Health for the Whole Family November 2013 Sleep Apnea Wake Up Call Your snores could be a sign of a potentially serious condition. If they are loud and punctuated by periods of silence, it might be time to get tested for sleep apnea, a potentially serious sleep disorder that is tied to a higher risk of stroke, heart attack and early death. While there is no cure, [FIRST Jane-Marie Raley, DO, an osteopathic Family physician provides tips to help manage this chronic condition, avoid serious complications, and get a good night’s sleep. Sleep Apnea Snapshot According to Dr. Raley, there are two main types of sleep apnea. The most common form, obstructive sleep apnea, occurs when throat muscles relax and the airway collapses or becomes blocked while sleeping. “This obstruction causes shallow breathing or breathing pauses. Sufferers are left snorting, choking or gasping, five to 30 times or more each hour, all night long,” says Dr. Raley. “Conversely, the second most common type, central sleep apnea, occurs when your brain doesn't send proper signals to the muscles that control breathing. As a result, sufferers don’t breathe for brief periods of time,” she continues. Who is affected by this sleeping disorder? “People who are overweight and small children who have enlarged tonsil tissues in their throats are the most commonly affected by obstructive sleep apnea, while studies have shown people with a history of heart failure and stroke are the most at risk for central sleep apnea,” says Dr. Raley. Sleep Apnea Symptoms Most people who have sleep apnea are unaware they have it, since most of the symptoms occur during sleep. Dr.Raley recommends asking a family member or bed partner to help you note these common signs: Excessive daytime drowsiness and sleepiness (which could lead to a motor vehicle accident) Loud snoring Breathing pauses during sleep Abrupt awakenings accompanied by shortness of breath Waking up with a dry mouth or sore throat Difficulty staying asleep (insomnia) Attention problems or hyperactivity (which is common in children with the disorder) Poor memory “If you are experiencing breathing problems during sleep or suspect you might have sleep apnea, you need to consult a medical professional immediately,” advises Dr. Raley. “Your lungs may not receive enough air if the airway is partially or fully blocked during sleep, and as a result, a drop in your blood oxygen level can occur. These frequent drops in your blood oxygen level and reduced sleep quality can trigger the release of stress hormones, which raise your heart rate and increase your risk for high blood pressure, stroke, and heart attack,” she explains. “Treatment is necessary to avoid these complications.” Evaluation and Treatment Options While severe cases of sleep apnea might require surgery or an airway pressure device to regulate breathing while you sleep, in some cases, self-care may be the most appropriate treatment. To alleviate the symptoms of sleep apnea, Dr. Raley suggests these tips: Lose excess weight. Even a slight loss in excess weight may help improve constriction of your throat. Exercise (but not before bedtime). Getting 30 minutes of moderate activity, such as a brisk walk, most days of the week may help ease obstructive sleep apnea symptoms. Avoid alcohol, caffeine and certain medications like sleeping pills, which relax the muscles in the back of your throat, interfering with breathing. Sleep on your side or stomach rather than on your back. Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat and block your airway. Keep your nasal passages open at night. A saline nasal spray can help; however, avoid Afrin. Stop smoking. Smoking worsens obstructive sleep apnea. Make your bedroom a place to sleep, not to work or watch television. Solution for Better Sleep “If you’re not getting enough rest, then there might be a real problem with your health,” says Dr. Raley. “Chronic daytime sleepiness and fatigue is not normal. Discuss your sleeping habits with your physician. Together, you can find a solution for better sleep.” Preventive medicine is just one aspect of care osteopathic physicians provide. DOs are fully licensed to prescribe medicine and practice in all specialty areas, including surgery. DOs are trained to consider the health of the whole person and use their hands to help diagnose and treat their patients.