This condition, sometimes referred to as Sleep-Disordered Breathing (SDB), involves repeated arousals from sleep—not necessarily to full awakening because breathing has ceased. In the most important form (obstructive sleep apnea) it is because the upper airway for breathing has momentarily been obstructed.
Sleep Apnea may or may not be evident, to the patient or to others. It may be manifested by marked daytime drowsiness–or noted by a spouse who is frequently awakened by the snoring, which almost always accompanies obstructive sleep apnea.
Sleep Apnea is considered a health problem because so many individuals lose so much sleep due to this condition that their lack of alertness poses a serious hazard. It is also associated with hypertension and heart disease.
Sleep Apnea may also cause impaired mental functioning, delayed reaction times, and difficulty maintaining vigilance and concentration. In its severe form it is accompanied by high pressures in the lung arteries leading to heart failure.
WHO IS UP AT NIGHT?
The National Heart, Lung, and Blood Institute estimates that (18 million Americans) have Sleep Apnea. Men are more susceptible than women, evidently due to hormonal influences (Sleep Apnea is rarely seen in premenopausal females). There are also Sleep Apnea clusters within families. Obesity, even if moderate, is a predisposing factor. It is worsened by the use of alcohol and sleeping pills.
African Americans may be at increased risk of SDB. A 1997 study, published in the American Journal of Respiratory and Critical Care Medicine, found that African Americans under the age of 25 were twice as likely to have SDB than their white counterparts. A 1999 study in the same journal that examined risk factors for sleep-disordered breathing in children and teenagers found that African American children were more than three times as likely as children of other races to develop SDB.
Elderly African Americans, according to a 1995 study published in American Lung Association’s American Journal of Respiratory and Critical Care Medicine , are more than twice as likely as elderly whites to suffer from sleep-disordered breathing.
The researchers, at the University of California, San Diego, studied 54 African Americans and 346 Whites aged 65 and older. They found that 17 percent of the African American subjects had Sleep Apnea, compared with 8 percent of the whites. Statistics are not available for other groups.
PREVENTION: RECOGNIZING AND REMEDYING A PROBLEM
The focus is on managing risks associated with the condition and on effective treatment. Try this advice:
- Talk to your doctor. The first step to doing something about SDB is admitting that it’s a problem and discussing daytime sleepiness or excessive snoring with your physician so that he can help you deal with the condition.
- Slimming down may help. Sleep Apnea is more common among people who are moderately overweight to obese, so a diet and exercise program may eliminate or dramatically reduce occurrences.
- Get technical help. If necessary, your doctor will advise a visit to a sleep lab to evaluate your condition. A technique called Nasal CPAP (continuous positive airway pressure) delivers air through a mask while a patient sleeps, which is effective in helping people get a good night’s rest and avoid daytime accidents. In some cases, anatomical surgery may be recommended. In mild cases, special dental appliances may help.
- Children. Sleep apnea occurs in children, usually due to enlarged tonsils and adenoids. A child who is sleepy during the day and snores at night should be medically evaluated.