Maybe I'm just feeling really crotchety today because the insomnia monster paid a pretty bad visit last night. But this article has me seeing red on so many levels.
The patient usually is an overweight male who's a loud snorer.
I am SOOOOO sick of dealing with this stereotype when telling my friends that I have apnea. Typical conversation:
- Them: "What's been going on? You've obviously been feeling horrible and you're not doing very well. Anything I can do to help out?"
Me: "I was diagnosed with sleep apnea earlier this fall and I'm having some difficulty adjusting to CPAP. Just bear with me and keep in mind I'm not sleeping very well yet."
Them: "WHAT? You can't have apnea. You're not a big fat overweight Buffalo guy. You're a skinny, small underweight woman!"
According to my sleep doctor's PA, some 40% of sleep apnea patients are NORMAL weight or UNDERWEIGHT.
Loose, flabby tissue in the throat completely collapses and blocks the passage of air to the lungs — the apnea phase.
This language continues the negative stereotypical language that
implies incorrectly that sleep apnea is primarily a disease of lifestyle choice---i.e. one that can easily be avoided by maintaining a "good" and "healthy" lifestyle. You know: Eat right, exercise right, don't gain weight. Well I basically do those things and guess what, I got apnea.
No, the truth is more complicated: OSA is not caused by "loose, flabby tissue" which implies the overweight apnea sufferer made the tissue loose and flabby the same way he made his belly "loose" and "flabby" by eating too much. Rather, in many OSA patients the problem is that the smooth muscles in our necks that support our airway simply relax too much when we are asleep. And we don't have much conscious control over smooth muscles---so it's not like we can do body building exercises to somehow get these muscles into "better shape." No, our bodies have a physical difference and we---at least the 40% of us who are normal weight and more than likely many of those who are also overweight as well---cannot control the fact that our neck muscles have a tendency to over relax when we are asleep.
Daytime grogginess is all but universal.
I for one had NO daytime sleepiness prior to starting CPAP.
A drop in the snorer's blood oxygen level is the reason bad things happen.
I had NO desats during my diagnostic sleep test. There are, however, good reasons for treating moderate to severe OSA even when daytime sleepiness and oxygen desaturation are NOT issues. I say this as someone who is continuing to have problems with treatment.
WHEN I manage to make my therapy work for me, I expect that finally having the ability to sleep the full night without having multiple, repeated respiratory arousals every single night, will have long term health benefits for my body. If nothing else, managing my apnea now---before I have started having desats---will prevent the damage that desats are associated with from occuring.
If your son is overweight, weight loss might be the thing that cures him. A mouth guard that pulls the chin slightly forward keeps throat tissues from collapsing. The family doctor or dentist can direct him to a place that sells these devices. CPAP — continuous positive airway pressure — is a device that delivers pressurized air to the patient through a face mask. The pressure keeps the throat opened at all times. In severe cases, surgical or laser removal of the redundant tissue permanently opens the air passageway.
Why is CPAP undersold here? It is accepted as the
gold standard treatment for those who make a serious, committed effort to adjust to it, unlike weight loss, dental appliances, or surgery. In particular, why isn't the fact that the various surgical procedures are often complex, painful, and not entirely effective at fully eliminating the apneas made clear?
