Is a Sleep Apnea diagnosis an inconvenience or a life saver?

Can you remember the last time you woke up feeling refreshed and well rested?

Can you remember the last time you woke up feeling refreshed and well rested?

My father suffered from severe sleep apnea for around twenty years until he was finally diagnosed and treated with a Continuous Positive Airway Pressure or (CPAP) machine. With his permission, I would like to tell you his story. I want you to pay close attention because if this sounds like you or someone you love then the information in this blog post may save your life or the life of someone close to you.

Growing up in our house we knew that if my dad sat down on the couch after dinner instead of going to do something else, within minutes, he would fall asleep and begin snoring very loudly. We are talking chain saws, jet engines and thunder bolts loud. This aural assault would continue for a while and then suddenly it would stop. The whole family would enjoy the peace and quiet for a brief time but if you watched him closely suddenly his whole body would stiffen and he would begin to gasp for air but would not fully wake up. Imagine how you look and feel when you break the surface of the water after a deep dive and your lungs are burning for oxygen. After a few big lungfuls of air he would fall back into a deeper sleep and shortly thereafter the snoring would begin again. This cycle would repeat over and over until we would wake him up and send him to bed or he would go off to work on one of his many projects.

So, if that isn't weird enough for you then check this out. My bedroom was directly above his home office, therefore, I was privy to his bizarre work schedule. Often at two or three in the morning I could hear him doing paperwork in his office or in my later years I would come home in the wee hours to find him puttering around in the garage fixing stuff. This is after he had already worked seeing patients from 8am until 6 or 6:30 at night. I would think to myself, "go to bed already, I can't believe you are still working." Even worse, this crazy old guy would sometimes wake me up in the middle of the night to help him build things in the garage or send me trudging through the snow to work with him in the barn. He would tell me that he couldn't sleep and we might as well get an early start on chores. I would think to myself, "I was sleeping just fine until your crazy carcass woke me up." Over the years we built storage shelves, welded car frames, serviced diesel generators, plowed snow for old ladies and maybe even built a dog house all in the middle of the night. I swear I'm not making this up. The same guy who would fall asleep as soon as he sat down would be up and working in the middle of the night because he couldn't sleep.  

I always chalked up his bizarre sleep schedule to his incredible work ethic. What I didn't know at the time is that he would often wake up at night from a dead sleep gasping for air and then wouldn't be able to fall back to sleep because his heart was racing so fast. So instead of just lying there in bed frustrated with his inability to get any sort of satisfying sleep he would just get dressed and go back to work in the middle of the night. No matter what he did, whether he tried to sleep or just went back to work, my father was always tired. He was even tired in the morning after what he perceived as a full nights sleep. 

I have come to learn that many, but certainly not all of my fathers crazy behaviors can be attributed to a severe case of sleep apnea. Now you are probably thinking that none of this sounds like you. You might snore a little or be a little tired in the morning but it's nothing like the story you just heard. You are probably right because what I have just described is a severe case, but even mild and moderate sleep apnea can have significant health consequences.

Sleep apnea is a common but serious sleep disorder affecting 18 million Americans. This disorder is characterized by pauses in breathing or shallow breaths while sleeping. In severe cases a person may stop breathing hundreds of times per hour. This sleep disorder is not commonly caught on routine physicals and will not show up on any blood test. There are two types of sleep apnea.  

  • Obstructive sleep apnea (OSA) is the most common form and is characterized by a blockage of the airway due to enlarged tonsils or tongue, a short jaw length or when the soft tissue at the back of the throat collapses during sleep.
  • Central sleep apnea (CSA) is the other form and occurs when the brain forgets to tell the appropriate muscles to breathe.
  • Some lucky folks have mixed sleep apnea (MSA) and suffer from characteristics of both types.

Untreated sleep apnea is associated with increased incidence of  the following problems

  • high blood pressure, heart attack, stroke and congestive heart failure
  • daytime fatigue and depression
  • disrupted metabolism, obesity, diabetes and liver problems
  • sleep deprived bed partners (For those who share a bed with someone who has sleep apnea. I want you to know that I feel your pain. I have been on a lot of camping trips with my father and there were times when sleeping out in the rain seemed more appealing than sharing a tent with him.)

Those most at risk for sleep apnea are

  • Males over 40 who are overweight, snore and have a neck circumference greater than 17" (16" for women). As we age the risk for sleep apnea continues to increase particularly in males over 60.
  • Women can also have sleep apnea and it tends to occur with increased weight and is more frequent in post-menopausal women.
  • Evidence suggests that black and latino males may be more susceptible to sleep apnea.
  • Smokers have significantly increased rates of sleep apnea.
  • Children with enlarged tonsils may also suffer from obstructive sleep apnea.

For more information visit the American Sleep Apnea Association or watch this video on the diagnosis and treatment of sleep apnea. Many people report difficulty using a CPAP machine at night because the mask is uncomfortable or becomes dislodged. At the end of the video that I linked to above you will see all the different styles of masks available. I always counsel patients to keep trying different masks until they find the one that works for them.

My father started treating his sleep apnea in my late teenage years. I remember when he told me one time that he had more energy as a 50 year old man than he did when he was 30. Now he takes his CPAP machine with him everywhere. My parents are now retired and living in Africa doing humanitarian work. I am glad to see my father healthy and happy in his later years. When I spoke with him recently he was trying to figure out how to get a special lightweight lithium ion battery over to Malawi so he could take his machine with him on an extended safari camping trip prior to returning to the United States. 

If you or a loved one are experiencing any of the symptoms discussed in this blog post or in the links provided above then I would counsel you to meet with your healthcare providers. They will be able to provide further evaluation and treatment recommendations if appropriate. A diagnosis of sleep apnea followed by appropriate treatment measures may not just be a change for the better it might save your life.