Sleep apnea testing can avert disaster

2013-06-27T00:00:00Z 2013-06-28T12:42:01Z Sleep apnea testing can avert disasterChristine Bryant nwitimes.com
June 27, 2013 12:00 am  • 

It affects millions - yet often goes undiagnosed.

For Robbin Brewer, sleep apnea was the furthest thing from her mind. She knew something was wrong - she would wake often at night, plagued by headaches, and was exhausted when she got home from work at night.

"Instead of my naps being an hour, they would be four or five hours," she says.

As someone who considered herself a healthy individual, her symptoms were perplexing.

Physicians, however, see a wide range of patients who have varying health and experience symptoms of sleep apnea - many of which have no knowledge of their condition.

Lisa Nowaczyk, a respiratory therapist and sleep technologist at the Ingalls Sleep Centers, says up to 75 percent of patients who have sleep apnea are untreated.

"The No. 1 sleep condition doctors are most concerned about is sleep apnea because it has a lot of medical consequences when left untreated," Nowaczyk says.

Brewer, who was treated at Ingalls' Calumet City Sleep Center, says she considers herself fortunate her primary physician referred her to the center, where she was put on continuous positive airway pressure (CPAP) at night to keep her airways open.

"I used to feel tired all the time," she says. "It's like a whole new world for me."

For others, going undiagnosed can cause serious health issues - even death, which is why so often physicians recommend screenings for any potential sleep problem.

Although sleep apnea is one of the most common sleep disorders, Dr. Robert Aronson, a pulmonary and sleep specialist at Advocate South Suburban Hospital Sleep Center, says he treats patients for a host of other issues including restless leg syndrome, narcolepsy and rapid eye movement behavior disorder.

"It's particularly interesting because people act out their dreams," he says of the REM disorder. "It's typically seen in older individuals. If they're in a fight or they're being chased, they'll get up, punch, kick and even swear."

Aronson says he has also seen patients who have experienced involuntary, repetitive leg jerks while sleeping - which can cause a disruption in sleep and daytime fatigue.

These are just a few sleeping disorders most commonly seen at sleep clinics. In fact, there are more than 100 different sleeping and waking disorders.

Because these sleep disorders can have overlapping symptoms, Aronson says it's important for those experiencing sleep problems to first contact their primary care physician, who will determine if lifestyle choices could be affecting the patient's sleep patterns.

Practicing an irregular sleep schedule, drinking excessive caffeine and exercising right before bed can all affect a person's sleep at night, he says.

"If those issues are cleaned up and the symptoms go away, there's no need to see a sleep specialist," Aronson says. "That's why the primary care physician is the first step - if it's not behaviors, they'll refer them to a sleep clinic."

Once at the sleep clinic, the patient is observed during their normal sleep time, says Janis L. Martin, a registered respiratory therapist and registered sleep technologist, as well as supervisor at Franciscan St. Margaret Health Sleep Disorders Center in Hammond and Dyer.

"The sleep clinic is set up similar to what a bedroom at home would look like," she says. "We want to make one feel comfortable while we monitor what happens while they sleep."

Each patient sleeps with monitoring devices that record brainwaves, heart activity, oxygen levels, air flow, chest movement, snoring and leg movements, she says.

Though visiting a sleep center can be inconvenient or uncomfortable for some, she says it's the best way to get to the bottom of what is causing a patient's inability to get healthy sleep.

SIDEBAR

Sleep apnea is one of the most common sleep disorders, affecting millions of Americans - many of which experience symptoms during their sleep, yet have no idea they do so.

Dr. Robert Aronson, a pulmonary and sleep specialist at Advocate South Suburban Hospital Sleep Center, says sleep apnea can lead to serious health problems including hypertension, strokes, abnormal heart rhythms, asthma and acid reflux.

It can also lead to other problems that can easily be misdiagnosed, he says.

"Sleep apnea can also cause nighttime urination, which in men is often passed off as prostate problems and in women as bladder problems," he says.

When someone attempts to breathe with an obstructed airway, blood is sucked back into the chest, which ends up in the heart, he says. That makes the heart think there's too much blood volume, so the heart then sends a hormone to the kidney, which causes the kidney to produce more urine, he says.

"It's amazing with men who think they have a prostate problem, then end up sleeping through the night without a problem once the apnea is treated," Aronson says.

Sleep apnea also may lead to an increased risk of cancer because of its effect on the body, and can be especially problematic to those with professions that involve driving.

"There's an increased risk for car crashes for people who don't sleep at night, which is especially a problem in the trucking industry," Aronson says. "A lot of trucking companies are interested in doing sleep apnea screenings for their employees."

Aronson says there are several risk factors for developing sleep apnea, including obesity, but says even allergies can affect a person's airway.

"Some people think you have to be obese to have sleep apnea, and that's not true," he says.

Here are some signs and symptoms that those with sleep apnea may experience:

* Loud snoring

* Choking or gasping while sleeping

* Headaches in the morning or after waking

* Excessive daytime sleepiness

* Irritability and depression

* Frequent nighttime urination

* Pauses in breathing while sleeping

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