Golden Opportunities

Does noisy snoring have your bedmate threatening to move next door? Don’t laugh! Here to wake us up to the importance of treatment is Dr. Sidney Steinberger, an ear, nose and throat specialist at Akron General Medical Center.

Question: What is sleep apnea?

Answer: It's a disorder where, during sleep, the muscles of the airway relax to such an extent that the airway narrows, disrupting airflow and causing a pause in breathing.
The oxygen level in a person's blood should not normally fall below 90% in sleep. But sleep apnea can cause the oxygenation level to fall mildly to the 80s, or even 50s or 60s in severe cases.
About 9% of women and 24% of men in the 30-60-year-old range are thought to have sleep apnea.

Question: What are some of the causes, or risk factors?

Answer:

• Being male (ratio is 3:1, male to female)
• Overweight-approximately 70% of sleep apnea patients are obese while 30% have normal body weight.
• Size of the airway, tongue, tonsils, and adenoids, position and shape of the jaw and throat
• Nasal congestion can exacerbate the condition.
• Depressants, like alcohol, sedatives, or sleeping pills.
• Pulmonary Disease
• Thyroid Disease/Hypothyroidism

Question: What are the dangers of untreated apnea?

Answer: Not getting quality rest, lack of energy, and dangerously falling asleep during the day (such as when driving).
Sleep apnea can also have consequences to the heart. It has been linked to high blood pressure, irregular heartbeats, and even sudden death.

Question: What are the symptoms?

Answer: Most often someone will tell you that you are snoring, or that you are stopping breathing while sleeping. Many times, we see a wife who has moved into a separate bedroom to sleep bringing her husband to the doctor.
Other signs include waking up feeling unrefreshed, waking up with a headache, falling asleep during the day, such as when sitting down to watch TV, or even when at a stoplight.
Short-term memory loss, mood alterations, or sexual dysfunction can also be symptoms.

Question: How is it diagnosed?

Answer: Polysomnography, which is a sleep study, most often conducted in a certified sleep lab. The patient stays overnight, and their breathing, heart, oxygen levels, EEG, eye movements, and more are monitored.

Question: What treatment options are available?

Answer: Since the 1980s, there is a machine, either a C-Pap or a Bi-Pap machine, which is worn in sleep. It blows under pressure through a mask worn over the nose, providing adequate ventilation during sleep. These machines used to be cumbersome, but now they are very lightweight.
About 70% of those with sleep apnea are overweight, and the apnea may go away after weight loss and exercise. These patients may use a C-Pap or Bi-Pap machine first, so that their energy goes up and they are more motivated to exercise.
The machines work for those who will and can use them. However, sometimes surgical options are available. The patient would be physically evaluated, and their airway critically evaluated as well. Surgical options would vary based on age and anatomy, and would include modifying the palate, tonsils, adenoid tissue, or even the tissue at the base of the tongue.
Tracheotomy is the gold standard for airway control but is not very practical for most patents. The most dramatic surgery would be advancing the jaw. This surgery would typically be done by an oral surgeon.

Wake up to the facts: a good night's rest is possible, even for those with sleep apnea. Give Akron General a call to learn more. My thanks to Dr. Steinberger.