Sleep Apnea
What is sleep apnea? Sleep apnea is a condition that makes you stop breathing for short periods while you are asleep. There are 2 types of sleep apnea. One is called “Obstructive Sleep Apnea,” and the other is called “Central Sleep Apnea.”
In Obstructive Sleep Apnea, you stop breathing because your throat narrows or closes. In central sleep apnea, you stop breathing because your brain does not send the right signals to your muscles to make you breathe. When people talk about Sleep Apnea, they are usually referring to Obstructive Sleep Apnea, which is what this article is about.
People with Sleep Apnea do not know that they stop breathing when they are asleep. But they do sometimes wake up startled or gasping for breath. They also often hear from loved ones that they snore.
What are the symptoms of Sleep Apnea?
The main symptoms of sleep apnea are loud snoring, tiredness, and daytime sleepiness. Other symptoms can include:
- Restless sleep
- Waking up choking or gasping
- Morning headaches, dry mouth, or sore throat
- Waking up often to urinate
- Waking up feeling unrested or groggy
- Trouble thinking clearly or remembering things
Some people with Sleep Apnea don’t have symptoms, or they don’t know they have them. They might figure that it’s normal to be tired or to snore a lot.
Diagnosis & Treatment of Sleep Apnea
Weight loss can help treat Sleep Apnea if you are overweight or obese. But losing weight can be challenging, and it takes time to lose enough weight to help with your sleep apnea. Most people need other treatment while they work on losing weight.
The most effective treatment for sleep apnea is a device that keeps your airway open while you sleep. Treatment with this device is called “continuous positive airway pressure,” or CPAP. People getting CPAP wear a face mask at night that keeps them breathing.
If your doctor or nurse recommends a CPAP machine, try to be patient about using it. The mask might seem uncomfortable to wear at first, and the machine might seem noisy, but using the machine can really pay off. People with sleep apnea who use a CPAP machine feel more rested and generally feel better.
There is also another device that you wear in your mouth called an “oral appliance” or “mandibular advancement device.” It also helps keep your airway open while you sleep. But devices do not work as well as CPAP for treating Sleep Apnea.
In rare cases, when nothing else helps, doctors recommend surgery to keep the airway open. Surgery to do this is not always effective, and even when it is, the problem can come back.
FAQs regarding Sleep Apnea
Should I see a doctor or nurse?
Yes. If you think you might have sleep apnea, see your doctor.
Is there a test for Sleep Apnea?
Yes. If your doctor or nurse suspects you have sleep apnea, he or she might send you for a “sleep study.” Sleep studies can sometimes be done at home, but they are usually done in a sleep lab. For the study, you spend the night in the lab, and you are hooked up to different machines that monitor your heart rate, breathing, and other body functions. The results of the test will tell your doctor or nurse if you have the disorder.
Is there anything I can do on my own to help my sleep apnea?
Yes. Here are some things that might help:
- Stay off your back when sleeping. (This is not always practical, because people cannot control their position while asleep. Plus, it only helps some people.)
- Lose weight, if you are overweight
- Avoid alcohol, because it can make sleep apnea worse
Is sleep apnea dangerous?
It can be. People with sleep apnea do not get good-quality sleep, so they are often tired and not alert. This puts them at risk for car accidents and other types of accidents. Plus, studies show that people with sleep apnea are more likely than others to have high blood pressure, heart attacks, and other serious heart problems. In people with severe sleep apnea, getting treated (for example, with a CPAP machine) can help prevent some of these problems.
Call Aamr Arif Herekar MD Neurology to make an appointment today to diagnose and treat Sleep Apnea.
Insomnia
What is insomnia? Insomnia is a problem with sleep. People with insomnia have trouble falling or staying asleep, or they do not feel rested when they wake up. Insomnia is not about the number of hours of sleep a person gets, because everyone needs a different amount of sleep. It is related to the quality of sleep.
What are the symptoms of insomnia?
People with insomnia often:
- Have trouble falling or staying asleep
- Feel tired during the day
- Forget things or have trouble thinking clearly
- Get cranky, anxious, irritable, or depressed
- Have less energy or interest in doing things
- Make mistakes or get into accidents more often than normal
- Worry about their lack of sleep
These symptoms can be so bad that they affect a person’s relationships or work life. Plus, they can happen even in people who seem to be sleeping enough hours.
Diagnosis & Treatment of Insomnia
Most people with insomnia need no tests. Your doctor or nurse will probably be able to tell what is wrong just by talking to you. He or she might also ask you to keep a daily log for 1 to 2 weeks, where you keep track of how you sleep each night.
In some cases, people do need special sleep tests, such as “polysomnography” or “actigraphy.”
Polysomnography – Polysomnography is a test that usually lasts all night and that is done in a sleep lab. During the test, monitors are attached to your body to record movement, brain activity, breathing, and other body functions.
Actigraphy – Actigraphy records activity and movement with a monitor or motion detector that is usually worn on the wrist. The test is done at home, over several days and nights. It will record how much you actually sleep and when.
Once Insomnia is diagnosed, your doctor will come up with a customized treatment plan which will initially focus on improving the patient’s sleep hygiene, offering relaxation therapy or counselling, and if these techniques don’t work then the doctor might suggest medicines.
FAQs regarding Insomnia
What can I do to improve my insomnia?
