What is Sleep Apnea?

There is plenty written about sleep apnea on mainstream medical sites, so I will not go into too much detail here.

Doctors have identified five levels of sleep.  Level five, the deepest level is the REM or dream sleep.  The average person spends about 12% of their sleep time at level 4 and 25% at level 5.

Apnea literally means "without breath".  When many people sleep, the muscles of their throats relax and the throat eventually closes off.  After 20 or 30 seconds, the brain senses the lack of oxygen and brings the person to a lower level of sleep to start breathing again.  If this occurs 20 times per hour, it is considered moderate sleep apnea.  If it occurs 40 times or more, it is severe.  (I have a level of 80 times per hour!)

Is it Widely Recognized? 

Yes!  Much of the research has been done at prestigious universities like Stanford.  Today, sleep clinics can be found in most areas of the country.  Look in your phone book or online under "Sleep Disorders".

What are the Dangers?

Sleep apnea has been linked to higher incidences of stroke and heart disease.  It has been discovered that human growth hormone is only generated at deeper levels of sleep.  Lack of this hormone is related to weight gain.

What are the Symptoms?

The biggest symptom is daytime sleepiness and a periodic stoppage of breathing for over ten seconds.  This is frequently noticed by a person's bed partner.  (If you're reading my site, you probably already know you have daytime sleepiness.)

Often this includes snoring that periodically stops and then restarts, but snoring is not always present.  Snoring does not always indicate sleep apnea and sleep apnea can occur without snoring.

Snoring is Not a Joke!

We often overlook this condition because we have always assumed the number of hours of sleep are what are important and have always assumed that sleep is sleep.  Few of us know that there is a huge difference in the levels of sleep.  We often joke about snoring unless it is so bad that it keeps our partner awake.

Testing

Many sleep disorder doctors will take an X-ray of the head and neck to see the size of the air passages and get an idea of whether sleep apnea is likely.  This generally costs $200 - $300 for the initial consultation.

The next step is an overnight sleep study. This can cost over $2,000.  It is done in a hotel-like room.  The patient is connected to a group of sensors that are connected to various places on the scalp an body.

NOTE:  Some sleep centers automatically prescribe Ambien sleep medication to their patients upon request.  Others do not.  I would strongly urge that if your center does not do this, you obtain a prescription for Ambien before the study.  You would not want to undergo an expensive sleep study and be unable to fall asleep!!

If this study shows that significant sleep apnea is present, the patient may then undergo a second study either in a clinic or at home to determine if they can tolerate a CPAP air pressure machine and what the adjustment should be.  Sometimes both studies are done in the same night.

CPAP Machines

CPAP stands for "Continuous Positive Airflow Pressure".  This machine will keep your air passages open so you can reach a deeper level of sleep.

Sleeping with a CPAP machine is a bit like sleeping with SCUBA gear on.  A mask is placed over the nose and positive air pressure is supplied.  Some people find they cannot tolerate it.  Many take weeks to get used to it.

Surgery 

There are various kinds of surgery possible for sleep apnea.  There are some simple procedures to firm up the tongue or roof of the mouth to allow freer airflow.

There are more complex operations to remove the tonsils and adenoids and reposition the tongue.  This can require ten days of recovery during which eating is very painful.  The CPAP machine is preferable if the patient can tolerate it.  Surgery is only effective about 50% of the time.  Often more than one procedure is needed.

Insurance

Quite simply, some insurance companies cover sleep apnea and others do not.  Check with your company to find out.

Links

The Sleep Apnea site of Stanford University

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