Learning with laughter

Sleep Apnea: Are you the person you want to spend the rest of your life with?

June 07th, 2011

Do you feel touchy, can’t think straight, are excessively tired during the day, & your bed partner says that your snoring is disrupting his/her sleep…Your only bedmates that love you are the spiders in the basement. This is stressful!

I hope by reading this article it could change your life. Do you want to remember what it’s like to be refreshed and alert every day?

Sleep ApneaFirst, take this test and notice how your body reacts to stress.

Make a fist and squeeze it tight. Keep squeezing—as hard as you can—while you count to 10. Most people find that they completely stop breathing. When we’re under stress our breathing patterns change for the worst. This becomes a habit which can be very damaging to your mind and body health over time. Many people in my practice justify and normalise the symptoms of sleep disordered breathing habits by saying, “my mother/father did this or that.” Always had an afternoon nap! I ask them …What quality of life did your Mum/Dad have when they retired? I believe genetics and family anatomical traits (narrow airway, palate, sinuses and faces, poor posture) play a key role in sleep apnea. You are not alone

Did you know? One in five Americans are having difficulty breathing during sleep. Those who suffer with Obstructive Sleep Apnea are 8-10 times more likely to experience heart attack and stroke. 50% of patients with impaired cardiac function suffer from sleep related breathing disorders.

In summary, snoring and sleep apnea are common sleep disorders breathing problems that can affect your sleep, health and quality of life!

Clinically I see daily people who have Sleep Apnea, airway and jaw issues which has been “undiagnosed” and untreated for decades. According to Mayo clinic, 80-90% of people who have sleep apnea are being treated for the end result.

Symptoms from lack of sleep are often what prompt people with obstructive sleep apnea to visit their doctor

These may include;

  • Excessive daytime sleepiness,
  • poor concentration,
  • poor memory
  • depression,
  • acid reflux,
  • diabetes,
  • allergies,

Think how many people you know are taking pills. How many people do you know who have pills to reduce high blood pressure, have had abnormalities in heart function & have ongoing gastric issues? (It is also known that significant sleep apnea happens in 35% of chronic snorers. It’s also important to note that you don’t need to snore to have sleep apnea) It could be UARS (Upper airway resistance syndrome). I will talk about this in next news letter

I remember filling out a health insurance form and the agent kept repeatedly asking if my husband and I were sure, that I did not take pills for high blood pressure, because everyone does! We were obviously freaks

I hear patients explaining their symptoms as their hormones, busy schedules and stressful jobs. True but what is this doing to their physiology? One lady told me today, that she almost wished the doctor would insist on her taking time out of busy life as health professional, mum and wife to have a hysterectomy! Someone else taking charge of her schedule was the only way she could make herself take a holiday! Does this sound familiar? Woman are worst for this. We love to feel needed!

We think that when we go on holiday then we will feel better …well, how many holidays can you go on? ….and the cycle starts again and we get stressed when we’re not better!

What is sleep apnea?

Sleep apnea affects the way you breathe when you’re sleeping. In untreated sleep apnea, breathing is briefly interrupted or becomes very shallow during sleep. (18 breaths a minute/ normal is 10-12 breaths a minute) These breathing pauses typically last between 10 to 20 seconds and can occur up to hundreds of times a night.

Untreated sleep apnea prevents you from getting a good night’s sleep. When breathing is paused, you’re jolted out of your natural sleep rhythm. I know someone who has trained themselves to lie on their side at night and therefore had forgotten that prior this adaptation, he had woken up gasping for air! As a consequence, one spends more time in light sleep and less time in the deep, restorative sleep one needs to be energetic, mentally sharp, and productive the next day.

Chronic sleep deprivation results in daytime sleepiness, (ask any new mum if this is true!), A new baby typically results in 400-750 hours lost sleep for parents in the first year. It also slows reflexes, affects concentration, and one has increased risk of accidents in some cases

In summary, sleep apnea can lead to serious health problems over time, including diabetes, high blood pressure, heart disease, stroke, and weight gain.

The good news is with treatment, you can control the symptoms, get your sleep back on track, and start enjoying what it’s like to be refreshed and alert every day.

Types of sleep apnea

Obstructive sleep apnea is the most common type of sleep apnea. It occurs when the soft tissue in the back of your throat relaxes during sleep, causing a blockage of the airway (as well as loud snoring).

Central sleep apnea is a much less common type of sleep apnea that involves the central nervous system, rather than an airway obstruction. It occurs when the brain fails to signal the muscles that control breathing. People with central sleep apnea seldom snore.

Complex sleep apnea is a combination of obstructive sleep apnea and central sleep apnea.

Anatomy of a sleep apnea episode: (Watch this hilarious video of visit to dentist to make sure you are breathing and can take in following information!)

As air flow stops during a sleep apnea episode, the oxygen level in your blood drops. Your brain responds by briefly disturbing your sleep enough to kickstart breathing—which often resumes with a gasp or a choking sound. If you have obstructive sleep apnea, you probably won’t remember these awakenings. Most of the time, you’ll stir just enough to tighten your throat muscles and open your windpipe. In central sleep apnea, you may be conscious of your awakenings.

It can be tough to identify sleep apnea on your own, since the most prominent symptoms only occur when you’re asleep. But you can get around this difficulty by asking a bed partner to observe your sleep habits or recording yourself during sleep.

