A doctor writes the article I am using
for this blog and she chooses to label it, ”5 Top Causes of
Sleep Problems in Seniors.” I am certain that Dr. Leslie
Kernisan understands this topic far better than I do, but I do feel
she left much out of the discussion on sleep apnea.
There are several warnings that should
be issued. First, even though mortality is mentioned, there should
be a clear warning about obstructive sleep apnea causing death and/or
heart attacks. Even central sleep apnea can cause serious health
problems.
I have had sleep apnea since 1999 and
have had treatment since 2001. I use a CPAP mask every night. I
have progressed from the original CPAP to a machine known as a Bi-PAP
machine, which is much quieter and more efficient. I am not like
many people that have problems and either won't wear the mask or only
use it part of the night. Two friends have moved to an oral device
and say they like the device better than the mask. Two other friends
like using the mask and are using their machine every night, like I
do.
Doctors use a language seldom used by
patients. Sleep apnea is no different. They use sleep-related
breathing disorders (SRBD) and it is sometimes referred to as
sleep-disordered breathing (SDB). The SDB is an umbrella term
covering a spectrum of problems related to how people breathe while
asleep.
Sleep apnea (as most patients know it)
is a common condition, which is important to have diagnosed since it
has been associated with many other health problems, especially in
adults of middle age. In sleep apnea, a person has frequent pauses
in their breathing during sleep. The most common form is obstructive
sleep apnea (OSA), in which the breathing pauses are due to
obstructions in the breathing passages. OSA is often associated with
snoring. A less common form is central sleep apnea, in which the
breathing pauses are related to changes in the brain.
The likelihood of having
sleep-disordered breathing disorders goes up with age. It’s also
more common in men, and in people who are overweight. In one study
of 827 healthy older adults aged 68, 53% were found to have signs of
SRBD, with 37% meeting criteria for significant sleep apnea.
Interestingly, most participants did not complain of excess
sleepiness.
Studies have found that untreated OSA
is associated with poor health outcomes including increased
mortality, stroke, coronary artery disease, and heart failure.
However, studies also suggest that these associations are strongest
in people aged 40-70, and weaker in older adults. For older adults
with symptomatic OSA, treatment can reduce daytime sleepiness and
improve quality of life.
Helpguide.org’s page
on sleep apnea has a useful 7-item
questionnaire, to help you determine how likely it is that symptoms
are sleep apnea. It also has a discussion on sleep apnea. You can
also ask the doctor about further evaluation if you’ve noticed a
lot of daytime sleepiness. To be diagnosed, you’ll need to pursue
polysomnography (objective sleep testing) either in a sleep lab or
with a home sleep testing kit.
Whether or not you pursue an official
diagnosis for SRBD, avoiding alcohol (and probably other sedatives)
is likely to help.
Other problems listed by Dr. Kernisan
in addition to the above:
#1. Sleep problems due to an underlying
medical problem.
#3. Restless leg syndrome (RLS).
#4. Periodic Limb Movements of Sleep
(PLMS).
#5. Insomnia.
In my research, I found an article in
Newswise that covers the problems with oral devices for obstructive
sleep apnea. You may read about it here. It does discuss a French
study with this opening statement: In patients with severe
obstructive sleep apnea (OSA), oral appliances that treat the
condition by moving the lower jaw forward appear to improve sleep but
not reduce key risk factors for developing heart and other
cardiovascular disease, according to new research published online,
ahead of print in the American Thoracic Society’s American Journal
of Respiratory and Critical Care Medicine.
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