Do You Have Sleep Apnea?
By John E. Kaiser, MD

 Sleep apnea.  Do you ever:

• fall asleep sitting & reading?
• while watching television?
• while sitting inactively in a public place?
• while riding as a passenger in a car for 1 hour?
• while sitting & talking with someone?
• while sitting quietly after lunch without alcohol?
• while sitting in a car as a driver?
• while lying down in the afternoon when circumstances take a break?

If you answer yes to 3 or more of these questions, you could have significant sleep apnea.

Sleep apnea is a common condition occurring in 4-9% of middle-aged men and women and 20% of elderly people.  People with sleep apnea tend to be chronic snorers.  They will have sleepiness during the day, restless sleep, night sweats, sometimes have a morning sore throat or dry mouth.

People close to them may notice personality changes.  They may have morning confusion and morning headache.  They may have deterioration in their intellectual performance, and impotency.

The typical person with sleep apnea is a middle-aged man with hypertension, obesity, and a thick neck, but obviously this is not always the case.  The problem with sleep apnea is that people suffocate during their sleep as they stop breathing and have episodes of lack of oxygen during sleep with fragmented sleep due to frequent awakenings.  The complications of sleep apnea are due to less alertness during the daytime and cardiovascular complications.

Sleep apnea raises one's blood pressure and increases the risk of death.

The diagnosis of sleep apnea is done with a test called a "polysomnogram."  The patient is asked to come to the sleep lab to sleep and be observed.  The number of times a person stops breathing and has lack of oxygen is recorded and quantified. People with more than normal episodes are recommended to have treatment.  Treatment for sleep apnea can be as easy as weight loss or sleeping in a different position instead of sleeping on one's back.  People with sleep apnea should avoid alcohol and sedatives at night.  If these measures are not successful, then orthodontic appliances can be found that can hold the patient's lower jaw forward to prevent the airway from collapsing at night and causing the sleep apnea.  The typical treatment for sleep apnea is a device called "continuous positive airway pressure," or "CPAP," which is a mask connected to an air compressor that forces air into the nose at night to keep the airway from collapsing.  Surgery is also a treatment to reconfigure the upper airway.  It can be either tonsillectomy,nasal surgery, or a palate surgery, and in worse cases, jaw advancement surgery can be done.

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