Sleep Apnea

By Joe Steck

When it comes to your health, one cannot be too careful.  This past week I was re-tested for Obstructive Sleep Apnea (OSA) at the VA Hospital in Minneapolis, a condition I have had for the past years.  The test reconfirmed that I do have OSA, and after attending a class on the subject, I decided to share the information and expand on what the possible side effects can be if you are not treated.

The biggest eye opener for me was not covering adults with OSA, but for children and the possible connection between OSA and Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD).

The first thing to look at is to answer the following questions:

Are you sleepy during the day?  Do you have disruptive snoring during the night?  Do you have pauses in breathing during the night?  Do you wake yourself up choking or gasping?

If you answered yes to two or more of the questions, you should talk with your doctor about being evaluated for Obstructive Sleep Apnea (OSA).

OSA is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

Breathing pauses can last from a few seconds to minutes.  They may occur 30 times or more an hour (mine occur 23 times an hour with the longest pause being 55 seconds).  Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.  As a result, the quality of your sleep is poor, which makes you tired during the day.

OSA often goes undiagnosed.  Doctors usually cannot detect the condition during a routine office visit.  There is no blood test that can help diagnose the condition.  Most people who have OSA do not know they have it because it only occurs during sleep.  A family member or bed partner might be the first to notice signs of sleep apnea.

The way to discover if you have OSA is through a sleep study.  You will go to a hospital and the staff will hook you up to a machine to monitor your heart and breathing.  It may seem a little strange, but it is worth the time and effort.  I suggest anyone that has to take this test do so with an open mind.  The attached link will show the ins and outs of a sleep test. (Sleep test video link)

The data is collected and enables the physician to determine the type and severity of sleep apnea and treatment options.

If you are diagnosed with OSA there are some simple solutions to help solve your sleeping problem.  The most common method is Positive Airway Pressure (PAP) therapy.  This therapy may include Continuous Positive Airway Pressure (CPAP) or Automatic Pressure (APAP).  These machines just blow air to open up your obstructed airway, it is not an oxygen machine.

Less common treatments include surgery, body position modification and oral appliances.  The PAP machine has been the most common treatment for over 28 years.

I was put on an APAP machine, and as a result, my breathing pauses went from 23 an hour down to 1 per hour.  A very dramatic result since the goal with the machine is to get the patient under 5 per hour.

I have heard from some people that there is no way they will wear the CPAP or APAP machine.  I can tell you that my experience has been very pleasant, plus I have had fantastic, restful sleeps since using my machine.  I also wake up feeling refreshed.

Still not sold?  Well consider the following If you do not address your sleep problem;  You increase the risk of high blood pressure, heart attack, stroke, obesity, diabetes, heart failure, work related or driving accidents and make arrhythmia or irregular heartbeats more likely.

The medical community has known for more than 20 years that sleep deprivation makes it difficult to learn (Journal of Experimental Psychology, March 1975).  Research in the past few years has verified that chronic poor sleep results in daytime tiredness, difficulties with focused attention, irritability and easy frustration and difficulty modulating impulses and emotions (Seminars in Pediatric Neurology, March 1996).  These are the same symptoms that can lead to the diagnosis of ADD or ADHD.

When children are identified with the symptoms of ADD/ADHD, often no one thinks to explore the child’s sleeping habits and whether they might be responsible for the symptoms.

Any child who snores may not be getting adequate sleep. OSA is a common medical condition that is now being identified in more and more children. The peak age for this is 2 to 5 years, but it can occur at any age.  Not all kids who snore have sleep apnea.

Children with sleepwalking, restless leg syndrome, narcolepsy, insomnia, or other sleep problems may also be misdiagnosed with ADD (Neurology, January 1996).

When parents of children with ADD are interviewed, they usually identify their kids as poor or restless sleepers (Journal of Pediatric Psychology, June 1997). Kids who have been diagnosed with ADD do wake up more often at night than their peers (Pediatrics, December 1987). Poor sleep is a common feature of ADD — a problem that can be made worse by the use of stimulant medications such as Ritalin or Dexedrine.

If your child has ADD symptoms or other behavior problems, he or she should be carefully assessed for sleep problems. If sleep disturbances are present, addressing these is important whether or not they are the root cause.

As parents, we all know what it feels like to be grumpy, contrary, and “not at our best” from lack of sleep. If our kids often feel this way, we owe it to them to find solutions to this problem.

OSA is a real problem with some pretty simple solutions to make our lives better and our bed partners nights a little quieter.

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