Winter 2015 - When a Snore is More Than Just a Snore

How sleep apnea affects more than just your sleep.

If you’ve ever been around someone who snores, you know that snoring can be a real nuisance. It can disrupt your sleep (and the snorer’s sleep), and it has been the cause of more than a few marital disagreements. But before you put in your earplugs or head to the guest bedroom, resigning yourself to a lifetime of snore-filled nights, you should know that sometimes, snoring can be a sign of a much more serious health condition called sleep apnea.

Beyond simple snoring, sleep apnea is a disorder in which you experience pauses in your breathing while you sleep. In obstructive sleep apnea, your airway is blocked, and the air that is able to make it around the blockage is responsible for the loud snoring. According to Dr. Richard Daw, a cardiologist with the Cary office of WakeMed Heart & Vascular Physicians, sleep apnea is not just bad for your sleep, it’s extremely hard on your heart.

“Sleep apnea puts a huge amount of stress on your heart,” said Dr. Daw. “It puts an enormous amount of stress on the system, and then that leads to atrial fibrillation and arrhythmia, that can lead to sudden heart attack and sudden cardiac death.” Sleep apnea also increases the risk of high blood pressure and stroke.

The American Heart Association estimates that one in five adults suffers from at least mild sleep apnea, which means they experience between five and 15 pauses in breathing per hour while they sleep. Dr. Daw said that he refers a significant number of his patients to a pulmonologist for evaluation but still knows that he’s not catching every case of sleep apnea.

“I refer a lot of people for sleep studies,” he said. “They come to me complaining of fatigue and shortness of breath, but it’s not their heart. Right now, 95 percent of the patients that I refer to the pulmonologist for sleep evaluation have sleep apnea. That means I’m not sending enough patients; I’m missing some.”

H2H Winter 2015 Doc

While there’s no blood test for sleep apnea, and it can be difficult to detect during a routine doctor visit, Dr. Daw noted that there are some classic signs and symptoms that can indicate that a patient might have sleep apnea. In addition to snoring, fatigue (often characterized by daytime napping and falling asleep while driving) and shortness of breath, signs and symptoms of sleep apnea include headaches (especially in the morning), concentration problems, depression, mood swings, and dry mouth or sore throat when you wake up.

If your doctor suspects sleep apnea, he or she may refer you to a pulmonologist for further evaluation. The pulmonologist will do a variety of tests to rule out other causes of shortness of breath, like asthma or emphysema. Once other causes are ruled out, a sleep study could confirm the suspected diagnosis of sleep apnea.

If sleep apnea is confirmed, the first line of treatment is a continuous positive airway pressure (or CPAP) machine. This machine, which Dr. Daw affectionately calls the “Darth Vader mask,” supplies a constant stream of air through a mask to keep your airways open. But not everyone is a fan of the machine.

“Compliance with the sleep machine is probably about 50/50,” said Dr. Daw. “I ask people to give it a good college try, and of those that do, half come back and say they can’t live without it, and the other half try it and say they couldn’t do it — it gave them anxiety or claustrophobia or it was just uncomfortable.”

For those who can’t or won’t use the machine, Dr. Daw said that the alternative to the CPAP machine is surgery, which offers its own complications, including the potential for chronic reflux, as well as the normal complications that go along with surgery.

Whether CPAP works for you or you undergo surgery, one of the most important steps in your treatment is often weight loss, said Dr. Daw, since the vast majority of patients with obstructive sleep apnea are also overweight or obese. In addition, he recommends practicing “good sleep hygiene,” which includes avoiding caffeine and alcohol at night, staying away from large meals right before bed, and establishing a regular bedtime routine.

H2H Winter 2015 snore

H2H Winter 2015 Office

What to Expect
at the Sleep Center

If your doctor refers you for a sleep study to determine whether or not you have sleep apnea (or any other sleep-related disorder), WakeMed Cary Hospital offers a comprehensive Sleep Center that can meet all of your needs.

An overnight sleep study aids physicians in properly diagnosing and treating sleep disorders. A sleep study is a simple, painless, overnight procedure. You’ll be monitored by trained pulmonary professionals using the latest technology available. Study results are sent to your doctor within a matter of days to help ensure prompt diagnosis and treatment.

Located adjacent to WakeMed Cary Hospital, the Sleep Center offers hotel-style décor to make you feel at home. The Sleep Center’s four bedroom-style rooms offer:

  • Queen-size beds with your choice of mattress firmness
  • Private baths and personal control over room temperature. Showers are also available.
  • Flat-screen, high-definition TVs in each room.

“Our patients often comment that the Sleep Center is like a four-star hotel room with your own specialist meeting your every need,” noted Bruce Handley, director of the Sleep Center.

“We can also provide the necessary supplies and equipment for sleep disorder treatment prescribed by your physician. You deserve and need consistent good sleep for your heart health and overall well-being. We are here to help you!”

For more information about the Sleep Center, call (919) 350-2359.

Importantly, Dr. Daw noted that while sleep apnea may not seem like a life-threatening problem, it’s important to take the condition and its treatment very seriously because of the significant impacts that it can have on all areas of your health.

“Untreated sleep apnea and obesity increase the risk of premature death,” he said. “There are consequences of choosing not to treat these conditions. Beyond the cardiac risks, just think about your next day. If you’re sedentary - you don’t do anything. You gain more weight and you’re not getting the stuff done you want to get done. Sleep apnea is associated with depression, and it’s just a downward spiral. That’s the problem.”

The good news, said Dr. Daw, is that CPAP machine technology continues to improve, meaning CPAP machines work more effectively and compliance is less of an inconvenience. And new research and technologies are leading to new and promising methods of treatment for sleep apnea.

“There’s a whole new frontier in the treatment of sleep apnea, and it has the potential to transform the way we treat this condition,” said Dr. Daw. “But for today, compliance is the key to treatment.”