Originally created 09/25/01

Apneas leave sleepers breathless

Donald Denard of Augusta snored for most of his life. But over the years, his family noticed it getting worse. The 31-year-old also was plagued by headaches in the mornings and extreme sleepiness during the day.

"When I woke up I felt more tired than when I went to bed," he said. "It even got to the point that I was nodding off in mid-conversation."

About half of the men and a quarter of the women in the United States snore, said Christin Engelhardt, executive director of the American Sleep Apnea Association in Washington, D.C. In women, snoring increases after menopause.

But if snoring is disturbing your sleep, or your spouse notices you stop breathing during the night, it may be a sign that there are more serious problems.

Mr. Denard nodded off any time he sat still. He had a particularly hard time at work as a computer programmer and analyst, where he sat at a computer all day.

"Coffee, or anything like that, just didn't help at all," he said. "It was a different kind of sleepiness, almost like it started out as a daydream."

Finally Mr. Denard went to see Bashir Chaudhary, who then was the director of the Georgia Sleep Center at Medical College of Georgia and now is director of the Sleep Institute of Augusta.

Dr. Chaudhary prescribed a night at the sleep center. Mr. Denard said that night changed his life.

Mr. Denard suffered from sleep apnea, a breathing disorder that causes a person to stop breathing many times during the night, most commonly due to a tissue blockage in the airways. Each interruption lasts at least 10 seconds, causing the sleeper to wake up.

Mr. Denard stopped breathing 192 times that night. He also suffered from 199 hypopneas, instances during which the airflow is not cut off, but is so low the person wakes up. Hypopneas also lead to a decrease of oxygen in the bloodstream.

An estimated 12 million Americans suffer from sleep apnea. About 10 million of those are undiagnosed, according to the Apnea Association.

There are three types of sleep apnea: obstructive, central and a combination of both.

Obstructive, the most common, occurs when tissue blocks the upper airways so that air cannot pass through. Typically, the soft tissue in the back of the throat collapses.

Central sleep apnea is when the brain fails to give the body the signal to breathe.

Usually, a person's spouse will be the first to recognize the signs of sleep apnea.

"Snoring is the first clue that a spouse will have," Dr. Chaudhary said. "Many times it is so bad, they won't even sleep in the same room."

Mr. Denard said his wife, Amy, had trouble sleeping in the same room with him. Her difficulty sleeping was the initial reason he decided to seek treatment. He said at the time, he didn't realize just how tired he really was.

"Sleep apnea gets worse gradually," Ms. Engelhardt said. "People get accustomed to the sleepiness. They get used to waking up tired. It's amazing to talk to them after they are treated. They are a different person."

Some treatments are as simple as not sleeping on your back. "Lateral posture therapy" keeps the tongue from falling back and blocking the air passages, Dr. Chaudhary said. He recommends sewing a tennis ball into the back of a T-shirt to encourage side-sleeping.

Losing weight also is effective in reducing apneas.

"Most of the time, a 10 percent reduction in weight will lead to 50 percent reduction in sleep apneas," Dr. Chaudhary said.

Dr. Chaudhary also said alcohol and smoking can aggravate the condition.

In the 1970s, tracheostomys were the standard treatment for sleep apnea. They are rarely done anymore, but other surgeries can correct some obstructions that cause sleep apnea. The uvula, the tissue that hangs down at the back of the mouth, tonsils and any other excessive tissue in the upper airways can be removed to make more room for air.

The most common treatment is an air pump called the C-PAP machine. The patient wears a small mask that blows a continuous stream of air into the nose, keeping the nasal and throat passages open. The C-PAP is successful in 90 percent of sleep-apnea patients, Dr. Chaudhary said, adding that the most common reason the C-PAP doesn't work is that patients aren't using it as often as they should.

The air pump and mask have improved Mr. Denard's condition.

"It felt a little weird, a little claustrophobic at first," he said, "but now I use it every night. I don't think I could fall asleep without it."

Mrs. Denard even misses the quiet whirring of the C-PAP machine when Mr. Denard is out of town.

"And all my symptoms have improved," Mr. Denard said. "I was almost hyper the first week or so. It was almost like my body was soaking in all the sleep."

Sleep disorders

Here's a description of the most common sleep disorders from the National Sleep Foundation:

Sleep apnea: A breathing disorder normally caused by blockage to the airways throughout the night. About 12 million adult Americans suffer from the disorder that causes brief interruptions in breathing and loss of oxygen during sleep. Symptoms include snoring, early morning headaches, depression, irritability, memory and learning difficulties.

Insomnia: The inability to fall and/or stay asleep. Other symptoms include restlessness, irritability, fatigue, memory impairment and difficulty coping with problems and completing routine tasks.

Restless leg syndrome: This disorder is marked by uncomfortable leg sensations that occur when the body is at rest, and worsen when lying down. About 4 million Americans suffer from symptoms such as an urge to move the legs, crawling, tingling, cramping or burning sensations, resulting in continuous sleep disruption and fatigue.

Narcolepsy: A neurological disorder that affects the part of the central nervous system that regulates sleep. An estimated 200,000 people in the United States suffer from this disorder. Symptoms include sudden, uncontrollable episodes of sleep, sudden loss of muscle tone, ranging from limpness in limbs to complete body collapse, and inability to talk or move when falling asleep or waking up.

Reach Lisa M. Lohr at (706) 823-3332 or lisalohr@augustachronicle.com.


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