By Colleen Janssen
In recent news, the coroner ruled that sleep apnea, along with other factors, killed actress Carrie Fisher. The idea that sleep apnea can be deadly, may have been a surprise to many.
By Colleen Janssen
In recent news, the coroner ruled that sleep apnea, along with other factors, killed actress Carrie Fisher. The idea that sleep apnea can be deadly, may have been a surprise to many.
Sleep apnea is the condition where a person stops breathing for periods while asleep. It can happen just a few times, or many times.
“Zero to five times per hour is considered normal,” said Susie Yim Yeh, M.D. at Kaiser Permanente in Orange County. “Five to fifteen times is mild, fifteen to thirty is moderate, and thirty plus is severe.”
“Symptoms of sleep apnea can include snoring, fatigue and sleepiness, and lack of concentration and focus.”
“Many-times a spouse or bed partner will force a person to get tested,” continued Dr. Yeh. “They are kept awake from the snoring or notice that their partner stops breathing.”
“Fatigue and sleepiness can cause the person to have a lack of energy and focus. They may have depression or low thyroid conditions, or it may be sleep apnea.”
Dr.Yeh explained that a person with sleep apnea may frequently fall asleep in a car, watching TV, or anytime they sit for a while. At Kaiser Permanente, a questionnaire is given to determine whether symptoms exist. The results can be a good indicator of sleep apnea.
The patient takes home testing equipment that is worn overnight. The equipment is returned and a report is generated that shows the number of times the patient stopped breathing and whether it was while sleeping on the patient’s back or side.
“In the service area of Orange County, we are treating 4,500 to 5,000 new cases annually,” said Dr. Yeh. “Ninety percent of patients are effectively treated with a CPAP.”
A CPAP is a Continuous Positive Airway Pressure machine. The patient wears a small face mask connected by tubing to a compressor that forces air through the nose into the throat. Most commonly, obstructive sleep apnea occurs when breathing is interrupted by blockage of the airflow. The CPAP compensates for the blockage.
Other options exist for those who dislike using a CPAP machine. One is a dental device that forces the patient’s jaw and tongue forward during sleep. Most important, is to begin treatment as soon as possible.
“When patients have low oxygen, it causes increased stress hormones and makes the patient wake up,” said Dr. Yeh. “A Canadian research study showed that sudden cardiac death in non-sleep apnea patients occurred in the early morning from 9:00 a.m. to 12:00 p.m.”
“In sleep apnea patients, they died in their sleep, due to surges of hormones at night,” continued Dr. Yeh. “We don’t know if sleep apnea causes heart disease, but it is a stressor on your body since you are struggling to breathe all night. It stresses the heart.”
“Sleep apnea can exacerbate heart problems, diabetes, high blood pressure, weight, and pain control. Also, when people don’t sleep well, they make poor decisions which contribute to these health problems.”
“When a person is not able to sleep, and feels fatigued, they don’t exercise. It’s a common story,” said Dr. Yeh. “Food choices when sleep-deprived are carb-rich, sugary foods. After using a CPAP, patients often develop better eating habits.”
“When a person doesn’t treat sleep apnea, they can have car accidents, decreased functioning, becoming forgetful and not effective, sleepy, and their quality of life is not as good. Overall, their other illnesses such as diabetes, blood pressure problems, etc., get worse.”
Dr. Yeh was quick to say that, while most people think of sleep apnea as a problem for only for overweight patients, many people with a normal Body Mass Index (BMI), and even thin people can suffer from the condition.
“Mary Ip in Hong Kong has done extensive study of Asian populations,” said Dr. Yeh. “It is well-documented that Asians with lower BMI and lower weight are diagnosed with sleep apnea more than Caucasians.”
Other ethnic groups have been observed to have more severe cases before being diagnosed. Men have a higher-degree of diagnosis, but, post-menopausal women catch up with men. The problem runs in families, too. No one is excluded.
“We are seeing more teenagers with the condition because of being overweight,” said Dr. Yeh. “Children over age three who have difficulty sitting still, but may not be sleepy, should be checked if they snore.”
Dr. Yeh offers hope for those who think they may have sleep apnea symptoms in that CPAP treatment or other treatment can help. She encourages anyone who is concerned they may have the condition to go to a sleep apnea specialist for evaluation.
Kaiser Permanente has an office in Orange County devoted exclusively to sleep apnea diagnosis and treatment. The healthcare organization welcomes new members, and information may be found online at kp.org, or by calling 800-488-3590.
The following appeared in the July 19 Anaheim Independent.
