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Disturbed sleep may lead to dangerous health problems

by Tom Chillemi

Edward Owen’s snoring was legendary.

When his stepdaughter brought her friends to their Urbanna home to spend the night, she would have to show them to prove that the sound resonating through walls was him snoring.

“I used to have a lot of stressful dreams. There were nights when I felt like I had slept under a bridge and woke up every time a car went across it.” – a sleep apnea patient
Owen had sleep apnea, and would actually stop breathing in his sleep. His wife would hear him struggling to breathe. No matter how much he slept, he woke up tired.

Jerry May also had sleep apnea that went undiagnosed for about 10 years. He said his business suffered. Sleep deprivation affected his ability to concentrate and multi-task. “It was very debilitating,” he said.

May actually fell asleep at a traffic light, and was awakened by someone tapping on his window, who told him he had slept through two traffic light cycles. “I was like a zombie.”

Owen and May are among the lucky ones—their sleep apnea has been diagnosed. Today they sleep soundly with the use of a CPAP machine. The machine is adjusted to blow a calibrated amount of air into the sleeper’s nose to keep the throat airway open. (CPAP stands for Continuous Positive Airway Pressure.)

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Dr. Tom Bond models some of the electrodes that monitor the brain during a sleep study.
The results are striking, said May of Deltaville. “I used to sleep 8-9 hours, wake up tired, and feel like somebody beat me up. Now I get 6 hours of sleep and feel great.”

Before using a CPAP machine, Owen would try to make up for his sleep deficit on weekends. He’d sleep 12 hours and still be tired. “Now at 8 hours I jump out of bed and I’m ready to go, and I have more energy.”

Owen’s wife Barbara was amazed by the instant results. “It was so quiet it was eerie. The first night I went over to make sure he was still breathing,” she said.

“Sleep apnea took so much from me,” said Owen. “I was struggling all night long, working hard to breathe.”

Obstructed airway

Sleep apnea occurs when the tissues in the upper airway collapse or are obstructed by other tissues such as tonsils, the uvula or the tongue, said Dr. Tom Bond of the Riverside Neurology and Sleep Disorders Center, which has sleep labs in Gloucester and Williamsburg. It may sound like the person has quit breathing or snoring, and this ends with a gasping, choking, snorting or with a deep breath, said Dr. Bond.

The person may not breathe for 10 to 30 seconds, causing blood oxygen levels to fall dangerously low. As the body is undergoing this strain, the person with sleep apnea probably will not realize what has happened. “They then fall back to sleep, and do it all over again,” said Dr. Bond. “It’s a repetitive cycle.”

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Sleep problems can be diagnosed during a sleep study, where 24 of the patient’s body functions are monitored.
Due to the repetitive strain on the cardiopulmonary system, people with untreated sleep apnea are at a much greater risk of dying from stroke, heart attack, high blood pressure or a car crash after falling asleep at the wheel, said Dr. Bond. Apnea can cause high blood pressure, and it may cause cardiac arrhythmia (attacks). Apnea is often worse around 4 to 5 a.m., and this is when most deaths occur to people as they sleep, said Dr. Bond.

“Every organ in your body suffers the same oxygen reduction,” said Dr. Bond. “If your blood oxygen drops several times a night, things are not going to be in tip-top shape.”

Two of the best predictors of whether a person has sleep apnea are weight and neck circumference, said Dr. Bond. Males with necks that are 17 inches or larger and females with 16-inch necks and up are prone to have sleep apnea. However, sleep apnea also can be caused by the shape of the neck. “Thin people are not immune,” he said.

Sleep study

Sleep problems can be diagnosed during a sleep study, which is like spending a night in a motel, except about 24 of the patient’s body functions are monitored as he sleeps. Small lightweight sensors are placed on the body. An elastic belt around the chest and abdomen measures breathing. A clip is placed on a finger to measure the level of oxygen in the blood.

None of the devices are invasive. One nervous patient who thought he would not be able to sleep with all the attachments had no problems, said Dr. Bond. It turned out he had sleep apnea.

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At first glance a CPAP machine looks cumbersome. However, its design is very friendly for the user.
Treatment

Treatment options include surgery to remove the obstruction, a mouth piece made by a dentist that repositions the lower jaw and helps hold the airway open or altering the sleep position.

However, the CPAP machine is the most successful treatment, helping about 3 out of 4 patients, said Dr. Bond.

He explained that the good thing about a CPAP machine is that it can be tried first to see if it works. The CPAP machine is rented for the first month and then it can be purchased. Most insurance companies cover their share of the CPAP machine cost.

And for most, once they see how much better they sleep, they wouldn’t be without it.

“I used to have a lot of stressful dreams,” said a CPAP user. “There were nights when I felt like I had slept under a bridge and woke up every time a car went across it.

“But the bad dreams have gone away since I started using the CPAP machine. In fact, I had a dream I was under water and I could breathe like I had a SCUBA tank.”

posted 02.26.2009

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