Ever fall asleep at the wheel while you're sitting at a stoplight? Snore at night? Have morning headaches?
If so, you have three of the symptoms doctors associate with sleep apnea, a condition often wrongly believed to be a problem only for people who are overweight or obese.
Dr. Robert Mazzola, a sleep disorders specialist at LDS Hospital's Intermountain Sleep Disorders Center, said that misconception keeps many people who could feel and function better from seeking treatment for the condition.
He and Dr. Howard Leaman, also a sleep disorders specialist at the Sleep Center, will answer questions about all kinds of sleep disorders, symptoms and treatment during Saturday's monthly Deseret News/Intermountain Healthcare Hotline, which runs from 10 a.m. to noon. The questions are confidential and will not be broadcast. Call 801-236-6061 or 1-800-925-8177 to ask a question.
"We see plenty of patients who are overweight and don't have (sleep apnea). We see many others who are quite athletic and in shape who do have it, so the first thing people need to realize is they should put away the stereotypes," Mazzola said.
While fatigue can also be a sign of sleep apnea, fatigue can be caused by many different factors, he said, noting it could be symptomatic of another disease like anemia or depression. "If it's a big enough problem, you should make your doctor aware of it," he said.
Other symptoms include daytime fatigue and a need to nap; noticeable shortening of one's attention span; frequent waking at night with the need to urinate; difficulty getting to sleep or staying asleep; and feeling extremely tired upon waking.
If multiple signs of sleep apnea are present, Mazzola recommends that people talk with their primary care physician to be screened for the problem. "Unfortunately, there is a wide variety in the comfort level some doctors have with sleep disorders, but in general, most are comfortable with doing that kind of screening," he said.
Doing nothing is often what people choose, but it's a poor option, Mazzola said. "The data is absolutely clear that if you have sleep apnea and don't treat it, you're at higher risk for high blood pressure, cardiovascular disease, pulmonary hypertension and stroke. It also makes it harder to control glucose levels in diabetics," he said.
The simplest definition of sleep apnea is that "for one reason or another, a person is not breathing appropriately at night," which causes airway obstruction and a resulting drop in the amount of oxygen getting to the brain and other vital organs.
"We view it as a whole body attack — a smoldering body attack similar to a heart attack. With a heart attack, a plaque breaks off somewhere in the body and lodges itself somewhere in the coronary arteries. Everything downstream is injured or dies if a cardiologist can't get to the vessel and open it again."
In the same way, when patients stop breathing at night, instead of closing off an artery, they're closing off the airway that keeps the entire body from getting oxygen.
"The difference is the body recognizes when the airway is closed and tries to wake the person to keep them from going into respiratory arrest. That up and down oxygen level is causing damage to the body as a whole."
Just as a cardiologist uses a metal stent to open a coronary artery, sleep doctors use what they call a small mechanical box and mask known as a CPAP (continuous positive airway pressure) that patients use at night to open their airway.
About the size of a lunch pail, the devices are portable enough that patients can take them through airport security. "It's the most effective treatment for the disorder," he said.
Other treatments include surgical intervention and a device constructed by a dentist. Patients with mild or moderate sleep apnea sleep with the device in their mouths to pull the tongue off the back of the airway.
"In the past, many people didn't think sleep was an important component of their medical care," Mazzola said. "But we've demonstrated that it's a critical part of your health.