Category Archives: Sleep Apnea

Katy Perry has Sleep Apnea!

No not really, but one of her hits has a slight twist!  I don’t usually digress to humor on a very serious topic, but you might enjoy the break.  Just remember, Shaq has apnea too.

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What it’s like to sleep with someone like me…

How funny Becca! You are exactly right!

Becca Joyce

images-10Imagine, if you will, that you are on a date with someone you’ve been attracted to for ages. The gender of this person is entirely up to you, but you really like them. Maybe you’ve already had a couple of lovely dates, engaged in conversations that have seriously bonded you, and you’re thinking, ‘yes, there’s something good happening here’. You’ve kissed. It was one of those ‘close your eyes and leave the planet’ type kisses, and now you’re aroused just by being near them.

You go back to their house for ‘coffee’. They turn on a side-lamp and not the main lights, so you know they’re creating a certain ambiance for your benefit. They put on some Nina Simone or some obscure recording from Ronnie Scott’s. The mood is enhanced.

You touch their hand as they approach you.

The coffee never gets made.

A hour or two later, you are…

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I Can Do Surgery from YouTube

Not really, but now that I have your attention, patients can learn lots of information from a good YouTube channel.

My YouTube channel has several videos that should interest you:

  1. How to use an inhaler from National Jewish Hospital.  It’s better to use a spacer (yes, always), but often the spacer gets separated from the inhaler.  Think I’m kidding…just check your purse.  If you’ve lost your spacer, use the three finger bridge technique that’s illustrated on this video.
  2. What can I expect from skin testing?  Does it hurt?  My colleagues from Allergy Partners will explain the who, what, when, where and why about skin testing.  And no, it doesn’t hurt like you think.
  3. And what would a blog be without celebrities?  Does anyone remember Shaq playing basketball?  You will remember his story about apnea!

Enjoy your weekend.

How Important is Your Sleep? ……zzzzzz

Sleep and allergy….I never would have known the connection.  Sleep is important for all persons in promoting physical and mental health.  High-quality sleep is crucial for learning and effective development in children.  Believe me, when I don’t sleep well, I become a scrooge or a troll and usually somewhere in-between.  Just ask my wife if you don’t believe me.  Looks like that happened to Shaq as well.

So what’s the big deal about not enough sleep?

  1. Deprivation in sleep can alter immune function in healthy subjects
  2. Sleep deprivation alters wound healing in animal models
  3. Sleep works because adequate amounts of sleep enhance the secretion of melatonin which in turn improves the immune response. 
  4. Sleep also enhances the secretion of growth hormone, which promotes wound healing. 

So now that you know WHY sleep is important, is sleep deprivation really that important?  According to the National Center on Sleep Disorders Research, sleep disturbance is very important as an indicator of poor control of allergy and has relevance for a patient’s daytime functioning and overall quality of life. 

Treating your allergies and sinus congestion will most likely improve sleep-disordered breathing events, including apnea, hypopnea, and snoring.  The most recent summary of Sleep and Allergic disease can be found here—Sleep and allergic disease: A summary of the literature and future directions for research.  Here’s the abstract for your review:

 Atopic diseases, such as asthma and allergic rhinitis, are

common conditions that can influence sleep and subsequent

daytime functioning. Children and patients with allergic

conditions from ethnic minority groups might be particularly

vulnerable to poor sleep and compromised daytime functioning

because of the prevalence of these illnesses in these groups and

the high level of morbidity. Research over the past 10 years has

shed light on the pathophysiologic mechanisms (eg,

inflammatory mediators) involved in many atopic diseases that

can underlie sleep disruptions as a consequence of the presence

of nocturnal symptoms. Associations between nocturnal

symptoms and sleep and poorer quality of life as a result of

missed sleep have been demonstrated across studies. Patients

with severe illness and poor control appear to bear the most

burden in terms of sleep impairment. Sleep-disordered

breathing is also more common in patients with allergic

diseases. Upper and lower airway resistance can increase the

risk for sleep-disordered breathing events. In patients with

allergic rhinitis, nasal congestion is a risk factor for apnea and

snoring. Finally, consistent and appropriate use of medications

can minimize nocturnal asthma or allergic symptoms that might

disrupt sleep. Despite these advances, there is much room for

improvement in this area. A summary of the sleep and allergic

disease literature is reviewed, with methodological, conceptual,

and clinical suggestions presented for future research. (J Allergy

Clin Immunol 2012;130:1275-81.)

