Sleep apnea was the topic of discussion at the Lunch and Learn Seminar held this past Thursday at Rolling Plains Memorial Hospital (RPMH).
The program was co-hosted by local physician Dr. Robert Eaker and Dr. Ted Dyer, the director of the Hendrick Sleep Study Clinic of Abilene. Dr. Dyer led the presentation, while both doctors fielded questions after the program.
One-third of a person's life will be spent sleeping, although sleep is not a "passive" period. While consciousness is reduced during this time, the brain is still active.
Sleep is necessary to maintain mind and body health. But, only in the last 60 years have doctors been able to understand how sleep and sleep disorders affect a person's health.
Various reasonings abound as to why we as humans need sleep. One instance is energy conservation, similar to how animals will hibernate.
On the other hand, REM (rapid eye movement) sleep can help store memories in the brain. In addition, some people will sleep just to pass the time as a result of boredom after darkness falls.
But the most popular theory is sleep being a restorative process for the brain. Although the brain greatly benefits from sleep, the act of sleeping — as well as sleep disorders — make an impact on all organs.
Four stages of sleep were cited: light sleep, restful sleep — in which a person will spend the most amount of time in this stage, deep sleep and REM sleep.
However, obstructive sleep apnea (OSA) — defined as the cessation of airflow for greater than 10 seconds with continued chest and abdominal effort — will affect around 25 million people. Annually, over $2,500 will be spent on health costs, and the condition is more common with men than women.
Other sleep conditions were mentioned such as hypopnea, which is cited as a decrease in the amount of air breathed by less than 30% with a desaturation of at least 3%. Central apnea is the cessation of airflow for more than 10 seconds without continued chest and abdominal effort.
A mixed apnea, however, will begin as a central apnea condition, but will become obstructive sleep apnea at the end of the episode.
The standard treatment for OSA is a positive airway pressure (PAP) theory. The pressure will gently hold the airway open so that an airway collapse can be prevented while the patient sleeps.
The source of the applied pressure is from a mask that is placed over the nose or mouth. The treatments are safe and effective, but the mask must be worn to see results. Many new models will not only show effectiveness, but also have memory chips to track and record use of the machine.
But in order to fully detect a suspected case of OSA, many doctors will conduct a "STOP-BANG" score test where patients are asked eight "yes or no" questions.
The test's name is an acronym formed from the question topics: snoring, tiredness, observed sleep — if the patient has stopped breathing, high blood pressure, BMI (body mass index), age, neck circumference and gender.
Another sleep condition discussed was insomnia, which is the inability to initiate or maintain sleep as well as wake up in the morning. Whether a person cannot sleep or stay asleep, long term effects could lead to irritability or depression.
The National Sleep Foundation (NSF), however, has listed a detailed list of recommendations for insomnia sufferers to follow.
Plan to sleep and wake up at the same time every morning and evening. Taking naps should be avoided in that they decrease the amount of sleep during the evening; if naps are needed, limit them to 20 to 30 minutes.
If a person cannot fall asleep within 15 minutes of lying in bed, he should get up and do a relaxing activity until he feels sleepy. If needed, repeat this task.
And, if a cell phone should be kept on during sleep, make sure that the alarm setting is the only operating function.
For eating and drinking, insomnia sufferers should abstain from caffeine, as its effect can linger from an average of 3 to 5 hours after ingestion. Nothing should be eaten or drunk in excess before bed — especially liquids, so that late-night bathroom trips can be avoided.
Sugary foods should be avoided before bedtime, but a person should not go to bed hungry. If necessary, a light snack can be eaten.
In addition, rigorous exercise can circulate endorphins, which can actually cause difficulty in initiating sleep. Body temperatures also rise during exercise and can take up to six hours to fall.
While exercise may promote sleep, it should not be done within a few hours of bedtime. The NSF recommended that exercise performed in the late evening, around 4 or 5 p.m., is best.
Finally, some "do's and don'ts" for a sleep-promoting environment were laid out. Dr. Dyer stressed that a person's bed should only be associated with sleeping.
Make sure to sleep in a quiet, dark and relaxing setting, as well as to sleep in a comfortable bed. Turn off the television, computer and all gadgets, while also having a bedtime ritual and only wearing pajamas to bed.
Don't read, do homework, watch TV, surf the web, or listen to heavy music in bed. Bright colors in room — like paint and posters — may serve as a distraction, along with a cluttered space.