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August 9, 2011
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Treating sleep apnea can be 'life-changing'


English writer Anthony Burgess probably said it best: "Laugh and the world laughs with you; snore and you sleep alone."

Very few - at one time or another - have not had their sleep disturbed by the torturous sound of sawing logs. Last year, the Associated Press reported that a Chinese college student confessed to stabbing his roommate to death due to his relentless snoring.

But it turns out snoring is not always just a simple annoyance. It can also be a sign of a condition known as Obstructive Sleep Apnea, or OSA, when a person repeatedly stops breathing while sleeping. Some sufferers have been known to have as many as 300 apnea episodes in one night.

This happens because the airway collapses, preventing air from entering the lungs. Because sleep is disrupted, the result can be excessive daytime fatigue and sometimes-profound health consequences.

"Snoring can definitely be an indicator of apnea, but not always," said Nancy Tuscano, a registered respiratory therapist in Nevada City. "Some people who have OSA don't snore, but they do experience nighttime restlessness or wake up gasping for air."

While no one physical characteristic guarantees a high likelihood of having OSA, roughly half of those diagnosed are considered obese, said Dr. Kimberly Hardin, director of sleep medicine at the UC Davis Medical Center.

"Since obesity rates have gone up in the past decade and public education on the condition has increased, the statistics for those diagnosed with OSA has risen sharply," said Hardin, who also serves as the medical director at Sierra Sleep Diagnostics in Nevada City.

"Twenty-five percent of men, 9 percent of women and 4 percent of children in the U.S. have been diagnosed with sleep apnea," Hardin said. "And many more out there haven't been diagnosed. It's a lot more common than people think."

As mentioned, all sufferers are not obese, said Hardin. Some are very thin and some simply have a family predisposition for the condition, most commonly a narrow airway, otherwise known as "bad plumbing." In children, enlarged tonsils or adenoids can sometimes cause OSA, said Hardin, and can result in day-time hyperactivity rather than fatigue.

When OSA goes undiagnosed, the risks of oxygen being regularly cut off to the brain can span from mild daytime fatigue to life-threatening conditions.

"OSA unchecked can cause a stroke or heart attack, which is why you sometimes hear of people dying in their sleep," said Tuscano, who runs Nevada City's Sleep Diagnostics. "It can also impact hormone, blood sugar and thyroid levels. Many people are on anti-depressants due to lack of sleep. They don't know it, but their sleep rhythms are out of whack. OSA can put people at an increased risk for high blood pressure and is the cause of many work and motor-vehicle accidents."

Those who suspect they may have Obstructive Sleep Apnea should see a doctor specializing in sleep disorders. If there appears to be a problem, the doctor will most likely recommend a sleep study, where patients spend the night at a facility - such as Nevada City's Sierra Sleep Diagnostics - that monitors muscle, heart, brain and sleep rhythms.

The most common treatment for OSA is a continuous positive airway pressure (CPAP) machine, which is a small device attached to a small mask that runs quietly all night.

"A CPAP works like a fan blowing into a wind sock," said Anthony Sunseri, a Nevada City polysomnographic technician who stays up three nights a week monitoring sleep test patients in "real time" at Sierra Sleep Diagnostics.

"A gentle flow of air keeps the airway open during sleep," Sunseri said. "Breathing becomes regular, snoring stops and most people finally get a good night's sleep. It can be life-changing."

"Some with 'upper airway resistance' don't need a CPAP, and can be treated with a simple oral appliance or type of pillow," added Tuscano. "A doctor just needs to interpret where the obstruction is. Of course, any treatment should include weight loss if needed, exercise and avoidance of alcohol and sedatives."

Dorothy Renquist of Penn Valley went in for a sleep test after her daughter noticed her start-and-stop breathing repeatedly during sleep.

"After sleeping for four hours during my sleep test, the technician came in and said, 'My you're working hard' and hooked me up to a CPAP," said Renquist, 82. "The next morning and ever since I've felt a lot better. I have a lot more energy and feel refreshed. I didn't realize until now just how bad I'd felt. My advice is if you think you need a sleep test, do it. Medicare and Blue Cross paid for my test and treatment."

People who are perpetually tired despite eight to 10 hours of sleep a night - especially if they have poorly controlled blood pressure - are strongly urged to seek out a doctor specializing in sleep disorders, Hardin said.

"No one is exempt from the possibility of having this condition," she said. "It's way more common than you think, and it can dramatically change your life and possibly save it."

To contact Staff Writer Cory Fisher, e-mail cfisher@theunion.com or call 530-477-4203.


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The Union Updated Aug 9, 2011 10:34AM Published Aug 9, 2011 10:31AM Copyright 2011 The Union. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.