Sleep Tight, Breathe Right

Frederick Jaccarino, M.D.

In a previous column we discussed the healthy diet. Diet is a frequent topic because it is a serious player in the pursuit of health and wellness, and it is a “modifiable” factor. Certainly diet is directly linked to most obesity. So today let’s discuss one good reason to avoid obesity – it can ruin a good night’s rest! Even folks lucky enough to usually report restful sleeping look forward to enjoying the next opportunity for a good refreshing sleep.

In reality, few Americans can say they usually sleep well. Among the common culprits ruining a good sleep are stress, certain medications, daytime inactivity, shift work, and excessive alcohol use. But, there is also a large group of poor sleepers who suffer from sleep apnea. If sleep apnea is causing your daily fatigue, it would make sense to deal with it.

Sleep apnea means that at times while you are asleep you stop breathing. Many patients are unaware that apnea has been happening. Often associated with sonorous snoring, the victim also has daytime sleepiness and the brain functioning issues associated with lethargy. A partner may note the absence of breathing for 5 to 10 seconds. If unrecognized and untreated, health consequences can be dire, and emphysema-like lung disease can result.

The diagnosis of sleep apnea is made in patients who have suggestive symptoms, and confirmed in a sleep lab. Symptoms to raise a concern for the disorder include fatigue, lethargy, snoring, or an observer’s report of breath stoppages during sleep. In the sleep lab a specialist will measure your brain, heart and lung functions while you sleep.

So, say your spouse has been sleeping in a separate room because of snoring, and you have a shortage of get-up-and-go when you should be most alert and energetic. A trip to the family M.D. may lead to a sleep study, and then… treatment options. Because most (not all) patients with sleep apnea are overweight, the first treatment suggestion is weight loss. There are surgical options if oral structures like tonsils, loose collapsable tissues, or the uvula, etc. are causing blockages in the upper airway. Also, because weight loss is so helpful, bariatric surgery (i.e. gastric banding) may be an option. There is a device, called CPAP, worn while sleeping which can support the loose collapsing oral tissues, easing air flow. The equipment is bulky and most patients find using it a disagreeable device. Besides, bed and equipment hardly belong in the same sentence!

My argument seems solid: eat wholesome food and lose weight. The alternative may lead you to the business end of a scalpel for a tonsillectomy or gastric bypass, or worse you can stumble through your days in a sleep deprived daze while your breathing steadily worsens. Convinced?