Do you suffer from:

  • Loud, chronic snoring, especially when lying on back. Most of us don’t think of snoring as something to be overly concerned about—unless our bed partner is disrupting our sleep! But frequent, loud snoring may be a sign of sleep apnea, a common and potentially serious disorder in which breathing repeatedly stops and starts as you sleep.
  • Waking up in the middle of the night, with an “Adrenaline spike”, choking or gasping for air
  • Sleepiness during the day and people at Starbucks know your name!
  • High blood pressure (taking pills that make you see dots in front of eyes if stand up too quickly)
  • Had numerous root canals for fractured teeth due to nightly teeth clenching /grinding
  • Morning headaches with facial tightness
  • Concentration, Memory problems & Learning difficulties
  • Feeling irritable and have low energy
  • Mood swings or personality changes; eg: feeling depressed
  • Feeling un rested & dry throat when you wake up

The Epworth Sleepiness Scale is an on-line questionnaire which will help you decide if you have a sleep problem.

In the meantime…

Try a “Breathing better program for 6 weeks” Awareness of Breathing (red dots everywhere to remind you, signs Just breathe! /do yoga/ pilates/ wear a pedometer to walk 10,000 steps daily, or swim regularly)

Here are some quirky stress busting technique

Heart-Calming Breeze

If you’re feeling anxious and can feel your heart racing, call your thumb into action. By blowing on your thumb, you can get your heart rate back to normal.

Throat Tickle Cure

To relieve that constant feeling in the back of your throat, tickle something else…your ear. Touching the area around your ear creates a reflex in the throat that eases the annoyance.

Stuffed Nose Cleared

Your body has a natural mechanism to unclog your nose. Just push your tongue against the roof of your mouth, then press between your eyebrows with a finger. Keep it up for about 20 seconds and your sinuses will start to drain.

Read more about Sleep Apnea…..it might save your life and answer many health questions.

Medline’s description of Obstructive sleep apnea syndrome (OSA); is

1. Recurrent interruption of breathing during sleep due to obstruction usually of the upper airway especially by weak, redundant, or malformed pharyngeal tissues, that occurs chiefly in overweight middle-aged and elderly individuals, and that results in hypoxemia and frequent arousals during the night and in excessive sleepiness during the day. Many people tell me that needing a nap is a hereditary habit not a possible health issue!

Who’s at risk?

scalloped tongue

A typical description of physical features for someone at risk for obstructive sleep apnea is an overweight, male, who is an obnoxious snorer whose neck is greater than 17 inches. One physical finding that’s rarely mentioned is tongue scalloping. This is when you have impressions or ridges on the sides of your tongue where it sits against your molars. One past study showed that having tongue scalloping can positively predict the presence of apnea or hypopneas and oxygen desaturation in 89% of cases. Overall, having scalloping is about 70 % sensitive in picking up obstructive sleep apnea.

The traditional explanation is that the tongue is too big, but for sleep apnea patients, the jaw is too small for the normal sized tongue. If you add additional inflammation due to chronic reflux from the stomach with each obstruction, the swelling of the tongue will only aggravate the dental impressions on the tongue. Along with the small jaws and scalloping, you’ll also have a high-arched hard palate, and the tongue sits very high in the mouth, preventing you from seeing the back of the throat more fully.

This condition is also described in hypothyroid patients, but sleep apnea can cause hypothyroidism.

A person with sleep apnea can stop breathing from 10 to 50 to even over 100 times every hour with each episode lasting anywhere from 10 to 30 seconds.

Central sleep apnea, which occurs when your brain doesn’t send proper signals to the muscles that control breathing

Additionally, some people have complex sleep apnea, which is a combination of both.

A BUNCH OF FACTS YOU MIGHT NOT HAVE KNOWN ABOUT SLEEP.

  • Do you fall asleep in under five minutes at night? This means you’re sleep deprived. The ideal is between 10 and 15 minutes, meaning you’re still tired enough to sleep deeply, but not so exhausted you feel sleepy by day.
  • In an interesting study that came out in the Journal of Paediatrics, researchers recruited 78 children who were about to undergo a tonsillectomy for various reasons including recurrent infections or sleep apnea and compared them against 22 other children undergoing other types of surgical procedures. All these children underwent formal sleep studies and a battery of psychological tests including that for attention deficit disorder and found that 22 children, or 28% of the tonsillectomy group, were found to have ADHD by official psychiatric criteria.  The control group only had 7% that were found to have sleep apnea. After surgery, one year later, 11 children or 50% of the children who originally had ADHD, no longer had by official criteria.  Furthermore, after the surgery, the incidence of sleep apnea in the tonsillectomy group was equivalent to that in the control group.
  • The record for the longest period without sleep is 18 days, 21 hours, 40 minutes during a rocking chair marathon. The record holder reported hallucinations, paranoia, blurred vision, slurred speech and memory and concentration lapses.
  • It’s impossible to tell if someone is really awake without close medical supervision. People can take cat naps with their eyes open without even being aware of it.
  • Experts say one of the most alluring sleep distractions is the 24-hour accessibility of the internet. Also the invention of the light bulb has upset our circadian rhythms
  • The extra-hour of sleep received when clocks are put back at the start of daylight in Canada has been found to coincide with a fall in the number of road accidents.

UARS – More about that in next month

One of the problems with these criteria for sleep apnea is that if you stop breathing for 9 seconds at a time and you stop breathing 50 times every hour, then officially you won’t have the diagnosis of sleep apnea and then you get into the realm of UARS (Upper Airway Resistance Syndrome).

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