remote, the activated device stimulates the airway muscles, so they remain open during sleep.
“Inspire is different from CPAP because it keeps airways open from inside the body,” Dr. Asare said. “It’s not appropriate for all sleep apnea sufferers, so you should talk to your doctor about whether it is right for you.”
If you notice any of the signs of sleep apnea, it’s important to mention it to your doctor. “So many people don’t know what normal, refreshing sleep feels like,” she said. “Treating your sleep apnea truly can change your life for the better.”
If disrupted sleep is beginning to disrupt everyday life, experts at Yale New Haven Health are ready to assist you in making a good night’s rest a priority. Click here to learn more about the Sleep Medicine Center at Yale New Haven with resources for patients with sleep disorders.
