On Your Health

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Everything You Should Know About Sleep Apnea

So how did you sleep last night? If you’re like the approximately 50 to 70 million Americans suffering from chronic sleep disorders, the answer is likely, “not that well.” Why is something so natural, and so essential for the body, so stressful for many people?

This week is a perfect opportunity to make your sleep a priority, since it’s National Sleep Awareness Week. This annual awareness campaign, spearheaded by the National Sleep Foundation, aims to help the public better understand the benefits of good sleep habits and the importance of identifying the signs of a sleep disorder.

“Sleep is important but to many people it’s a nuisance. It's something they HAVE to do. Or if it’s disturbed, it’s something they don't look forward to. But you SHOULD look forward to going to bed, fall asleep and wake up feeling refreshed. Too few people do that," says Dr. Jonathan Schwartz, Medical Director at the INTEGRIS Sleep Disorders Centers of Oklahoma.

Sleep is key to a healthy life because it’s a restorative process that allows every system within our bodies to hit refresh each night. But what happens if our sleep is constantly interrupted? Millions of Americans suffer from this problem. It’s called sleep apnea, a disorder that causes pauses in breathing during sleep. Sleep apnea is diagnosed when you stop breathing for 10 seconds or longer — at least five times an hour — during sleep.

Sleep apnea is a serious medical problem. Left untreated, it can cause cardiac arrest and possible death due to sudden drops in blood oxygen from an irregular heartbeat. Actress Carrie Fischer died from sleep apnea back in 2016. Sleep apnea also increases the risk of high blood pressure and stroke.

In addition, the repeated awakenings associated with sleep apnea make normal, healing sleep impossible. People with sleep apnea often experience severe daytime drowsiness, fatigue and difficulty concentrating.

How common is sleep apnea?

Across the U.S., sleep apnea affects between five and seven percent of the population, with a slightly higher prevalence in men.

Obesity is the most common risk factor for sleep apnea. While Oklahoma has a higher rate of obesity than the national average, the prevalence of the disorder among Oklahomans is consistent with the national average.

Restless leg syndrome, or RLS, is another condition commonly associated with sleep apnea, and it affects five to 10 percent of Americans. In fact, 80 percent of those with RLS may also have sleep apnea, so it’s important to talk to your physician about any sleep-related concerns you may have, as some conditions are closely related.

Risk factors, signs and symptoms of sleep apnea

“Snoring is the most common outward sign of sleep apnea, but not everyone who has sleep apnea will snore,” Dr. Schwartz advises. “If you’re observing someone, watch for irregular interruptions in their breathing.”

Both genetic and lifestyle factors play a role in sleep apnea risk. Even facial shape and physical characteristics of the upper throat, like long tonsils, can put someone at higher risk. “Having a recessed jaw and the chin set back means there is less room in the back of your throat and less room in the upper airway,” Dr. Schwartz says.

Along with obesity and smoking, prescription painkiller use is also linked to sleep apnea. “Certain pain medications, opiates and benzoates, can relax the airway and make sleep apnea worse,” Dr. Schwartz says, “and we know there is a high prevalence of prescriptions in this state.”

Getting up frequently during the night to use the bathroom could actually be a sign of sleep apnea. “When your upper airway is obstructed, your heart releases a hormone that causes the kidneys to get rid of water,” Dr. Schwartz explains. Another unexpected symptom of sleep apnea? Waking up with a headache.

What can I do to decrease my risk of sleep apnea?

Taking care of excessive nasal congestion can help decrease your risk. “Nasal congestion can cause nasal drip, which can worsen snoring or even cause mild sleep apnea by itself,” Dr. Schwartz says. Treating nasal congestion with over-the-counter or prescription medications may help decrease sleep apnea risk.

In addition, addressing lifestyle-related risk factors is always a smart option in the long term. Quitting smoking, losing weight, and decreasing alcohol use can all help lower your risk of sleep apnea, but of course, these options take significant commitments over time.

“We work with patients on good sleep hygiene,” Dr. Schwartz says. “For instance, waking up at the same time every day helps keep our circadian rhythm in check and helps us fall and stay asleep later, especially for adults experiencing significant changes in activity and routine, like retirement.”

