Palm Beach Post
Dr. Jeff Davis demontrates wearing a CPAP mask for a portrait at his home in Tequesta. Dr. Davis had all the symptoms -- daytime sleepiness, depression, snoring -- but it took another physician friend to make the diagnosis. He had obstructive sleep apnea. After two nights at a sleep center he now cuddles up each night with a CPAP mask that sends positive air pressure into his airway all night long.
All the symptoms were there: Daytime sleepiness, nighttime snoring, weight gain, depression, elevated liver enzymes and even low testosterone.
And yet, Dr. Jeff Davis admits, it took another physician to suggest the root cause of his difficulties: a lack of good, restful sleep.
He suffered from obstructive sleep apnea.
After a night of observation and therapy in the sleep center at Good Samaritan Medical Center, Davis, 59, now cuddles up with a device that sends continuous positive air pressure into his nose.
It looks a little goofy, he acknowledged.
"But I sleep so much better now, and I'm not tired during the day," Davis said. "It's a pretty cool thing. It definitely changes your quality of life."
The National Institutes of Health estimates sleep apnea afflicts around 12 million people in the United States.
It happens when the pharyngeal muscle at the back of the throat collapses into the airway during sleep, partially or completely blocking breathing.
This causes a cascade of problems.
Oxygen levels in the blood fall. The brain senses it, and sends out an alert, rousing the sleeper to the point where he snorts, gasps or changes position enough to let in more air.
This can happen hundreds of times a night, leaving the sleeper unable to achieve the sustained, deep sleep their body needs. Over time, chronic health problems can develop.
They include heart and vascular disease, metabolic problems including fatty liver and diabetes complications. Appetite increases, and weight gain is common.
More seriously, stroke, heart attacks and sudden death can result.
In children, it can be misdiagnosed as attention deficit disorder and irritability. In adults, some cases of depression may actually be sleep apnea, a team of researchers based in Tampa recently found.
Around 30 percent of the patients seeking help at Dr. Daniel Schwartz's sleep clinic presented with a depression diagnosis, more than the general population. So he and colleagues set up a study to see if sleep treatment improved their depression.
It did, and in many cases, the improvement was dramatic, Schwartz said.
His research was published in two articles, one in the journal Chest in 2005, and a follow up in 2007 in the Journal of Clinical Sleep Medicine.
"Lack of motivation, lack of interest in daily activities, fatigue and tiredness may be seen by the patient and their physician as depression, but it may be sleep apnea," said Schwartz, medical director of the University Community Hospital in Tampa.
Davis agreed. Two months into his treatment, he has lowered the dose of his antidepressants and sees a day soon when he'll not need them. He's no longer tired during the day. He has more energy and feels more relaxed.
"People say 'Ah, I'm not going to wear a mask,' but the mask is actually very comfortable," Davis said. "I sleep so much better. If I don't use it I don't feel rested."
WHAT IS SLEEP APNEA?
* Sleep apnea is a condition that affects a person's breathing during sleep. When the soft area of the throat behind the tongue, the pharyngeal muscle, collapses during sleep, it blocks air flow, causing obstructive sleep apnea.
All the symptoms were there: Daytime sleepiness, nighttime snoring, weight gain, depression, elevated liver enzymes and even low testosterone.
And yet, Dr. Jeff Davis admits, it took another physician to suggest the root cause of his difficulties: a lack of good, restful sleep.
He suffered from obstructive sleep apnea.
After a night of observation and therapy in the sleep center at Good Samaritan Medical Center, Davis, 59, now cuddles up with a device that sends continuous positive air pressure into his nose.
It looks a little goofy, he acknowledged.
"But I sleep so much better now, and I'm not tired during the day," Davis said. "It's a pretty cool thing. It definitely changes your quality of life."
The National Institutes of Health estimates sleep apnea afflicts around 12 million people in the United States.
It happens when the pharyngeal muscle at the back of the throat collapses into the airway during sleep, partially or completely blocking breathing.
