Southport Magazine

Wake up to a solution! 

BY: LESLIE RESCHLY BSN, RN

Back in the days of black and white TV, I recall an episode on a sit com that involved snoring and the impact it had on the non-snoring bed partner.  Ahhh, days were simpler then and it was so very funny to watch the antics tried in order to get some sleep! Those of you who suffer from severe snoring or who are bed partners with someone who snores loudly can clearly relate.  Loud snoring can however be a health concern to some sufferers especially if it is accompanied by periods of time where no breathing occurs.  This is known as Obstructive Sleep Apnea.

Obstructive Sleep Apnea is the most common form of a potentially serious medical problem for about 4% of males and 2% of females.  This condition of loud snoring and interrupted breathing is often accompanied by feelings of “fatigue or being tired” after a night of rest, morning headaches especially in females, dry mouth or sore throat upon awakening, daytime sleepiness with attention problems to activities and irritability or moodiness.

Risk factors to Sleep Apnea include the following:

Obesity-increasing the risk by 4 times

Neck circumference-greater than 17 inches in male and 15 inches in a female

A Narrow airway as a result of genetics or enlarged tonsils/adenoids

Male-2 times more likely than a female

Age-this most typically develops in later life as muscles atrophy

Family History

Smoking-3 times more likely and associated with inflammation and fluid in upper airways and

complicated by a diagnosis of COPD or Chronic Obstructive Pulmonary Disease.

Nasal congestion-especially with anatomical issues such as a deviated septum.

Use of Alcohol, sedatives or tranquilizers that relax the throat muscle.

Given these risk factors, the primary reason for Obstructive Sleep Apnea to occur is a relaxation of the muscles in the back of the throat which causes the airway to close or narrow as you breathe in. Lack of adequate air causes the level of oxygen in your bloodstream to drop, initiating the protective mechanism in the brain that rouses you from sleep so that you can reopen the airway. This is often noted with a snort, a choke or a gasp and may or may not be recalled by the person experiencing the event. This pattern repeats itself over the course of the night and interferes with achieving restful stages of sleep.

Left untreated, Obstructive Sleep Apnea has been linked to multiple medical conditions including Hypertension and Heart problems such as Atrial fibrillation (irregular heartbeats), heart attack, stroke and sudden death, Type II Diabetes or elevated blood levels of glucose, Metabolic syndrome and its associated elevated BP, elevated cholesterol, obesity and elevated blood sugar. Persons who suffer from Obstructive Sleep Apnea are more likely to experience issues with anesthesia so be sure to notify your surgeon and anesthesia provider if you will be sedated. Daytime fatigue may correlate to motor vehicle accidents as well as on the job injuries. In addition, excessive daytime fatigue and moodiness make you non-productive and not fun to be around! Let us not forget the stress you may be imposing on your sleep deprived partner!

Dr. Barton Schneyer, is a local pulmonologist who has diagnosed and treated sleep apnea for many years.  I met with him at his Southport office to obtain more knowledge of this disease. Dr. Schneyer stated, “I take treating sleep apnea as seriously as treating high blood pressure or diabetes.”  He was quick to point out the symptoms differ often in men and women.  Females typically experience early morning headaches, chronic fatigue and mood disorders whereas males may be referred after snoring and witnessed spells of apnea (no breathing) by a sleep partner, often who moves to another room to sleep. In addition, he also stressed the importance of treating this disorder, citing untreated sleep apnea as a contributing factor to Heart Attack, Stroke, Congestive Heart Failure, Hypertension, Atrial fibrillation and high blood glucose levels.  Diagnosis is made in a Sleep Lab (which is also available locally) through Nocturnal Polysomnography. Overnight, as you sleep, your heart, lungs, brain activity, breathing patterns, oxygen levels and arm/leg movements are monitored in this non-invasive study. The number of times per hour that your upper airway completely or partially obstructs is measured and reported as an AHI Score or Apnea Hypopnea Index. Based on your score, you may qualify for treatment of the problem.

Dr. Schneyer discussed a variety of treatment options available to those who qualify.  Most common is the use of CPAP or Continuous Positive Airway Pressure.  A machine delivers cycles of pressured air through a mask or nasal device that keeps your airway passages open as you sleep. There are several other pressure devices that vary in the amount, methodology and length of pressure delivered. In addition, oral appliances which move your jaw forward have been developed that assist in keeping the throat/airway open. Dr. Schneyer identified these devices as an option for people with mild sleep apnea that are unable to tolerate the CPAP machine. Surgical interventions can also be attempted but are often only utilized after failure of all other devices. Many times I have heard people report that they have sleep apnea but could not “tolerate the mask”. Dr. Schneyer and his staff are committed to helping you find a solution if this is your issue. In fact, you will return for an evaluation 5-6 weeks after you start using your treatment device to determine if changes need to be made. In addition, his office currently takes multiple appointments weekly and does not require a referral but will provide thorough communication to your primary care provider if you desire.

If you or your loved one suffers from what you may believe is obstructive sleep apnea, please seek medical attention.  This is important especially if your snoring is loud enough to disturb the sleep of others or yourself, if you wake up gasping for air or choking, if you have witnessed pauses of breathing during sleep or if you are experiencing daytime drowsiness or moodiness. Treatment will ease your symptoms and prevent complications. Your health depends on it!