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Excessive Sleepiness Could Be Serious Sleep Disorder
Posted on Wed, Mar. 21, 2007
By Dr. Mark Wille
Snoring can be bad for both your love life and your health. Take my patient, "Harry" (not his real name). He came in complaining that he hadn't felt good for several months.
He was always sleepy, even though he spent nine hours in bed every night, and he often had a headache. On top of that, his wife moved into another room to sleep because of his snoring.
Like many of the patients I see with these complaints, I immediately suspected sleep apnea, a potentially serious condition that causes a person to intermittently stop breathing during deep sleep. This disorder has potentially serious health effects, but fortunately is usually easy to treat.
- Usually affects men
Traditionally, older men, and the overweight, rather than women, are more likely to suffer from sleep apnea, with about 10 percent of men 50 and older having at least a minor form of the disorder.
And, unfortunately with the increase in obesity, we're seeing more cases of sleep apnea in both men and women.
- Caused by airway blockage
During deep sleep, the throat muscles relax and partially close. Extra weight around the neck area and upper body can cause the throat to completely close, cutting off air. Loud snoring, like Harry's, is caused by a partial airway blockage, and is a common indicator of sleep apnea.
Very rarely, sleep apnea can cause death because the person doesn't start breathing again. Most people start breathing again by changing positions, often punctuated by a loud snore, without fully awakening.
- Serious health risks
This condition results in oxygen deprivation, which stresses the body and can cause problems such as high blood pressure and congestive heart failure.
It also causes chronic sleepiness. No matter how long they sleep, sleep apnea sufferers don't wake up feeling refreshed. This affects the quality of life both physically and emotionally and can negatively impact work performance and driving ability.
Some people complain of falling asleep at work or while driving, which is particularly dangerous for commuters.
- Diagnosis
Excessive daytime sleepiness like Harry had is the most common reason doctors screen for sleep apnea, especially if the patient is overweight. Often the patient's bed partner also complains about loud snoring.
To diagnose sleep apnea, the patient spends the night in a sleep center or at home with equipment that monitors oxygen level, respiratory rate and air flow.
- Treatment
Once diagnosed, the most common treatment for sleep apnea is a nasal C-PAP mask. The apparatus is fitted to the mouth and nose and gently pushes air into the airway to keep the throat open.
Surgery can be used for people who don't respond well to the mask because they have big tonsils or a jaw deformity.
Losing weight also is a good way to treat sleep apnea, but I have found most people are more willing to wear a mask to bed than lose 40 pounds.
Harry uses a C-PAP mask and has been very happy with the results. His blood pressure has improved, he feels better and his wife has even moved back into their bedroom.
If you or someone you know has symptoms similar to Harry's, talk to your health care provider so you can have a happy ending, too.
Wille was chief of internal medicine at Contra Costa Regional Medical Center for almost 30 years.
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