Bringing sleeping secrets to light:
Dr. C. Mohan Gera’s thoughts on sleep-related breathing disorders
"Most people aren’t in touch with the quality of their sleep, unless their bed partner says: ‘You snore all night,’ or ‘You snore and stopped breathing for a few seconds, then went back to snoring,’ or ‘You stopped breathing for several seconds and your snoring got you to breathe again last night.’ I’m concerned because you don’t seem well-rested, and you’re often irritable over little things."
"What I’ve described is are sleep-related breathing disorders – from chronic snoring, to Upper Airway Resistance Syndrome, to full Obstructive Sleep Apnea. The National Sleep Foundation estimates that between seven and 18 million Americans experience sleep-disordered breathing.
"These conditions are serious, because even small lapses in breathing result in decreased levels of oxygen in the blood. This can lead to pulmonary high blood pressure (hypertension), angina or heart attack, and stroke. These conditions aren’t intermittent: they occur night after night. We find these conditions are often under-diagnosed because the bed partner is a really sound sleeper, or there is no bed partner to notice heavy snoring or breathing lapses. All sleep-related breathing disorders are serious health problems. A person who is sleepy is less likely to be alert at the wheel, while using machinery, or just going up and down stairs. We’ve already mentioned the risks for high blood pressure, heart attack and stroke.
"Individuals who generally experience sleep-related breathing disorders are:
- Male. One in 10 men over 40 are reported to have a sleep-related breathing disorder, according to the National Sleep Foundation. This doesn’t mean these disorders cannot occur in women, but men are more prone to these disorders, perhaps because of hormonal influences on upper airway muscles.
- Overweight. The body must struggle, while awake and at sleep, to force enough oxygen to their vital organ systems. These individuals frequently experience shortness of breath, inability to walk for more than a short distance, and on physical exam, often have high blood pressure.
- Reported to experience nasal congestion, sinus problems or allergies – these contribute to an inability to draw enough breath during sleep.
- Found to have bouts of frequent daytime sleepiness, fatigue, poor concentration, irritability and depression. These outcomes are the result of not having quality sleep, for nights on end.
"Less common symptoms include incontinence, sexual dysfunction, night choking and decreased ability to perform work during the day.
"Even for an individual with benign snoring, they would be well-advised to talk with their family physician about this condition, and determine if a sleep study is needed. For those who seem to fit the profile of Upper Airway Respiratory Syndrome, or the more serious Obstructive Sleep Apnea, an appointment with their family physician is imperative. A physician must make the referral for a sleep study. During the sleep study, computers record sleep patterns, lapses in breathing, arousals, and by analyzing the data, we can make an accurate diagnosis.
"The treatment is almost always to have the individual fitted for a Continuous Positive Airway Pressure (CPAP) mask that is worn while sleeping. The mask keeps the airway open and forces continuous oxygen to flow throughout the body during sleep. When tolerated, individuals with sleep-related breathing problems report dramatic symptom relief from daytime sleepiness and the ability to function while awake. Finally, they experience the benefits of a quality night’s sleep."
Note: C. Mohan Gera, M.D., is board certified in pulmonology, internal medicine and sleep medicine. He is one of three pulmonary physicians that staff the Sleep & Alertness Center. Dr. Gera also practices pulmonary medicine full-time with Pulmonary Services, P.C., 405 W. Greenlawn. For more information about the Sleep & Alertness Center, call (517) 975-3375.