I don’t know about you, but I love learning new things. In fact, you will often hear me use the expression, “you learn something new every day.” Learning something new gives me confidence that my brain is still functioning – at least at a minimal level – and lets me know that I’m not totally useless.
Sometimes, learning something new comes in the form of a new life experience. I had a new life experience earlier this month – I had a polysomnogram (PSG). Yeah, I know, it sounds like a multi-sided, irregularly shaped object, but it’s actually an overnight sleep study. Having a sleep study is probably “old hat” for some of you, but for me it was interesting, to say the least. The technician had me hooked up to more wires than Boeing puts in a 787 Dreamliner! I had electrodes attached to my face, scalp, chest, and legs, and harnesses around my chest and my waist. I thought for a minute that my doctor had sent me to the electric chair!
Various types of sleep studies are used in order to diagnose or rule out specific medical conditions. The daytime multiple sleep latency test (MSLT) is used to diagnose narcolepsy. The two-night evaluation PSG and CPAP (continuous positive airway pressure) titration provides general monitoring and evaluation for sleep apnea. If sleep apnea occurs, the patient returns for a second night to determine the correct air pressure for future CPAP treatment. In my case, I did show a moderate level of sleep apnea and am scheduled for night number two.
The Mayo Clinic defines sleep apnea as a “potentially serious disorder in which breathing repeatedly stops and starts,” and is categorized in one or two main types. Obstructive sleep apnea, which is the more common form, occurs when the muscles in the back of your throat relax causing your airway to narrow or close as you inhale. This leads to low oxygen levels in the blood. Thankfully, your brain senses this and wakes you up enough so you can reopen your airway. Generally speaking, you never realize this is happening unless you get a sharp elbow in the side from your wife. ☺ In my case, I wake up feeling like I’m choking – and I really am. Frankly, it’s quite a scary sensation.
Another form is central sleep apnea which occurs when your brain fails to transmit signals to your muscles that control respiration. These are the muscles around your rib cage that act like “bellows” to help you breathe. The inspiratory muscles help you inhale oxygen rich air, and the expiratory muscles help you exhale the oxygen-depleted air. These muscles are unique in that they are very resistant to fatigue and are controlled both voluntarily (take a deep breath now) or involuntarily, when you don’t even think about breathing.
Symptoms include loud snoring, gasping for air during sleep, waking up with an extremely dry mouth and a tongue that feels like sandpaper, inability to stay asleep, and excessive drowsiness during the daytime, to name a few. Risk factors include excess weight, large neck circumference, an anatomically narrow airway, being male, being older, smoking, or a family history of sleep apnea. Not surprisingly, tonsils or adenoids can become enlarged and block the airway, especially in children.
To get to the “heart” of the matter, we need to talk about the complications that can occur with sleep apnea. It is a serious medical condition that can fly under the radar for a long time. Untreated sleep apnea increases your risk of several serious medical conditions, namely high blood pressure, heart attack – sometimes fatal, stroke, and abnormal heartbeats such as atrial fibrillation. In my case, I’ve had atrial fib for over 30 years and lost my father at a young age (47) to a heart attack, so this subject has personal significance for me. The website, sleepapnea.org, has a very good article about untreated sleep apnea and stroke risk, and offers an easy-to-read explanation of how they are related.
Bottom line, if you think you have a sleep breathing problem, snore loudly or gasp for breath as you sleep, don’t ignore the obvious. Have your doctor set you up for a PSG. It might just save your life.