Page 5 - Valley Life & Health

THE MORNING CALL SATURDAY, APRIL 27, 2019 5
WAKE UP
Continued from page 4
UNDIAGNOSED

SLEEP APNEA IS

A REALITY FOR

ONE IN FIVE ADULTS Hospital

Easton
n today’s fast-paced society, sleep deprivation by wide swings in heart rate, a precipitous de-
has become increasingly pervasive in our de- crease in oxygen saturation, and brief electroen-
Imanding daily routines. Whether we lose out cephalographic (EEG) arousals concomitant with Group’s
on sleep because we don’t make it a priority or loud breathing sounds as a bolus of air is exhaled
due to unwelcome stress, insomnia or sleep dis- when the airway reopens. Medical
ordered breathing, we put ourselves at a growing When we continuously have hypoxemiayp
risk for a number of cardiovascular issues – includ- (decreased oxygen levels in the bloodstream)bloodstrtreaeam)m) Steward
ing high blood pressure, stroke, atrial fibrillation, and carbon dioxide retention accompanied byccomompanied by of
and heart disease. many brain awakenings throughout the night, ourhoutut the night, our
Although it may be hard to believe that body’s reflex response is to increase the produc-rerease the prododucuc- courtesy
people spend around one-third of their lives tion of hormones, which also lead to sympatheticeadd to sympapaththeticic Photo
sleeping, emerging research has begun to eluci- nerve activation. This in turn leads to increasedadads to increreaseded
date the complex inter-relationship and impor- blood pressure and heart rate, which over timewhich ovever timeme Shailendra Singh, MD, Chief of Cardiology
tance between sleep disordered breathing and can cause repetitive damage to blood vessels,blood vesessels, for Steward Medical Group’s Easton Hospital.
cardiovascular disease. “Sleep is no longer con- structural damage to the heart, and cardiac ar-anand cardiaiac ar-
sidered a passive and homogenous state; instead rhythmias thus leading to the possible sequelaepossssible sequeuelae
it is understood to consist of cyclic periods of of hypertension, atrial fibrillation, heart attack,on, heart attackck,
complex and changing brain activity, behavior and stroke, and heart failure. observe a variety of sleep-associated disturbancesobserve a varirietety ofof sleleep-associaiatetedd disturbabancnces
(s
physiology,” says Shailendra Singh, MD, Chief (such as, apneas, periodic leg movements, seizures,uch as, apneas, peririododicic lleg movements, seizures,
or
of Cardiology for Steward Medical Group’s OBSTRUCTIVE SLEEP APNEA or REM behavior disorder).REM behavior disorder).
APNEA
Easton Hospital. Sleep cycles can be divided The treatment of OSA usually entails reduc-
into rapid eye movement (REM) and non-rapid (OSA) IS THE MORE COMMON tion of weight and a continuous positive airway
eye movement (NREM), which individually carry FORM ASSOCIATED WITH pressure (CPAP) machine, which provides a con-
out various functions that impact cardiovascular SNORING AND OCCURS DUE stant stream of forced air through a face mask and
physiology and biomechanics, as well as activa- TO INTERMITTENT COLLAPSE prevents the back of the throat from collapsing and
tion of the sympathetic nervous system. obstructing airflow. “The delivery of oxygen at that
“Most people wonder how the cardiovascu- OF THE UPPER AIRWAY, WHICH high pressure opens up the airway for the patient,
lar system can be negatively affected during the TRANSLATES TO CESSATION OR which decreases the effort required to breathe and
seemingly benign activity of sleep. What tran- SIGNIFICANT DECREASE thus reduces snoring with gaining continuous sleep
spires during sleep, which is designed to be restful without interruption. Although it may take time
and reparative for the body’s processes, that IN AIRFLOW. to adjust to having oxygen therapy while sleeping,
can adversely affect the heart?” says Dr. Singh. many innovative devices have improved options for
“Pathological sleep begins as a respiratory-related Dr. Singh explains, “we may think we have had patient comfort and my patients dramatically feel
issue, most commonly termed sleep apnea or sleep a good night’s sleep and unknowingly brush off better,” Dr. Singh says of CPAP treatment.
disordered breathing. There are two main types of symptoms – including disruptive snoring, daytime “The question we are investigating now is,
sleep apnea: obstructive and central.” sleepiness, fatigue, morning headache and confu- essentially, whether effective CPAP treatment
Obstructive sleep apnea (OSA) is the more sion – which could be signs of sleep apnea.” causally decreases cardiovascular mortality. We
common form associated with snoring and occurs One of the larger problems with diagnos- have recently developed randomized trials that are
due to intermittent collapse of the upper airway, ing sleep apnea is that many adults may not be currently being administered, but we don’t have a
which translates to cessation or significant decrease aware of the abrupt awakenings they experience definitive answer yet. Often there is an improve-
in airflow. throughout the night, which are usually accom- ment in high blood pressure. But the most encour-
“Collapse of the upper airway may happen panied by gasping or choking for air before they aging result is that thousands of patients have said it
during the deep stages of REM sleep, since we drift back to sleep again. It is estimated that one improves their quality of life.”
lose postural muscle tone thus allowing the airway in every five adults has mild OSA, one in 15 adults As with any medical condition, one of the
to become transiently flaccid. Therefore, when has moderate to severe OSA, and at least 75 per- more difficult things to fully comprehend is the
we breathe in, the airway collapses on itself, and cent of those who could benefit from treatment comprehensive scope of potential health risks
stays obstructed until we overcome the physical remain undiagnosed. associated with lack of sleep, poor sleep quality or
obstruction or when the brain actually wakes up A polysomnography (overnight sleep study) sleep apnea. Dr. Singh has found that when discuss-
momentarily,” says Dr. Singh. is necessary to accurately diagnose OSA and to ing these risks, breaking it down into non-complex
These episodes may occur hundreds of times assess treatment benefit. Data is collected in the terminology leads to patient satisfaction, more ef-
nightly – up to one to two times per minute – in laboratory in the presence of a qualified technician. fective communication with patients, and increased
patients with severe OSA. It is often accompanied This protocol provides the opportunity to directly adherence overall.