Sleep disordered breathing

Often allergy patients have sleep disordered breathing and want to know if allergies contribute.  Most of the time, interruptions in your sleep due to allergy consist of congestion, snoring, sneezing, and possibly apnea.  Anything other than those symptoms should be evaluated for alternative causes.  Specialists dealing with sleep disorders are allergists, ENT (otolaryngologists) and pulmonologists.  There is a board-certification for sleep medicine, so you might want to check for this on listed credentials.  Good night! 

Sweet Dreams!

Sleep disordered breathing  (click to review slides; e-mail me if you need a password) —> lwiens@cox.net

Sleeping Beauty–the story of undiagnosed apnea!

Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.  All you need is this video about sleep apnea with Shaq!

Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.  Don’t try this one on your spouse–

What happens during sleep apnea

it’s very unnerving!

This results in poor sleep quality that makes you tired during the day. Sleep apnea is one of the leading causes of excessive daytime sleepiness, but that’s not all.  Sleep apnea contributes to traffic accidents from falling asleep at the wheel, and apnea is associated with more high blood pressure, heart attack, and stroke.

Sleep apnea often goes undiagnosed. Doctors usually can’t detect the condition during routine office visits unless you ask about daytime naps and be sure to ask wives what hubby sounds like when he’s fast asleep.

The most common type of sleep apnea is obstructive sleep apnea. When you try to breathe, any air that squeezes past the blockage can cause loud snoring. Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone. For example, small children may have enlarged tonsil tissues in their throats, which can lead to obstructive sleep apnea. That’s why tonsillectomy is more effective in children than in adults!

The animation below shows how obstructive sleep apnea occurs. Click the “start” button at the bottom of the page to play the animation. Scroll down to the bottom of the page–it’s well worth 5 minutes of your time.

 Untreated sleep apnea can:

How does it feel to have sleep apnea?  Click on the video to find out.

Who Is at Risk for Sleep Apnea?

Millions of American adults have obstructive sleep apnea. More than half of the people who have this condition are overweight.

Sleep apnea appears to be more common in men than in women. The condition also becomes more common as you get older. At least 1 in 10 people older than 65 has sleep apnea. Women are more likely to develop sleep apnea during pregnancy and after menopause.

Is this condition genetic? Yes, if someone in your family has sleep apnea, you’re more likely to develop it.

People who have small airways in their noses, throats, or mouths also are more likely to have sleep apnea. This is where allergy comes in!  Smaller airways may be due to inflammation from allergy that cause congestion in the nose & throat.

What Are the Signs and Symptoms of Sleep Apnea?

Major Signs and Symptoms

One of the most common signs of obstructive sleep apnea is loud and chronic (ongoing) snoring. Pauses may occur in the snoring. Choking or gasping may follow the pauses.

The snoring usually is loudest when you sleep on your back; it may be less noisy when you turn on your side. Snoring may not happen every night. Over time, the snoring may happen more often and get louder.

You’re asleep when the snoring or gasping happens. You likely won’t know that you’re having problems breathing or be able to judge how severe the problem is. Your family members or bed partner often will notice these problems before you do.

Another common sign of sleep apnea is fighting sleepiness during the day, at work, or while driving. Remember when grandpa would fall asleep in his rocking chair during a conversation?  Probably sleep apnea.

Others signs and symptoms of sleep apnea may include:

  • Morning headaches
  • Memory or learning problems and not being able to concentrate
  • Feeling irritable, depressed, or having mood swings or personality changes
  • Urination at night
  • A dry throat when you wake up

How Is Sleep Apnea Diagnosed?

Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and results from sleep studies.

Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung and nerve specialists and ear, nose, and throat specialists.

