Along with food and shelter, sleep is quickly becoming
widely recognized as one of the most crucial commodities, a necessity rather
than a luxury. Forced sleep deprivation has been used for decades in the
interrogation of prisoners, sparking debates over whether the technique
qualifies as torture or not. Navy SEAL trainees must endure, as part of their
infamous Hell Week, days of little to no sleep, putting their bodies and minds
under extreme duress. And approximately four ordinary people like you and me are
fatally injured in vehicular accidents related to tired drivers falling asleep
at the wheel or unable to avoid a crash due to slowed reflexes and focusing
skills.
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| Warning Sign in Utah |
The National Highway Traffic Safety Administration asserts
that drowsy driving is a leading cause of accidents, injuries, and deaths,
accounting for at least 100,000 crashes, 40,000 injuries, and 1,550 deaths
yearly; they also proclaim these numbers should realistically be higher due to
the underreporting of fatigue as a cause of an accident. [1]
Drowsy driving accidents characteristically involve a single car with a lone
driver and occur during the late night, early morning, or mid-afternoon hours,
when exhaustion is most likely to set in. The three population groups who are
considered to be at the highest risk of fatigue-related accidents are teenagers
and young adults, night-shift workers and those with long or irregular hours,
and people of all ages suffering from untreated sleep disorders, namely sleep
apnea and narcolepsy.[2]
What is sleep apnea?
Approximately 70 million Americans suffer from a sleep
disorder of some sort.[3]
One of the most common sleep disorders is sleep apnea, a condition in which the
affected person’s breathing becomes highly irregular during sleep. Sleep apnea
is typically characterized by loud snoring, restlessness, and/or low or
interrupted breathing while asleep. The condition does not permit regular
breathing patterns, resulting in frequent moments in which the person does not
breathe, often leading to a snoring sound when he or she finally draws breath.
The condition often goes unnoticed and undiagnosed due to the fact that the
sufferer does not hear him or herself breathing or snoring heavily at night.
The symptom of daytime sleepiness if often attributed to poor sleep habits,
uncomfortable bedding, stress, feeling “run-down,” or a host of other
unremarkable excuses.
Sleep apnea is divided into three categories: central apnea,
obstructive apnea, and mixed or complex apnea. Central sleep apnea is caused by
an imbalance in the brain’s respiratory centers, leading to irregular blood
levels of carbon dioxide and an uneven respiratory rate. People with coronary
artery disease and central sleep apnea may suffer arrhythmia or heart attack
due to the drop in blood oxygen. Mixed/complex sleep apnea is a combination of
central and obstructive apnea; a persistent, untreated case of obstructive
apnea can lead to episodes of central apnea.
Obstructive sleep apnea is the most common type of apnea; it
occurs when the airway is narrowed or compressed during sleep. While we sleep,
our throats naturally relax, which normally does not affect our breathing. and
people with enlarged tongues or tonsils, which block the airway. Some people
have sleep apnea due to the shape of their head or neck, enlarged tongues or
tonsils, or low muscle tone. The risk increases with age; 10% of people over 65
suffer from it. Obstructive sleep apnea is prevalent in overweight people,
whose extra fat tissue can narrow the windpipe; in a true chicken-and-egg relationship,
lack of sleep can lead to weight gain, which worsens the apnea.
Risks of sleep apnea
The lack of sleep and regular breathing is not only
irritating and exhausting, it can take a terrible toll on the sufferer’s body.
Someone with undiagnosed and/or untreated sleep apnea is at increased risk for
acute conditions such as high blood pressure, heart attack, stroke, and
diabetes. Drowsiness can lead to serious car accidents, often resulting in
grave or fatal injury. Aside for the health risks, the extreme fatigue
associated with sleep apnea can significantly impair one’s quality of life. A
constantly tired employee may lose his job; the exhausted father and husband
may frequently lose patience with his family, and his wife will lose sleep as
well due to her roommate’s heavy snoring and odd breathing pattern.
How is sleep apnea diagnosed and treated?
Because it can be difficult to trace the source of the
patient’s fatigue to sleep apnea, especially if he or she lives alone, the
condition may go undiagnosed for years. A comprehensive polysomnogram, more
commonly known as a sleep study, is a non-invasive but accurate diagnostic test
that can be invaluable in the diagnosis and subsequent treatment of sleep apnea
and any secondary conditions. Once the diagnosis is made, several levels of
treatment options exist to address every type of the disorder.
Typically, with less severe cases of apnea, doctors
recommend simple, natural behavioral remedies as a starting point. Firstly,
patients are encouraged to stop smoking, drinking alcohol, and taking sleep
aids or recreational drugs. Some patients respond well to propping up the head
of their bed by two to four inches to improve airflow; others eliminate
symptoms with weight loss or conscientiously sleeping on their side. A British
study showed that playing the Australian didgeridoo or other similar wind
instruments can strengthen the airway.[4]
Minimally invasive treatment known as oral appliance therapy (OAT) consists of
a specially fitted mouthpiece designed to keep the mouth and airway open at
night. Some doctors may prescribe medication to balance blood pH and regulate
respiratory rates in patients with central or complex apnea.
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| Full Face CPAP Mask |
Moderate to severe cases of obstructive sleep apnea are
frequently treated with continuous positive air pressure (CPAP) or automatic
positive air pressure (APAP) therapy. Patients receive a CPAP device, which
forces a steady flow of air into an attached plastic mask worn by the patient
at night. The regulated air pressure pushes air into the patient’s airway while
he or she sleeps, ensuring that he or she maintains a regular breathing rate.
CPAP therapy has proven to be most effective in treating sleep apnea, but many
patients find it uncomfortable and refuse to continue therapy long-term,
compromising the results. The most important factor in ensuring continuity of
CPAP therapy is finding and wearing the right mask. CPAP masks may be full-face
or nasal only; many are one-piece and constructed of comfortable materials such
as silicone or neoprene. Every patient must select the mask that is right for
him or her, choosing from features such as cushioned headgear, padded forehead
straps or half-face masks without forehead straps at all, and adjustable
connectors for extra comfort. With the right mask, patients will willingly use
their device and greatly improve their quality of life.
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| Nasal CPAP Mask |
Extreme cases of sleep apnea that do not respond to CPAP
therapy are treated with radical measures such as surgery. A patient with
narrow nasal openings may undergo septoplasty or turbinate surgery; someone
with enlarged tonsils may benefit from a tonsillectomy. More minor surgical
procedures include injections or insertion of plastic plates to stiffen tongue
and throat tissue. One of the most effective surgeries in treating sleep apnea
are maxillomandibular advancement (MMA) and tongue advancement, in which the
jaws and/or tongue are moved forward to open the airway. This is typically a
last-resort option due to its longer recovery time, but has been proven to be
highly successful.
A person with chronic fatigue and related health conditions
may exhaust all available resources in search of a cure. The solution often
lies in a simple-to-treat diagnosis of sleep apnea. If you or a loved one
suffer from weariness despite getting enough sleep, start with a sleep study;
the results may save you a lot of time and effort. Be sure to visit
TigerMedical.com for all your CPAP needs; we are here to help you find the
right mask to ensure that your therapy is as effective as possible and make a
significant difference in your life.
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