Sleep apnea's real health risks

By Ruth Underwood
CNN

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Do you toss and turn while your partner appears to be in a deep sleep, complete with loud snoring? You may not be the only one who is missing out on a good night's sleep.

When Paul Surratt began to feel tired all the time, taking naps during his lunch break and lacking the energy to participate in activities, his doctor suggested he participate in a sleep study. Surratt learned he had sleep apnea.

Dr. David Schulman, co-director of the Emory Clinic Sleep Disorders Lab, explains the disorder this way: "Sleep apnea is a problem where people have short pauses or basically cut-downs in their breathing for brief periods of time at night. And in an effort to restart the system or reboot the computer it interrupts sleep and starts it out again, and that's a process we call an arousal." (Watch what sleep can mean for your health. )

The National Institutes of Health estimate more than 12 million people in the United States have obstructive sleep apnea.

Schulman explains patients with sleep apnea are not aware of most arousals. But the quality of their sleep is poor, leaving them tired and sometimes wondering why they feel so drained. Surratt's apnea included around 120 sleep arousals per hour.

And, fatigue is not the only result of sleep apnea. Said Schulman,"We know uncontrolled apnea over many, many years leads to higher risks of heart disease, high blood pressure, strokes and probably death."

Sleep apnea is more common in men than women. Risk factors include overweight, abnormalities in the structure of the nose or throat and a family history of apnea.

"The most common risk factor for sleep apnea, and particularly obstructive sleep apnea is weight, obesity," says Schulman. "And interestingly, the size of the neck may be more important than the size of the belly.

"Studies have shown that a man with a collar size that is greater than seventeen inches around or a woman with a collar size greater than sixteen inches around is at a very increased risk of having obstructive sleep apnea," he said, "presumably because that's a marker of fat deposit around the airway."

Sleeping on your back, smoking, and drinking alcohol can also increase your risk of apnea.

In order to diagnose the condition, doctors often recommend a sleep study. The patient spends a night in a sleep lab, where his or her brain waves, breathing and movement are monitored in an effort to recognize disruptions in sleep and determine their cause.

If the diagnosis is sleep apnea, Schulman points to several treatment options. "The therapies that I may prescribe for them come in three types - dental appliances, surgical interventions -- surgery -- and then something called CPAP."

CPAP stands for continuous positive airway pressure. CPAP therapy involves a machine about the size of a shoebox that is placed by the bedside. A tube connects the machine with a mask and the machine pushes air through the airway, keeping it open.

There is a downside to CPAP therapy, says Schulman. "The acclimation period can be significant. That said, if you can get a cure in somebody, they'll often wake up the first morning after having used it saying I have not slept that well in years."

For Surratt, the CPAP therapy was so effective, he couldn't wait to use it on a regular basis. "I was fortunate. I adapted to it very, very quickly." And, Surratt says, his whole family is enjoying the results. "It's been very good. I'm able to sleep at night, stay active during the day, attend the kids' events. I've even been able to lose weight, exercise...everybody in my entire house is happy because they're not awakened by my snoring, I do sleep very, very comfortably, entirely through the night."