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6/1/2011 6:00:00 AM
Sleep apnea could have deadly consequences
JC AMBERLYN/MinerMark Hopkins, the clinical supervisor for KRMC’s Sleep Disorders Center, shows off a sleep-lab room where sleep apnea can be diagnosed.

Mark Hopkins, the clinical supervisor for KRMC’s Sleep Disorders Center, shows off a sleep-lab room where sleep apnea can be diagnosed.

Suzanne Adams-Ockrassa
Miner Staff Reporter

KINGMAN - Snoring can be more than just a mere annoyance, it can be a serious health problem. According to 2005 poll by the National Sleep Foundation, approximately 90 million people in the U.S. snore.

According to Bob Walton, the branch manager for Breathing Disorder Services in Kingman, loud snoring is one of the leading sign of obstructive sleep apnea. Other signs include excessive daytime sleepiness, poor concentration, short-term memory problems, depression, irritability, falling asleep during the day, waking up at night from a dead sleep gasping, choking, snorting or actually ceasing to breath while sleeping.

Sleep apnea can mean more than just a missed night's sleep. The disease is linked to high blood pressure, cardiovascular disease, memory problems, weight gain, impotency, headaches, diabetes, stroke and more.

Walton explained that as people sleep the muscles of the soft palate and tongue hold open the airway. In people who snore, the palate may relax slightly while they sleep, blocking part of the airway and causing the palate to vibrate.

Obstructive sleep apnea is caused when the palate temporarily blocks a person's airway while they are sleeping. A person with sleep apnea can actually stop breathing for 10 seconds or more during one of these episodes, Walton said. This can happen several times a night for some people.

The net effect of sleep apnea is a decrease in the amount of oxygen in the blood and stress on the heart and lungs as the body labors to breath before jolting the person awake.

The poor quality of sleep caused by sleep apnea messes with the body's circadian rhythm preventing the body from making necessary repairs and disrupting hormone balances such as insulin levels in the blood, leading to pre-diabetes or diabetes in some people, said Dr. Robert Matheny, a Kingman pulmonologist.

According to the National Sleep Foundation, nearly 50 percent of the patients with Type 2 Diabetes also suffer from sleep apnea.

It can also mess with the hormones that make you feel full after eating a meal, causing a person to actually crave carbohydrates when they wake up in the morning, Matheny said. A large number of people who are overweight or obese suffer from sleep apnea, he said.

Sleep apnea can also affect a patient's partner. According to information from BDS, a person bothered by their partner's snoring loses an average of 49 minutes of sleep a night.

The best way to diagnose sleep apnea is to have a doctor prescribe a sleep study, Matheny said.

Mark Hopkins, the clinical supervisor for Kingman Regional Medical Center's Sleep Disorders Center, said the four-bed sleep lab is full nearly every night they are open, six nights a week.

Patients come in to the sleep lab around 5 or 6 p.m. and are wired with a number of electrodes that measure brain activity, breathing, blood oxygen, blood pressure and more. They are then made comfortable in a room with a large comfy bed, recliner, TV and private bathroom, he said. Most people fall asleep within an hour or two of being situated in their room.

It can be hard to sleep with all those electrodes and wires, Hopkins said. On rare occasions, lab staff have to offer a patient a sedative in order to fall asleep.

After the patient has spent the entire night in the lab, Hopkins gathers the data and puts in a report for doctors, such as Matheny.

Matheny then interprets the results and offers a solution to the patients sleep problems. In the case of sleep apnea, some solutions include weight loss, use of a continuous positive airway pressure (CPAP) machine or surgery.

BDS is a supplier of CPAP machines. The machines force air through a mask covering the patient's nose. The force of the air acts as a splint holding the airway open, Walton said.

A humidifier is often used in conjunction with the CPAP to keep the patient's airway from drying out.

The device also measures and transmits how many times and how long it is used.

Walter, who uses the device, admitted it can be hard to get used to.

He's had patients moan and groan and even throw the machine across the room.

However, most patients eventually get used to the machine and even panic when they accidentally leave it behind while on vacation.

"I have patients who say, 'I have to wear this for the rest of my life?' A few weeks later they're saying they can't live without it," Matheny said.

Matheny said the results provided by the machine can be nearly instantaneous. After a few nights on the machine, a person's blood pressure, insulin and hormone levels can return nearly to normal.

However, once a patient stops using a CPAP machine, all of the symptoms and problems return, Matheny said.

For some patients a CPAP isn't the answer. Some can't get used to the machine, others don't want to be bothered with a machine and for some it just doesn't work for them. In that case, surgery is option, Matheny said. Surgery can help alleviate the symptoms, but it doesn't always provide the results that a CPAP can, he said.

The only way to know if your symptoms are related to sleep apnea or another sleep disorder is to talk to your doctor and be referred to the Sleep Disorder Center, Matheny said.

For more information on sleep apnea or other sleep disorders, contact your doctor or the KRMC Disorders Center at (928) 692-4144.

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Reader Comments

Posted: Friday, June 3, 2011
Article comment by: Aviisha Medical Institute

While it may not be accurate to say that obesity exclusively causes OSA, I don't think that's what Poor Quality of Life was implying, nor do I think it's accurate to say that obesity does NOT cause OSA, as Dr. Jones implied. The relationship between obesity and sleep apnea is a two-way street: both conditions exacerbate each other. They are not the only antecedents, but are high on the list.