You can find a sample sleep diary in the National Heart, Lung, and Blood Institute’s “Your Guide to Healthy Sleep.”

Sleep Studies

A sleep study is the most accurate test for diagnosing sleep apnea. It records what happens with your breathing while you sleep.

There are different kinds of sleep studies. If your doctor suspects you have sleep apnea, he or she may recommend a polysomnogram (poly-SOM-no-gram; also called a PSG) or a home-based portable monitor.

PSGs often are done at sleep centers or sleep labs. In some cases, doctors suggest using portable sleep monitors at home.

Home-Based Portable Monitor

Your doctor may recommend a home-based sleep test with a portable monitor. The portable monitor will record some of the same information as a PSG. For example, it may record:

  • The amount of oxygen in your blood
  • How much air is moving through your nose while you breathe
  • Your heart rate
  • Chest movements that show whether you’re making an effort to breathe

A home monitor is more convenient & is a good way to “rule out” sleep apnea.

Lifestyle Changes

If you have mild sleep apnea, some changes in daily activities or habits may be all the treatment you need.

  • Avoid alcohol and medicines that make you sleepy. They make it harder for your throat to stay open while you sleep.
  • Lose weight if you’re overweight or obese. Even a little weight loss can improve your symptoms.
  • Sleep on your side instead of your back to help keep your throat open. You can sleep with special pillows or shirts that prevent you from sleeping on your back.
  • Keep your nasal passages open at night with nasal sprays or allergy medicines, if needed. Talk with your doctor about whether these treatments might help you.
  • If you smoke, quit. Talk with your doctor about programs and products that can help you quit smoking.

Mouthpieces

A mouthpiece, sometimes called an oral appliance, may help some people who have mild sleep apnea. Your doctor also may recommend a mouthpiece if you snore loudly but don’t have sleep apnea.

A dentist or orthodontist can make a custom-fit plastic mouthpiece for treating sleep apnea. (An orthodontist specializes in correcting teeth or jaw problems.) The mouthpiece will adjust your lower jaw and your tongue to help keep your airways open while you sleep.

If you use a mouthpiece, tell your doctor if you have discomfort or pain while using the device. You may need periodic office visits so your doctor can adjust your mouthpiece to fit better.

Breathing Devices

CPAP (continuous positive airway pressure) is the most common treatment for moderate to severe sleep apnea in adults. A CPAP machine uses a mask that fits over your mouth and nose, or just over your nose. The machine gently blows air into your throat.

The air presses on the wall of your airway. The air pressure is adjusted so that it’s just enough to stop the airways from becoming narrowed or blocked during sleep.

Treating sleep apnea may help you stop snoring. But not snoring doesn’t mean that you no longer have sleep apnea or can stop using CPAP. Sleep apnea will return if CPAP is stopped or not used correctly.

Usually, a technician will come to your home to bring the CPAP equipment. The technician will set up the CPAP machine and adjust it based on your doctor’s prescription. After the initial setup, you may need to have the CPAP adjusted on occasion for the best results.

CPAP treatment may cause side effects in some people. These side effects include a dry or stuffy nose, irritated skin on your face, dry mouth, and headaches. If your CPAP isn’t adjusted properly, you may get stomach bloating and discomfort while wearing the mask.

If you’re having trouble with CPAP side effects, work with your sleep specialist, his or her nursing staff, and the CPAP technician. Together, you can take steps to reduce these side effects. These steps include adjusting the CPAP settings or the size/fit of the mask, or adding moisture to the air as it flows through the mask. A nasal spray may relieve a dry, stuffy, or runny nose.

There are many types of CPAP machines and masks.

This is a CPAP device

Tell your doctor if you’re not happy with the type you’re using. He or she may suggest switching to a different type that may work better for you.

People who have severe sleep apnea symptoms generally feel much better once they begin treatment with CPAP.

Some people who have sleep apnea may benefit from surgery. The type of surgery and how well it works depend on the cause of the sleep apnea.  Getting good sleep makes EVERYTHING more than just a bad dream!