Obesity has become an epidemic
in America. Sleep-related breath-
ing disorders also are widespread
and increasingly common because
of t hei r l ink to obesit y—
approximately 20 million Ameri-
cans have obstructive sleep apnea.
Te interactions between OSA
and obesity are complex andmore
than mere coexistence, according
to DCH Sleep Center Medical
Director Dr. James D. Geyer.
“Patients with OSA may gain weight
or be unable to lose weight for a num-
ber of reasons,” Dr. Geyer said. “Sleep
apnea tends to make patients tired and
fatigued. Tis limits an individual’s abil-
ity to exercise.
“Sleepy people tend to eat higher-
calorie foods and snack in order to stay
awake. Patients with OSA may have altera-
tions in proteins in the blood, which are
associated with fat deposition and weight
gain. Finally, these patients also tend to
Desperately seeking snoozin’?
The DCH Health System offers two accredited facilities to diagnose sleep problems
such as obstructive sleep apnea. If you’re tired of tossing and turning at night,
DCH Sleep Services can help. Go to www.dchsystem.com/sleep.
If you’re diagnosed with OSA and CPAP therapy is prescribed for treatment, DCH
Home Medical Equipment is here for you. Click on “CPAP Services” and then “DCH
Home Medical Equipment” to learn how DCH Home Medical Equipment can provide
the equipment, the education and the support for dealing with OSA.
have lower overall metabolism.”
Tese issues ofen improve with CPAP
(continuous positive airway pressure) ther-
apy. And losing weight can signifcantly
decrease the severity of OSA, according
to Dr. Geyer.
THE HEART OF THE MATTER
“OSA also
is a risk factor for developing or worsen-
ing high blood pressure,” Dr. Geyer said.
“Nasal CPAP in hypertensive patients with
moderate-to-severe OSA can improve
blood pressure control.”
OSA and coronary artery disease fre-
quently coexist—at least 50 percent of
patients with heart disease have signifcant
OSA, Dr. Geyer said. “OSA is an indepen-
dent risk factor for heart attack similar to
hypertension and smoking,” he explained.
“Te decreases in the blood oxygen level
that can accompany OSA further contrib-
ute to nighttime chest pain.
“Te sleepiness and snoring associated
with OSA are frequently the presenting
symptoms and those with which the pa-
tients are most concerned,” Dr. Geyer said.
“However, untreated sleep apnea has been
shown to have a major impact on a vari-
ety of serious vascular disorders. Aggres-
sive treatment of sleep-related breathing
Sleep disorder
definitions
Sleep apnea
Sleep apnea is a common disorder
in which one or more pauses in
breathing or shallow breaths occur
while you sleep.
Breathing pauses can last from
a few seconds to minutes. They
often occur 5 to 30 times or more
an hour. Typically, normal breath-
ing then starts again, sometimes
with a loud snort or choking
sound.
Sleep apnea usually is a
chronic condition that disrupts
your sleep. You often move out
of deep sleep and into light sleep
when your breathing pauses or
becomes shallow.
This results in poor sleep qual-
ity that makes you tired during
the day. Sleep apnea is one of
the leading causes of excessive
daytime sleepiness.
CPAP
CPAP (continuous positive airway
pressure) is a treatment that
uses mild air pressure to keep
your airways open. CPAP typi-
cally is used for people who have
breathing problems, such as sleep
apnea.
CPAP treatment is done using
a CPAP machine. CPAP machines
have three main parts:
■
■
A mask or other device that fts
over your nose or your nose and
mouth. Straps keep the mask in
place while you’re wearing it.
■
■
A tube that connects the mask
to the machine’s motor.
■
■
A motor that blows air into the
tube.
Source: National Heart, Lung, and Blood Institute
disorders not only
decreases vascular
risk, but also im-
proves the quality
of life of both the
patient and their
spouse.”
WHAT TO
WATCH FOR
People with OSA
typically have very loud snoring inter-
spersed with prolonged periods when
breathing stops, or apneas, Dr. Geyer said.
“During sleep, the muscles of the throat
normally relax,” he said. “In patients with
OSA, that relaxation causes a collapse of
the airway, which requires partial awak-
ening to restore the muscle tone to open
the airway again. In other words, people
with OSA must awaken themselves many
times each night to ensure that they will
continue to breathe.”
Commonly recognized symptoms of
OSA include:
●
●
Loud snoring.
●
●
Gasping for air.
●
●
Dry mouth.
●
●
Witnessed pauses in breathing.
“Te pauses and gasping may be ac-
companied by feelings of anxiety or panic,”
Dr. Geyer said. “Morning headaches also
are a frequent complication of sleep apnea.
Some patients report frequent urination at
night or nighttime acid refux.”
Dr. Geyer explained that a physician
specializing in sleep medicine can con-
duct a sleep study in a special laboratory
designed to allow a patient to sleep com-
fortably while a variety of body systems
are monitored. If OSA is diagnosed, there
are several treatment options available.
CPAP is the most commonly used treat-
ment for sleep apnea in patients with sig-
nifcant vascular disease. Other treatment
options include nasal surgery, several types
of throat surgery and, for less serious cases,
dental devices as well as positional therapy,
in which simple devices are used to prevent
patients from sleeping on their back.
“Treatment must be individualized,”
Dr. Geyer said. “OSA is not a one-size-fts-
all disorder.”
Dr. Geyer is a Diplomate of the American Board of Sleep Medicine
and American Board of Psychiatry and Neurology with additional
credentials in sleep medicine and a Fellow of the American Academy
of Sleep Medicine. He is an attending physician at Alabama
Neurology and Sleep Medicine and is the medical director of the DCH
Sleep Center. He has edited several textbooks on sleep medicine,
including Clinical Sleep Disorders. He has coauthored numerous
textbooks and journal articles. He also serves on the National
Restless Legs Advisory Board, among other national committees.
James D. Geyer,
MD, FAASM
OBSTRUCTIVE SLEEP APNEA IS A SERIOUS MEDICAL CONDITION
MORE THAN
SNORIN’
F A L L 2 0 1 1
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H E A L T H Y C O M M U N I T Y
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