Don’t Let Poor Sleep Play Havoc With Your Health

Getting enough sleep isn’t easy, especially when so many other things – children, job, illness, stress, environment and, yes, even Daylight Savings Time – are working against you. Poor sleep can be caused by sleep apnea, doctors say, which can trigger cardiovascular problems and other serious health issues.

So how do you know if your sleep problem really is a problem? And is it actually possible to get a better night’s sleep? Baptist Health sleep medicine specialists spoke with Resource recently about the dangers of sleep apnea, and what you can do to manage it.

“Sleep apnea is a common condition affecting millions of Americans of all ages that’s caused by a temporary collapse of the airways in your throat,” says Timothy Grant, M.D., a board certified neurologist and sleep medicine specialist who serves as director of Baptist Health Sleep Center. “It’s marked by lengthy pauses in your breathing as you sleep. These can last from just a few seconds to a couple of minutes or more, and can occur repeatedly throughout the night.”

Those frequent and extended pauses in breathing, which are sometimes followed by a gasping or choking sensation as you awaken suddenly struggling for air, deprive your body of the oxygen it needs and leave you feeling tired and irritable during normal waking hours, Dr. Grant says.

“Sleep apnea results in constant awakenings throughout the night, and low blood oxygen levels,” says Dr. Grant. “These, in turn, can cause other health issues such as high blood pressure, glaucoma and atrial fibrillation, or an irregular heartbeat.” Left untreated, he says, moderate to severe sleep apnea can lead to an increased risk of diabetes, heart attack, stroke and, in rare cases, death.

The various physiological changes that occur in patients with sleep disorders can actually be measured, according to Harneet Walia, M.D., medical director of Sleep Medicine and Continuous Improvement at Miami Cardiac & Vascular Institute.

“We can measure for decreased oxygen levels; excessive carbon dioxide in the bloodstream; changes in intrathoracic pressure and increased systemic inflammation,” Dr. Walia says. “We can also measure for increased activation of the sympathetic nervous system, meaning your body’s engine is always in high alert mode, just as when you’re faced with a dangerous or stressful situation. All of these things can make you more prone to negative changes in your heart health.”

Are you at risk for sleep apnea?

Sleep apnea is common in men in their 20s, 30s and 40s, but women typically don’t suffer from it until after menopause, Dr. Grant says. A common misconception is that sleep apnea victims are old and overweight. “One-third of the patients we treat in our sleep centers are thin or even frail, and some are children,” Dr. Grant notes. “But if you are overweight, losing 10 to 20 percent of your total body weight can actually reduce the severity of your sleep apnea and help you feel better overall.”

Loud snoring is frequently associated with sleep apnea, he says – less so with women, who tend to be more subtle snorers. “If your partner complains about your snoring, you might want to ask your doctor about a sleep study, which can determine whether or not you have sleep apnea,” he says.

What to expect in your sleep study

Jeremy Tabak, M.D., medical director of the Baptist Health Sleep Center at Galloway, says the first step is an evaluation of the patient’s sleep health. “We need to get an accurate picture of your sleep habits and the quantity and quality of your sleep,” he says. “When do you go to bed? When do you wake up? How do you feel when you wake up? What’s waking you up in the middle of the night? Are you tired in the morning? How much coffee do you have to drink during the day to stay alert? These are all things that inform our diagnosis and treatment plan.”

The next step is the sleep study itself, Dr. Tabak says. There are two types of studies, he says – an in-home study using a portable device the patient takes home with them, or an in-lab study done at a sleep center such as Baptist Health’s.

“Many people find the idea of a home study attractive, but there are times when an in-lab study is really necessary,” says Dr. Tabak. “If we have a strong clinical suspicion that someone has sleep apnea, and they don’t have a lot of other unrelated health conditions, then we can consider an in-home study. The amount of information we get from that is limited, however. An in-lab study gives us much more information to work with.”

Baptist Health has four sleep centers in South Florida where patients can come for a sleep study. Each is staffed by experienced sleep medicine physicians and technicians, and fully accredited by the American Academy of Sleep Medicine, the highest rating possible.

“The rooms in our outpatient sleep centers are very comfortable,” Dr. Tabak says. “They’re like a nice hotel room, actually, with quality furnishings and linens, a private bathroom, cable TV and other comforts of home. Some patients actually report getting a better night’s sleep here than they do at home.”

Studies can be done day or night, whichever is your usual sleep time, and are non-invasive, Dr. Tabak says. “The technician simply attaches some leads to your skin that will measure your blood pressure, pulse, respiration rate and blood oxygen level while you sleep. All you have to do is get yourself ready for bed, relax and go to sleep.”

Treating sleep apnea with CPAP therapy

Patients diagnosed with obstructive sleep apnea can manage their condition with Continuous Positive Airway Pressure (CPAP) therapy. “You wear a comfortable, custom-fitted snore mask connected to a small machine by your bedside,” says Dr. Grant, who has been using CPAP therapy himself for 15 years. “The CPAP machine gently pushes air into your airway to keep it propped open while you sleep.”

CPAP technology has improved significantly in recent years, Dr. Grant says. “The old machines were big and bulky and noisy. The new ones are smaller and quieter, and can adjust air pressure depending on your position and sleep stage,” he says. “They can relay data to your phone so you can get a daily report on how you slept and, if you want, they can even allow your doctor remote access to check your vital signs and adjust your machine’s settings.” Compact-size CPAP machines are also available for frequent travelers, he adds.

Other therapies, including surgical procedures, are also available for sleep apnea, according to Dr. Grant. “A qualified sleep medicine specialist will be able to provide an accurate diagnosis and determine which therapy best suits your needs,” he says.

Considering that the average American spends roughly a third of their life sleeping – or trying to sleep – Dr. Grant appreciates how important a good night’s sleep is to one’s overall health.

“So many sleep disorders go undiagnosed because people just accept them and put up with them,” says Dr. Grant. The majority of sleep disorders can be treated, however, and he says the result can be life-changing. “As sleep doctors, we can significantly improve your quality of life by helping you sleep better and feel better.”