Posted: Thursday, June 2, 2011
Article comment by: Mack Jones, MD

As a retired neurologist with sleep apnea, I can tell you that there is a lot of misinformation out there (including this blog) about this disease. "Deadly Sleep," Is Your Sleep Killing You,? book I wrote for my former patients and students about obstructive sleep apnea (OSA), what it is, how it's diagnosed, it's consequences (a lot more than even most physicians realize), and treatment.
BTW, OSA causes obesity (not obesity causes OSA). Weight gain makes OSA worse and weight loss makes it better, but rarely gets rid of it altogether. The thinnest person can have one of the worst cases. Why? Because OSA is a disorder of autonomic nervous system.

Posted: Thursday, June 2, 2011
Article comment by: Serene Voice

@ Apnea Sufferer your comment sounds suspiciously like an advertisement for a DME. DME's have between 28% and 50% CPAP compliance rates.
I wonder how you could not know that KRMC has a number of Respiratory therapists on staff? Additionally ALL DME's in the area have respiratory therapists on staff. KRMC is providing a valuable service for a serious condition and is educating people about that condition not just suppling CPAP equipment. I liked the article very much and I would definitely go to KRMC for a sleep study, education and equipment.

Posted: Thursday, June 2, 2011
Article comment by: the first time and not the last time

free ad for krmc as they need the cash as they have a BIG shake up going on - but the story i know that is going on at krmc will not hit this paper as this paper is on the payroll but the story i know will hit the out of town papers then all of kingman will know

Posted: Thursday, June 2, 2011
Article comment by: Last Name First

@Um, or not,

I just read an article that says there are 2 forms of sleep apnea. 10% of people have the kind that the brain fails to make the muscles that cause you to breathe to respond. The other 90% is due to obstruction. You can guess which one the obese fall under.
I too have known people with sleep apnea and they have ALL been obese.

Posted: Thursday, June 2, 2011
Article comment by: R .

@ Poor Quality of Life

You're wrong! I'm thin, my brothers thin, my late father was thin and we all have had the problem. It's often hereditary as is the scenario with my family. The surgical solution moves forward the tissue below the tongue allowing the tongue to stay out of the way of the throat and restoring airflow.

You need to learn the facts before you open your mouth and make stupid comments!

Posted: Thursday, June 2, 2011
Article comment by: Um, or not

@Poor Quality of Life

Actually, I'm sure obesity is a cause of sleep apnea and obese people have a high rate of sleep apnea... but it would be a stretch to say MOST sleep apnea is obesity related.

The three people in my life I've known with sleep apnea are actually rather thin and athletic. One was in the army. It's a breathing disorder. Anyone can get it.

Posted: Thursday, June 2, 2011
Article comment by: Poor Quality of Life

It's hard to believe that people are complaining about uncomfortableness of CPAP's, expensiveness and other factors. Bottom line sleep apnea, in most cases, is caused by obesity. You would not need any of these machines if you took the time to lose 10% of your body weight. It's so much cheaper and convenient to be healthier. You should thank equipment like this for keeping you breathing at night not complain about it, or lose weight!

Posted: Thursday, June 2, 2011
Article comment by: RaZZZ Harris

I've suffered from poor sleep my entire life. My mother always mentions how as a baby I would never nap, while my sisters loved to. Now in my adult life I struggle with keeping a healthy, daily routine to ensure I get adequate sleep. Along my journey to find peaceful slumber, I have learned many useful tricks, as well as weeded out the useless ones. There's a great ebook you can download called Get To Sleep Now! [DELETED] that lists many helpful techniques as well as things to avoid.
Many people live fast and stimulating lives, but few of us take the time to unwind before bed. Stimulating activities you want to AVOID before bed are TV, reading, working, computer, stress/fights, and certain foods. The book will always suggest what is beneficial to do before bed, like writing, or talking.

Posted: Thursday, June 2, 2011
Article comment by: R .

@ Breathless Sleepless

I haven't gone in and gotten my permanent machine and mask yet because I got sick and then tied up while trying to get caught up. However, I went to the lab here in town and they introduced me to a newly introduced mask that I found more comfortable than the other two they offer. It's still sucky but it's better than the other masks and I was able to sleep.
Perhaps you should go visit Dr Ramirez for him to determine whether or not you're a surgical candidate since the masks aren't working for you?

Posted: Wednesday, June 1, 2011
Article comment by: Apnea Sufferer

This is an informative article BUT, it doesn't give the full picture. This is not the only place in Kingman that people suffering from apnea can go to get help with their problem. I received help several years ago from a different docor in Kingman and he sent me to a place with much more experience in fitting patients with masks etc. STAT Medical is the only provider in the Kingman area that actually has a licensed Resperatory Therapist on staff full time. They have much more experience in this issue, and it is a disservice to the citizens of our area to have them think that this is the only place thaey can go for help with this issue.

Posted: Wednesday, June 1, 2011
Article comment by: Breathless Sleepless

I have moderate obstructive sleep apnea - dx about 7 years ago. I have a CPAP machine and CANNOT tolerate it. Most do not adapt well, though some do and it makes remarkable difference. I have tried multiple headgear and mask combinations. I got a heated humidifier. I still lie awake, have used flonase and lunesta to aid in sleeping, and IF I fall asleep, the thing ends up on the floor.

In desperation, I ordered a mouthpiece device which I hope makes some difference. Has anyone had any experience with the dental appliances? They are WAY too expensive to just try, like I did the CPAP.

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