What's keeping you from sleep?

Diagnosing and treating sleep apnea in men

Dr. Ronald Wainz

In today's society, it's common to feel drained from busy work and family schedules. But chronic fatigue and excessive tiredness could be a sign of a larger problem.

Men, especially, might have a hard time recognizing the signs of a common medical condition called sleep apnea. Is it robbing you of healthy sleep? Here are some basic facts you should know:

What is sleep apnea?

Sleep apnea is a condition where you stop breathing during sleep, either due to a blockage of the airway or to a failure of the brain to signal your body to breathe.

When this happens, oxygen levels decrease and your brain wakes you up just enough to allow you to start breathing again. This condition can be present in children and adults; women and men. However, it is most common in middle-age or older men, especially those who are overweight.

In fact, it is common for those with sleep apnea to have these three characteristic symptoms: overweight/obesity, snoring during sleep, and excessive daytime sleepiness. However, alone, no one symptom is adequate to prove sleep apnea, and not all have to be present for its diagnosis.

Other symptoms of sleep apnea include waking up with a very sore or dry throat, occasionally waking up with a choking or gasping sensation, morning headaches, irritability, and forgetfulness.

Sleep apnea is a chronic condition, and the consistent interruption of breathing and sleep can lead to some serious conditions. Many individuals with sleep apnea are sleep-deprived and are at an increased risk for heart disease, high blood pressure, heart attack, stroke, accidents, and mood disorders such as depression.

Treatment

Fortunately, there are treatment options that can reduce the risks associated with sleep apnea.

Diagnosing the condition requires an overnight sleep study, most commonly suggested to be done at an accredited sleep center. This study monitors your oxygen levels, brain waves, and breathing mechanisms. A home test, available at pharmacies such as The Pharmacy Counter, can be obtained for those who think they might have sleep apnea. This home test isn't considered adequate to diagnose the condition, but it is helpful in determining if further testing is needed. This home study can be ordered by your doctor and is used for screening purposes.

A sleep study not only helps to diagnose sleep apnea, it also helps doctors determine the level of the condition's severity, which will influence the type of treatment. One consideration in determining the severity of sleep apnea is to monitor how many episodes you experience in one hour. More than five episodes of interrupted breathing per hour is considered abnormal. At 15 or more episodes, treatment almost always is recommended.

The most common form of treatment is a portable machine with continuous positive airway pressure, or CPAP. This keeps your airways open by sending pressurized air through your nostrils and/or mouth via a small mask worn over your nose and/or mouth. A dental device might also be worn to pull the lower jaw forward and allow for more space at the back of the throat and easier breathing. This generally is considered for those with the mildest degree of sleep apnea.

Also, in milder cases where breathing is interrupted fewer than 30 times per hour, surgery to remove excess tissue at the back of the throat might be considered. Yet surgery is only effective in 40 percent of cases, as opposed to a near 100 percent cure rate for those compliant with CPAP treatment.

Other lifestyle changes, such as exercising, losing weight, quitting smoking, and avoiding alcohol can help improve symptoms and risks associated with sleep apnea.

Seeking help

Because sleep apnea presents itself only while you are asleep, it might be difficult to recognize symptoms.

Many men might overlook daytime symptoms, such as excessive tiredness and irritability, or think they are simply due to stress or generalized fatigue from the work of the day.

In these cases, a bed partner can be helpful in determining whether or not symptoms such as snoring or gasping are present at night. One commonly accepted rule is that if your bed partner says you snore heavily and stop breathing at night, you most likely have a sleep apnea problem.

If left untreated, sleep apnea can lead to very serious health complications. If you think you might have sleep apnea, talk with your doctor. He or she can help lead you to a better night's sleep.

Dr. Ronald Wainz, a pulmonologist with ProMedica Physicians, sees patients at Toledo Pulmonary & Sleep Specialists. For more information please visit ppgdocs.org.