Do you snore? Do you have daytime fatigue? Has someone ever told you that you stopped breathing while sleeping? Do you sometimes fall asleep while you are driving?
If you answered yes to any of these questions, there could be a chance that you have something called sleep apnea. There is more than one type as well – obstructive sleep apnea, central sleep apnea and mixed sleep apnea which is a combination of the two.
Central sleep apnea is when the brain fails to make the muscles that help a person breath while sleeping function, and obstructive sleep apnea is caused by the collapse of the airway during sleep.
Some people only have it happen a few times an hour, while others can stop breathing hundreds of times in an hour.
Srinivasan Devanathan, Medical Director of Parkview Health Sleep Centers, said that sleep apnea is a prevalent disorder and is getting diagnosed more and more each year because people are more aware of it.
People with sleep apnea have a higher risk for strokes, heart attacks, diabetes and other ailments.
Sleeping with undiagnosed sleep apnea
Most people with sleep apnea are just born that way. Anatomically, their airway is narrow, their jaw is in a specific place or other reasons. Other times there are outside factors like obesity and smoking that can promote sleep apnea.
Sleep apnea patients, because of the frequency of the stopping of breathing, sometimes don’t get to go through the sleep cycles like they should.
“This is why someone with sleep apnea feels tired and fatigued because every time that they stop breathing, they usually will have an arousal right after where their brain is actually waking up,” Weldon Cline, polysomnographic technologist at Parkview Noble Hospital, said. “If this is consistent throughout the night, they aren’t getting enough rest.”
Each time a person wakes up, they have to go through the sleep stages again.
There are many symptoms of sleep apnea, but sometimes those can go unnoticed or can be seen as symptoms of something else. Symptoms sometimes become more apparent when a person is sleeping. Oftentimes, sleep apnea is noticed by someone else.
“People are often told that they snore, their bed partner may be concerned that they are holding their breath, snoring loudly, they may wake up with headaches in the morning, they can wake up with the sensation of having acid reflux, their chest could be pounding with the heart beating faster, waking up often to use the restroom and have excessive daytime sleepiness,” Devanathan said.
People will sometimes just suffer with these symptoms because they do not know that sleep apnea exists. They will just think this is how their body is supposed to work. But these symptoms occur, according to Devanathan, because the brain doesn’t truly get to shut down when people stop breathing because it will cause the brain to wake up to help a person breathe.
It is when the sleepiness affects people’s job or when they start falling asleep while driving that people will search for answers, according to Devanathan.
There are a couple different ways that people can be diagnosed with sleep apnea depending on where a patient goes.
At Parkview, they have the options of a take-home sleep test or coming to the hospital to take the sleep test.
“If it’s sleep apnea that you are looking at, those home-study kits are actually quite accurate,” Cline said. “They have might substantial improvements over the years.”
The take-home sleep test comes with a monitor that goes around the patient’s chest to measure how deep or shallow your breathing is, an oximeter to be worn on a finger to measure oxygen levels and air pressure sensors that go in your nose and near your mouth to detect when you stop breathing.
The monitor saves the information to be downloaded by the doctor.
With the sleep study at the hospital, they attach electrodes to different parts of the patient’s body to measure many different things while a person sleeps. The room looks like a typical bedroom, and there is even a bathroom in it. There is a TV and a hotspot so patients can have entertainment while they are there.
“Sometimes people come in and can’t sleep with all the wires connected to them,” Cline said. “Or they sleep just fine and snore horribly, and they do stop breathing at night or their breathing gets shallow. That’s still countable if they have an oxygen desaturation.”
If a person stops breathing fewer than five times an hour, that’s considered normal, according to Cline and Devanathan. When a person stops breathing anywhere from 5-15 times a night, that is considered mild sleep apnea. Moderate sleep apnea is when a person stops breathing 15-30 times a night. Any number above 30 is severe.
“I’ve had people who would come in here and stop breathing 100 times an hour,” Cline said. “It’s incredible how many times people can stop breathing. Sometimes when people come in, it’s torture to watch them struggling to breathe.”
In those instances, there is something called a split study where he people will go to sleep and he will figure out if they have a problem. He has to wait a minimum of two hours before he can go in and create a treatment plan and help people breathe. But in order for people to qualify for this type of study, they have to stop breathing at least 15 times an hour.
Medications that the patient is on is also reviewed to see if any of those are causing the patient to not be able to sleep.
Sleep apnea is treated in a few different ways, but the most common, and most effective, of those is with a continuous positive airway pressure machine. A CPAP machine will blow air through a tube and into a mask that is attached to the patient’s face. The air that is blown will open the airway, and if someone stops breathing, the automatic-setting machines will recognize that and blow more air into the patient to get them to breathe again, while other patients have one setting for the whole night. This helps to prevent people from snoring.
There are many different types of CPAP machines but the most common ones now have automatic settings that will adjust for each specific person and what sleeping position that person is in. Most of the machines now come with an app for the patient’s cellphone that can create an estimate of how that person slept. It will keep track of how long the patient used the machine, how many times they stopped breathing an hour during the night, how many times the patient took the mask off and more.
The most common issue with CPAP therapy though is that patients can sometimes have trouble adjusting to sleeping with something attached to their face. Sometimes it can take up to three months to fully feel comfortable. People will even have to wear it in increments before they can wear it for a full night.
Ann Kadish, who handles communications and media relations at Parkview Noble and LaGrange Hospitals, sat in on the interview and revealed that she has sleep apnea, and when she had her test, she stopped breathing around 200 times an hour.
“I am a convert to the CPAP machine,” Kadish said. “I had some trouble adjusting to the full mask … but I have what they call a nose pillow now. It’s only on my nose, not around my mouth. It’s much easier for me. I’m not fighting the mask all night long which made it just as bad as without it.”
Cline uses a CPAP machine as well.
He said some people will come in and tell him that when they used their CPAP machine for the first time that it was the best sleep they ever had. So some people see results quickly, and with some people it takes some time to get used to sleeping with the mask. There are also cases where people take it off in their sleep and don’t even realize they did.
Most people who need a CPAP machine will have to use it the rest of their lives.
If more issues occur with the machine than expected, a sleep study at the hospital would be the suggested to the patient.
There are also surgeries that patients could request, but Cline said those are not guaranteed to work. One surgery is where a doctor would go into a person’s throat and remove some of the soft tissue in the esophagus.
“They have not been very effective,” Devanathan said.
There are also times where if people lose weight, quit smoking or just generally become healthier that the severity of their sleep apnea could lessen, but weight is not always the cause of sleep apnea. There are even people who are diagnosed with mood disorders, but they actually have sleep apnea.
Devanathan suggests to not go to bed until you are ready to fall asleep, have a consistent wake up time in the morning every day, avoid clock watching and avoid stimulants.
Relief can come with proper testing and treatment.