Sleep Apnea:
What You Should Know

Dear Savvy Senior,

Can you tell me about sleep apnea and what can be done to treat it? My 59-year-old husband snores like a chain saw and wakes himself up so frequently he keeps me up, too.

Sleep Deprived Susan

Dear Susan:

Sleep apnea is a common and potentially serious condition that affects more than 12 million Americans. But the problem is that most cases (up to 90 percent) go undiagnosed and untreated. Here's what you should know.

Apnea

Sleep apnea is a disorder that causes a person to stop breathing during sleep, dozens and even hundreds of times during the night for up to 30 seconds at a time. If that sounds dangerous, it is. Untreated, sleep apnea can cause high blood pressure and can sharply increase the risk for stroke and heart attack. It can also cause morning headaches, memory problems, mood swings or feelings of depression, impotence and excessive daytime sleepiness which is a major cause of car accidents. But the good news is that sleep apnea is treatable and most insurance companies, including Medicare, cover it.

Symptoms to Know

There are two different types of sleep apnea: central apnea, the least common form that occurs when the muscles you use to breathe don't get the signal to function from your brain, and obstructive apnea (nine out of 10 people with apnea have this type), which occurs when the throat muscles relax during sleep blocking the airway. Some people may have a combination of both. Symptoms of obstructive apnea include loud snoring (however, not everyone who snores has apnea), long pauses in breathing, gasping or choking during sleep and daytime drowsiness. But because most of these symptoms happen during sleep, many people don't recognize them. They're usually noticed first by the person they sleep with.

Who's at Risk?

While anyone, even children, can have obstructive apnea, it's typically more common in men. Other factors that can increase the risks are being overweight, smoking, drinking alcohol, having high blood pressure, being over the age of 60 and having a family history of the condition. African Americans, Pacific Islanders and Hispanics are also more prone to having apnea.

Seek Help

If your husband has any of the listed symptoms, he should talk to his doctor or a sleep specialist, who may recommend an overnight study at a sleep center (see www.sleepcenters.org) to determine if he's suffering from apnea or another problem.

Treatment Options

If your husband is diagnosed with apnea, the most commonly prescribed treatment is a continuous positive airway pressure (CPAP) device. This involves sleeping with a snorkel-like mask that's hooked up to a machine that blows air up your nose to keep the passages open. As unpleasant as it sounds, CPAP is the most effective treatment for apnea. However many find the mask uncomfortable and difficult to adjust to. Others simply can't tolerate it at all and opt for dental appliances or surgery to keep the throat open and prevent blockages.

In milder cases of obstructive apnea there are various lifestyle changes that may help relieve the problem including:

+ Losing weight. Excess body weight, especially around the neck, puts pressure on the airway, causing it to partially collapse. Even a slight weight loss may help relieve symptoms.

+ Avoiding alcohol and sleeping pills. These can relax the muscles in the back of your throat, interfering with breathing.

+ Stopping smoking. Smoking can increase the swelling in the upper airway, making apnea and snoring worse.

+ Sleeping on your side or stomach. Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat and block your airway. (Tip: To prevent sleeping on your back, sew a tennis ball in the back of your pajama top.)

+ Keeping nasal passages open while sleeping. Nasal strips such as "Breathe Right" might provide some relief. Also, talk to your doctor about using nasal decongestants or antihistamines.

Savvy Resource: For more information, the American Sleep Apnea Association offers a wide variety of free publications that are very helpful and a national directory of apnea support groups. See www.sleepapnea.org or call 202-293-3650.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to the "NBC Today Show" and author of The Savvy Senior books.

The Gazette does not endorse the contents of The Savvy Senior. Check with professionals about the contents of this column.