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The Snore!
Janine
Posted: Friday, February 24, 2012 5:20 PM
Joined: 02/05/2008
Posts: 392


Have you ever been in earshot of someone who was snoring like a freight train, then suddenly the noise stopped and all was quiet? Your nerves were on edge waiting for the next snore to come and when that person finally began the next snore, it started with a loud gasp or snorting sound. It’s possible your bunkmate actually stopped breathing for the period of time in between the snoring.  If this person does this often throughout the night, he or she may have sleep apnea.  
    
Do you wake up often in the night short of breath or with a dry throat or mouth?  Do you wonder why you seem to have to urinate often during the night, have a headache each morning or have to drag yourself through the day from being so tired?  You might have sleep apnea, and not even know it!  Studies show that most of the people suffering from this condition are not even aware of it (although their roommates or partners probably are).   

At first glance it may not seem like sleep apnea is a very serious health problem — annoying, definitely, but serious? Consider that the periods of apnea typically last from 10 to 30 seconds, or even longer, and a person must breathe anywhere from 12 to 20 times per minute (every 3 to 5 seconds) while sleeping.  All of the body’s cells — especially those in the heart and brain — depend on the amount of oxygen that gets delivered to the bloodstream with each breath, in order to function properly. When the oxygen level in the bloodstream drops due to the apnea, changes can occur in the heart’s normal rate and rhythm, causing potential heart attacks or strokes in one’s sleep, or long term wear-and-tear damage that could eventually cause a heart attack or stroke even in the waking hours.  

In addition, when your body is unable to reach the proper stages of sleep to allow the body and heart to rest, fatigue becomes a cycle. You feel fatigued, but cannot sleep. You cannot sleep so you remain fatigued. The cycle continues, increasing all risks and side effects.

There are three different types of sleep apnea:

Obstructive Sleep Apnea – This happens when the muscles that support the soft tissues of the mouth and throat- that is, the tongue, tonsils, lining of the throat, and uvula relax during sleep, allowing the soft tissues to collapse in on themselves, blocking the air from moving in and out during breathing. Everyone’s muscles relax in sleep, but some people are more prone to the relaxation causing the obstruction problems, either because they have a very small airway, a large neck, very flabby or fatty soft tissues in the area, jaw misalignment or other things of that nature.

Central Sleep Apnea – This is more serious than the obstructive type, but is fairly rare. Central sleep apnea accounts for fewer than five percent of sleep apnea cases. Often, it’s the result of underlying heart disease or brain damage due to a previous stroke. In this type of sleep apnea, the long pauses between breaths result from the brain failing to send the signal to the breathing muscles to take the next breath.  The person suffering from this type of sleep apnea may not even snore.  

Complex Sleep Apnea is a combination of the above two types, and is the rarest of all.

Symptoms and consequences

There are other complications from sleep apnea that can affect one’s health and quality of life.  Some of these are:
•    Headaches or “brain fog” when waking (due to too little oxygen to the brain overnight.)
•    Daytime fatigue
•    Memory problems
•    Mood swings or depression
•    Weight gain
•    Increased risk of complications with anesthesia for surgery
•    And, of course, irritable roommates and partners, due to sleep deprivation.

Diagnosis and treatment

Just who is at risk for sleep apnea? There are some people who have risk factors that are out of their control. Men over the age sixty five who have a family history of sleep apnea or who have an unusually shaped or large head or neck or unusually small airway are at higher risk.  

On the other hand, smoking, obesity, high blood pressure, overly large tonsils, use of alcohol or sedatives and prolonged sitting are all suspected in contributing to sleep apnea and all of these factors can be addressed in one way or another.

If you suspect you, or someone you know, has sleep apnea, the first thing to do is to figure out how bad it is. If there are any previous or current serious illnesses (heart disease, high blood pressure or stroke) or concerning symptoms like shortness of breath, a racing or irregular heartbeat or excessive daytime drowsiness, the best thing to do would be to call your telemedicine service as soon as possible. They may make a diagnosis based on the symptoms alone or may recommend a sleep study to know more.

Fortunately, sleep apnea can be treated and the dangers eliminated, or at least greatly reduced and sometimes it can even be cured. In many advanced cases, a special machine called a CPAP (continuous positive airway pressure) machine blows additional air toward the mouth via a mask for use during sleep.  In other cases, surgery may be necessary to remove enlarged tonsils, or to remove or “stiffen up” excess or flabby soft tissue in the airway. Alternatively, a dental device fitted to the individual can be helpful as well. If Central Sleep Apnea is suspected, the underlying cause, such as heart disease, is addressed, and certain medications can be prescribed.

Prevention
Of course, the best cure is prevention, and there are things we can all do to prevent sleep apnea, or to try and resolve mild to moderate cases at home. Most importantly, lose weight. This is the single most important thing you can do to help yourself. Even a “small” weight loss of five to 10 kilograms can reduce or even eliminate sleep apnea in some people. This can be accomplished by dietary changes such as cutting out fatty, starchy or sugary snacks and sodas, and getting at least 30 minutes of aerobic exercise five times a week.
Stop smoking, and avoid alcohol within three to four hours of bedtime (same goes for sedatives or sleep aids).
If you have high blood pressure, monitor it closely, and take your blood pressure medicines as prescribed.
Sleep on your side, not on your back. Some people sew a tennis ball into the back of their pajamas to prevent them from sleeping on their backs.
If you suffer from blocked nose or allergies at night, a nasal saline spray may help, and your telemedicine service can recommend an over-the-counter allergy or congestion medicine to take if necessary.

Even if you don’t think you have sleep apnea, you might consider trying some or all of the above suggestions — you may be pleasantly surprised at the positive changes in your mood, alertness, and energy levels.  Pleasant dreams!
 
If you would like to know more about sleep apnea, please visit:

http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/

www.cdc.gov/sleep/about_sleep/key_disorders.htm

http://www.mayoclinic.com/health/sleep-apnea/DS00148



By Christina M. Garcia, RN, BSN, coordinating nurse at MedAire. Visit www.medaire.com/yachtlifeline for more information.


Henning
Posted: Saturday, February 25, 2012 4:00 AM
Joined: 01/06/2008
Posts: 1052


If you have Sleep Apnea and hold an ENG1 you may want to look through the rules about it all first. You may discover it is a condition that if diagnosed might disqualify you from holding a command position. I'm not sure with the ENG1 but it is the same basic physical as a flight physical and Sleep Apnea is definitely disqualifying at all levels.

If this happens to be a circumstance that causes you concern, may I suggest that you seek treatment out of pocket; no insurance means no diagnosis required.

Anonymous
Posted: Monday, February 27, 2012 2:18 PM
Ok another one of theese i do not know what to write. First of all, a lot of people mostly everybody has sleep apnea, speacilly after a few drinks. sleep apnea in its cronic way, is very easily cured there is some little compresors with a nose mask and you sleep with it on after a month, your body is trained to breathe again throo your nose. I was a comertial diver for many years, and in the end i breatheded throo my mouth. but one month on the machine gone. Please stop beeing so alarmist with issues like this one, Because if this is the case 90% of people can t have comand due to other things. [comment removed by moderator]

 
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