This causes a cascade of problems.
Oxygen levels in the blood fall. The brain senses it, and sends out an alert, rousing the sleeper to the point where he snorts, gasps or changes position enough to let in more air.
This can happen hundreds of times a night, leaving the sleeper unable to achieve the sustained, deep sleep their body needs. Over time, chronic health problems can develop.
They include heart and vascular disease, metabolic problems including fatty liver and diabetes complications. Appetite increases, and weight gain is common.
More seriously, stroke, heart attacks and sudden death can result.
In children, it can be misdiagnosed as attention deficit disorder and irritability. In adults, some cases of depression may actually be sleep apnea, a team of researchers based in Tampa recently found.
Around 30 percent of the patients seeking help at Dr. Daniel Schwartz's sleep clinic presented with a depression diagnosis, more than the general population. So he and colleagues set up a study to see if sleep treatment improved their depression.
It did, and in many cases, the improvement was dramatic, Schwartz said.
His research was published in two articles, one in the journal Chest in 2005, and a follow up in 2007 in the Journal of Clinical Sleep Medicine.
"Lack of motivation, lack of interest in daily activities, fatigue and tiredness may be seen by the patient and their physician as depression, but it may be sleep apnea," said Schwartz, medical director of the University Community Hospital in Tampa.
Davis agreed. Two months into his treatment, he has lowered the dose of his antidepressants and sees a day soon when he'll not need them. He's no longer tired during the day. He has more energy and feels more relaxed.
"People say 'Ah, I'm not going to wear a mask,' but the mask is actually very comfortable," Davis said. "I sleep so much better. If I don't use it I don't feel rested."
WHAT IS SLEEP APNEA?
* Sleep apnea is a condition that affects a person's breathing during sleep. When the soft area of the throat behind the tongue, the pharyngeal muscle, collapses during sleep, it blocks air flow, causing obstructive sleep apnea.
* Pauses in breathing followed by snorts or choking sounds are a telltale sign.
* Sleep apnea can diminish the amount of oxygen reaching the brain, and so the brain responds by partially rousing the body, sometimes hundreds of times a night, leading to inadequate rest. Seven or eight hours of sleep feel more like three or four to the body.
SLEEP DISORDERS ARE LINKED TO CHRONIC DISEASES:
* People with sleep apnea are more likely to suffer from high blood pressure, stroke, coronary heart disease and irregular heartbeat.
* Inadequate sleep affects the hypothalamus, the part of the brain that regulates appetite and energy. Lack of quality sleep can lead to weight gain, weight gain can worsen apnea. It's a vicious cycle. It can make it more difficult for diabetics to control their blood sugar, too. In Missouri, consult a St. Louis Neurologist.
WAKING A SLEEPING GIANT
* A 2005 paper in the journal Chest found that over
40 PERCENT OF PATIENTS WITH DEPRESSION who were treated for sleep apnea reported improvement in mood.
* A 2007 Israeli study found that middle-aged men with sleep apnea used nearly twice as much health care resources as other men.
* As many as 50 to 60 percent of patients with impaired cardiac function suffer from sleep-related breathing disorders Detroit.
FOR A DIAGNOSIS, SLEEP ON IT:
To detect obstructive sleep apnea doctors can order an overnight test in a sleep center. Most are based in hospitals. They involve using a variety of sensors to track pulse, respiration, blood oxygenation during sleep.
Less costly home-based devices are also available through some doctors. Boca Raton-based Watermark Medical recently received FDA and Medicare authorization for its forehead sensor that allows sleep tests to be conducted at home, and the data to be downloaded by the physician.
Effective treatments exist:
* Depending on the severity of sleep apnea, it can be treated with weight loss, an oral appliance that pushes the tongue and jaw forward, throat surgery or most commonly, the assistance of a CPAP device, which stands for continuous positive airway pressure.
* The latest CPAP masks on the market are lighter and cover less of the face than older models, and patients are happier with them.
No comments:
Post a Comment