You can follow good “sleep hygiene” which means you:
- Only sleep long enough to feel rested and then get out of bed
- Go to bed and get up at the same time every day
- Do not try to force yourself to sleep. If you can’t sleep, get out of bed and try again later.
- Have coffee, tea, and other foods that have caffeine only in the morning
- Avoid alcohol in the late afternoon, evening, and bedtime
- Avoid smoking, especially in the evening
- Keep your bedroom dark, cool, quiet, and free of reminders of work or other things that cause you stress
- Solve problems you have before you go to bed
- Exercise several days a week, but not right before bed
- Avoid looking at phones or reading devices (“e-books”) that give off light before bed. This can make it harder to fall asleep.
Other things that can improve sleep include:
- Relaxation therapy, in which you focus on relaxing all the muscles in your body 1 by 1
- Working with a counselor or psychologist to deal with the problems that might be causing poor sleep
Should I see a doctor or nurse?
Yes. If you have insomnia, and it is troubling you, see your doctor or nurse. He or she might have suggestions on how to fix the problem.
Are there medicines to help me sleep?
Yes, there are medicines to help with sleep. But you should try them only after you try the techniques described above. You also should not use sleep medicines every night for long periods of time. Otherwise, you can become dependent on them for sleep.
Insomnia is sometimes caused by mental health problems, such as depression or anxiety. If that’s the case for you, you might benefit from an antidepressant rather than a sleep aid. Antidepressants often improve sleep and can help with other worries, too.
Can I use alcohol to help me sleep?
No, do not use alcohol as a sleep aid. Even though alcohol makes you sleepy at first, it disrupts sleep later in the night.
What is daytime sleepiness?
Daytime sleepiness is feeling sleepy during the daylight hours, when most people are awake and alert.
What causes daytime sleepiness?
Daytime sleepiness can be caused by:
- Not having good sleep habits – For example, not having enough time to sleep at night or not having a regular sleep schedule.
- A sleep disorder, such as:
Sleep apnea – People with this condition stop breathing for short periods during sleep.
Narcolepsy – People with this condition are very sleepy in the daytime and sometimes fall asleep suddenly during normal activities.
Insomnia – People with this condition have trouble falling or staying asleep.
- A medical problem, such as:
Hypothyroidism – This is the medical term for when a person does not make enough thyroid hormone. This hormone controls how your body uses and stores energy.
Depression – People with this condition feel sad or down a lot of the time. They often also have trouble working or doing everyday tasks.
- Things that disturb your sleep, such as:
Sounds – For example, if you have a new baby, he or she might cry and wake you up at night.
Health conditions, such as restless legs syndrome or nighttime leg cramps.
Schedule changes that affect sleep – This might include working a night shift or traveling to another time zone.
Medicines – Certain medicines can cause daytime sleepiness.
That depends on the cause of your daytime sleepiness. But you can try having good sleep habits. This means that you:
- Go to bed and get up at the same time every day.
- Have drinks with caffeine in them only in the morning (these include coffee and tea).
- Avoid alcohol.
- Avoid smoking, especially in the evening.
- Lose weight if you are overweight.
- Exercise several days a week, but not right before bed.
- Stay off your back when sleeping. (This is not always possible and does not always work.)
- Avoid looking at screens that give off light before bed. These include phones, tablets, “e-reader” devices, and television. Looking at screens just before going to bed can make it harder to fall asleep. It might also make your sleep less restful.
- Should I see a doctor or nurse? See a doctor or nurse if:
- You are often very sleepy in the daytime.
- You fall asleep in the middle of normal activities.
- You fall asleep in a dangerous situation, such as while driving.
- You see or hear things that are not really there.
- When you wake up, you can’t move right away.
- Your muscles feel weak if you laugh or get excited or angry.
Will I need tests?
Your doctor or nurse will decide which tests you should have. There are many different tests, but you might not need any. It depends on your age, other symptoms, and individual situation.
A “sleep study” is the most common test doctors use to find the cause of daytime sleepiness. For this test, you spend the night in a sleep lab at a hospital or doctor’s office. You are hooked up to different machines that monitor your heart rate, breathing, and other body functions. The results of the test tell your doctor or nurse if you have a sleep disorder.
Your doctor or nurse might also ask you to keep a daily log for 1 to 2 weeks, where you keep track of how you sleep each night.
How is daytime sleepiness treated?
That depends on what is causing your daytime sleepiness. Treatments can include:
- Lifestyle changes – These can include changing your work schedule, taking naps, losing weight, or avoiding caffeine and alcohol.
- Devices you wear at night – These can help people with sleep apnea.
- Medicines – There are medicines that can help you stay awake in the daytime or sleep better at night.
- Surgery – A few people with sleep apnea have surgery to treat it. But most people don’t need surgery for daytime sleepiness.
If you have a medical condition that is causing your sleepiness, you might need treatment for that, too.
Can daytime sleepiness be prevented?
You can reduce your chances of daytime sleepiness by having good sleep habits. If your doctor or nurse prescribes medicine or a device to wear, use it exactly how he or she tells you.
What if my child gets daytime sleepiness?
In children, daytime sleepiness is usually caused by not sleeping enough at night or not having good sleep habits. Some medicines can also make your child sleepy in the daytime.
Children with daytime sleepiness can act differently from sleepy adults. For example, your child might:
- Have trouble paying attention in school
- Be more active than usual
- Act angry or emotional
If you think your child might have daytime sleepiness, talk to the doctor or nurse.