ONE OF THE MOST COMMON SLEEP DISORDERS affecting an estimated 22 million Americans is sleep apnea, according to the American Sleep Apnea Association. And an estimated 38,000 patients die annually of untreated sleep apnea. In addition to affecting your sleep pattern and leaving you tired the following day, sleep apnea also harms your heart.
Dr. Vic Bahal of Advanced Cardiology of South Jersey wants to educate as many people as he can of the symptoms, risks and treatments of sleep apnea so they can live better, healthier lives.
Understanding Sleep Apnea
There are two forms of sleep apnea. The first, and least common, is central sleep apnea (CSA), which is the result of parkinsonism, stroke and Alzheimer’s disease. The second and most common form of sleep apnea is obstructive sleep apnea (OSA) which the majority of the time is caused by excess weight and obesity.
“Sleep apnea is when you repeatedly stop breathing for 10 seconds or more during your sleep,” says Dr. Bahal. “Because of that, the oxygen content decreases and it can affect all of the organs in the body, including the heart.”
On a cardiac spectrum, Dr. Bahal says sleep apnea can cause great havoc.
“If you don’t breathe, there is no oxygen,” he explains. “Even with mild sleep apnea, it can be a detriment to the patient’s heart because the heart isn’t getting enough blood and all organs basically start to suffer. For example, hypertension heart rhythm problems like atrial fibrillation (AFib) and congestive heart failure can start,” says Dr. Bahal. “I highly recommend anyone with congestive heart failure or AFib consider having a sleep study done.”
Identifying the Symptoms
Just like any disorder, disease or medical issue, there are very obvious signs that a person has sleep apnea. These are the most common signs Dr. Bahal has seen when diagnosing OSA sleep apnea:
• Day time somnolence (sleepiness)
• Feeling tired upon waking up
• Fragmented sleep pattern
• Tossing and turning at night
• Frequently getting up during the night to urinate
• Restless legs
• Difficulty concentrating
Knowing the Risks
The first step to prevention is knowing exactly what types of contributing factors develop sleep apnea. If you haven’t shown any signs, here are some risks that may make you more susceptible to OSA sleep apnea:
• Over 40 years of age
• Men with a neck size greater than 17 inches
• Women with a neck size greater than 16 inches
• Those with Gastroesophageal Reflux disease, diabetes,
hypertension, heart failure
• A family history of sleep apnea
“These are the kinds of risk factors and these are the types of patients that should be checked,” instructs Dr. Bahal.
Dr. Bahal provides patients with a questionnaire that allows him to determine which patients should be evaluated for sleep apnea. In the past, patients suspected of having sleep apnea had to sleep at a sleep center to diagnose the problem. Patients often complained about the anxiety of sleeping in a lab and in a different bed and would procrastinate doing the test. Dr. Bahal now offers sleep testing in the comfort of your home by utilizing a “portable at home sleep study device” (as shown on the left) to diagnose sleep apnea. This device has made it much easier for patients to get diagnosed without being uncomfortable and giving up other activities for the day.
Dr. Bahal stresses that sleep apnea is underdiagnosed, undertreated, and is a very serious condition. Essentially, if patients have it and don’t treat it, they could die.
The first step to treating sleep apnea is with continuous positive airway pressure (CPAP) machines.
As the medical equipment technology has advanced, doctors no longer need to input a pressure amount into these machines. With auto titration, the machine will give the patients the amount of airway pressure they need.
“If you pull in 300 CCs of air and your body requires 450,” explains Dr. Bahal, “the machine will give you the remaining pressure to fill up the lungs.”
Although the CPAP machine is very effective, most people can’t handle sleeping with the mask on due to discomfort. For those patients, Dr. Bahal’s office now offers an oral appliance that moves the tongue out of the way and pulls the jaw forward—thus treating OSA. Most insurances pay for sleep testing and treatment, including oral appliances.
A more extreme method to treat sleep apnea would be uvulopalatopharyngoplasty, which surgically removes both the tonsils and adenoids if necessary.
The treatment for OSA and CSA is the same in many cases.
“Not only are we treating sleep apnea, we are contributing to the quality of their lifestyle,” says Dr. Bahal. “Sleep apnea-treated patients have more energy, are more motivated to exercise and live a happier and healthier lifestyle which all translates into reducing cardiovascular risk.”
To learn more about sleep apnea, get tested and receive more information about alternative treatments, contact Dr. Bahal’s office.
Advanced Cardiology of South Jersey
(856) 241-3838 • firstname.lastname@example.org
Published (and copyrighted) in Suburban Family Magazine, Volume 8, Issue 4 (June, 2017).
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