He continues, "Really, these are just common sense practices that can be helpful in improving your sleep."

Good Sleep Hygiene

  • Having the same bedtime and wake time every day, seven days a week, and sticking to it even on the weekends.
  • Use the bed and bedroom only for sleeping or intimacy. This means no laptop, no TV, no phones, no texting, no reading and no bright, artificial lights or screens that will stimulate you.
  • Avoid alcohol, cigarettes, and heavy meals in the evening. Also, avoid caffeine after 2 or 3 pm. Alcohol, cigarettes and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. If you can, avoid eating large meals for two to three hours before bedtime.
  • No napping! Especially in the afternoon.
  • Exercise daily. Vigorous exercise four to six hours before bedtime is best to help you sleep later. Try not to exercise for two to three hours before bedtime.
  • Create a comfortable environment for sleeping. Your bedroom should be cool, around 65 degrees, dark and quiet.
  • Practice a relaxing bedtime ritual. A relaxing routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep.
  • Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity such as reading. For some people, using an electronic device such as a laptop can make it hard to fall asleep, because the particular type of light emanating from the screens of these devices is activating to the brain. If you have trouble sleeping, avoid electronics before bed or in the middle of the night.
  • If you can't sleep, go into another room and do something relaxing until you feel tired.

Sleep apnea treatment options

If you’re experiencing symptoms of sleep apnea, it’s extremely important to be seen by a physician who can create a customized treatment plan. A physician may advise reducing or stopping certain medications that may be causing or worsening your sleep apnea, or they may refer you to a dentist for dental appliances or even surgery to improve the flow of air through your mouth, nose and throat.

“The most common treatment we currently use is CPAP — continuous positive airway pressure — which is a device that continuously blows air to the back of the throat through a mask on the nose. But there’s not just one treatment for everyone,” Dr. Schwartz says.

Sleep shouldn’t be a luxury

“Everybody knows how they feel when they don’t get enough sleep. Most of us are sleep-deprived, (but) it’s about quality of sleep over quantity,” Dr. Schwartz says.

Dr. Schwartz’s philosophy on sleep addresses more than just sleep apnea. He explains how sleep affects every part of our lives.

“We’re designed to spend a third of our lives sleeping, and there’s a reason for that. It’s a restorative function that’s necessary for our bodies — all organ functions — to function properly,” Dr. Schwartz says. “Poor-quality sleep or inadequate sleep is associated with depression and anxiety. Lack of sleep is associated with so many chronic illnesses or worsening issues you may already have, like arthritis, heart disease and lung disease, so a number of conditions can be improved with improved sleep. It comes down to giving ourselves the opportunity to get good sleep.”

Could you have a sleep disorder?

The quiz below can help you determine if your sleep habits are generally healthy or if you should consider speaking with a physician about the quality of your sleep.

If you answer “YES” to two or more of these questions, you may have a sleep disorder.

1. Has anyone ever told you snore?

2. Do you awaken tired and unrefreshed?

3. Do you wake up gasping for air, or have you been told your breathing is irregular?

4. Are you tired or feel “run down” during the day?

5. Do you have difficulty falling asleep at night?

6. Have you noticed your memory is not as good as it was?

7. Are you experiencing a decrease in your sex drive?

8. Do you frequently feel more moody or irritable?

9. Have you been told you kick at night?

10. Do you have an urge to move your legs that is relieved by moving them?

If you try the sleep hygiene tools consistently and are still having trouble sleeping, it may be time to visit the Sleep Disorders Center to participate in what is known as a sleep study.

The INTEGRIS Sleep Disorders Centers of Oklahoma are located in North Oklahoma City and South Oklahoma City. Using a multidisciplinary approach and the latest cutting-edge diagnostic tools and treatments, the INTEGRIS Sleep Disorders Centers are the only sleep centers in Oklahoma, and one of only nine accredited sleep centers in the U.S., that have all locations accredited by the American Academy of Sleep Medicine.

At the INTEGRIS Sleep Disorders Centers, experts are trained in sleep medicine to evaluate test results and develop a treatment plan to resolve sleep related issues. Their board-certified sleep specialists and registered sleep technologists can help you get a better night’s rest. For more information check the website or call 405-636-7700.