January 20, 2005

Public service announcement

I was diagnosed this morning with Obstructive Sleep Apnea (OSA). This condition is when you go to sleep, your airway closes and you stop breathing. The major problem with this is that oxygen levels drop dramatically and you never enter a deep restful sleep. I can sleep 16 hours and still not feel rested. I had a sleep study done and in a 150 minute time span, they counted over 200 episodes where I stopped breathing. The solution however is pretty easy. I recieved a CPAP (continual positive airway pressure) machine this morning, and I'm dying to try it out. It's a small machine that fits onto an air mask that uses air pressure to keep the airway open. The most publicity this condition has gotten was the sudden death of NFL great Reggie White. Here is a great site to learn more about the condition. I hope they don't mind, but I'm going to rip the symptoms and paste them here.

The signs and symptoms of OSA result from disruption of the normal sleep architecture. The frequent arousals and the inability to achieve or maintain the deeper stages of sleep can lead to excessive daytime sleepiness, nonrestorative sleep, automobile accidents, personality changes, decreased memory, erectile dysfunction (impotence), and depression.

Patients rarely complain about frequent awakenings due to obstruction, but awakenings do occur. Excessive daytime sleepiness may be mild or severe, depending on the severity of the obstruction. Some patients suffering from OSA fall asleep in a nonstimulating environment, such as while reading in a quiet room. Others may fall asleep in a stimulating environment, such as during business meetings, eating, and even while having sex. Patients with OSA often complain of waking up feeling like they had never slept at all. They often feel worse after taking a nap than they did before napping.

The so-called drowsy driver syndrome, which a growing number of law enforcement authorities believe to be responsible for many automobile accidents, may result from OSA, which causes some drivers to fall asleep at the wheel or to suffer from lack of alertness because of sleep deprivation. Decreased alertness places a person at risk in a variety of potentially hazardous situations. It is recommended that persons with excessive daytime sleepiness not drive or operate dangerous equipment until their condition is effectively treated. Other symptoms of OSA, such as morning headaches and frequent urination during the night, may be caused by apneic events themselves.

The physical signs that suggest OSA include loud snoring, witnessed apneic episodes, and obesity. Patients with OSA often say that their only problem is that their bed partner complains about their snoring. A large number of snorers are believed to have OSA. Many times, a sleep partner will witness an apneic event.

Hypertension is prevalent in patients with OSA, although the exact relationship is unclear. It has been shown, however, that treating OSA can modestly lower blood pressure.

Not everybody who snore has sleep apnea, but if two or more of the above symptoms are present the person should consider consulting a sleep specialist. A high score on the Epworth Sleepiness Scale is also a strong indicator of possible sleep apnea.

Complications

The most obvious complication arising from OSA is diminished quality of life brought on by chronic sleep deprivation and the symptoms described above. Coronary artery disease, cerebral vascular accidents (strokes), and congestive heart failure are being evaluated to define the exact nature of their connection to OSA. Some linkage between OSA and coronary artery disease and stroke has been demonstrated, although it is still uncertain whether OSA leads to an increased risk of stroke and coronary artery disease or if both OSA and cardiovascular problems are caused by a common problem, such as obesity. Obstructive sleep apnea aggravates congestive heart failure by placing stress on the heart during sleep. There is a high prevalence of OSA in patients with congestive heart failure.
If you or anyone you know fits this profile, please have it checked out. I'll report on how things have changed for me in the coming weeks.