People who have sleep apnea can wake up 15 to 25 times an hour during sleep – without knowing it. The condition causes them to awaken for only a few seconds, but leaves the sufferer feeling exhausted, even after a full night’s rest. “Sleep apnea is a problem with the upper airway, the part of the airway that runs from the voice box to the back of the throat,” says Aris Iatridis, M.D., a pulmonologist and sleep medicine specialist at Piedmont Physicians Pulmonary and Sleep Medicine Austell.
The airway is held open only by muscle and when you fall asleep, this muscle naturally relaxes. This is why so many people snore, Dr. Iatridis says. However, in patients who have sleep apnea, the airway narrows so much that they start choking and cannot get enough air in and out.
What happens to the body
“As they are lying in bed asleep, they start choking, and the body starts to panic a little bit,” Dr. Iatridis explains. “Adrenaline kicks in, the chest starts to work, the heart starts beating faster, they wake up for two to three seconds, then their body goes back to sleep, and they don’t remember a thing about it.” This process happens throughout the night and in severe cases of sleep apnea, people wake up a staggering 15 to 25 times every hour – and sometimes even more.
Most people aren’t aware that they are waking up throughout the night. “One of the properties of sleep is that it causes amnesia,” he says. “Nobody really remembers what happened during their sleep, even though most people come awake several times during the night.” You won't remember being awake unless you wake for a minute or more. “Sleep apnea patients perceive that they go to bed, they lie in bed for eight hours and are fully asleep, they wake up the next morning and feel just as tired as they did the night before,” he says.
How sleep apnea is detected
If a physician suspects a patient has sleep apnea, he or she may recommend the patient undergo a sleep study. During a sleep study, the patient will go to the sleep center around 9 p.m., “and we hook you up to a whole lot of wires on your scalp, chin, chest and legs,” Dr. Iatridis explains. Patients are monitored by sleep technicians, who record brain activity, breathing, EKG results and muscle activity. “If you have sleep apnea, it becomes obvious,” he says.
Treatment options
If a patient has a bad case of sleep apnea, they will be woken up halfway through the night and put on a CPAP (continuous positive airway pressure) machine. The CPAP machine is a mask that fits over the nose and mouth and is connected by some tubing to a small machine. The machine generates pressurized air to push through the tubing into the mask, which inflates the airway. Dr. Iatridis likens this process to inflating an inner tube with a bicycle pump. “It works very well,” he says. “It has been shown that people who wear CPAP and are able to use it routinely, not only feel better in general – a lot less tired and a better quality of life, but also long-term it will help prevent strokes, heart attacks and other morbidities associated with sleep apnea.”
Unless they do something to change the anatomy of the upper airway, a sleep apnea patient will need to wear the CPAP machine for the rest of their life. However, there are options for certain patients. “If you weigh 300 pounds and you lose a substantial amount of weight, there is a chance you could cure your sleep apnea,” Dr. Iatridis says. “There are also surgeries you can do for sleep apnea.” In some cases, an oral appliance, or mouthpiece, is used to attach the lower jaw to the upper jaw.
It is worn inside the mouth, pushing the lower jaw forward and opening the airway. “This device is reasonably effective in mild to moderate sleep apnea, and in people who are relatively thin,” he says. “The success rate is about 50-60%. It’s a reasonable option to try in people who can’t tolerate or don’t like the CPAP and want to try something else.” For more information, visit Piedmont Sleep Services.
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