Scott Webb (Host): Most of us have had a bad night's sleep. But when that's a regular occurrence and you wake up not feeling refreshed, or you're sluggish and foggy all day, you might be suffering from chronic fatigue or sleep apnea. And here today to tell us about the signs and treatment options for sleep apnea and to encourage good bedtime routines for all of us is Emily O'Brien. She's a nurse practitioner with Genesis.

Host: This is Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. I'm Scott Webb. Emily, thanks so much for your time today. We're mainly going to talk about sleep apnea and chronic fatigue and so on. So probably just a good baseline as we get rolling here, what is obstructive sleep apnea? What does that mean?

Emily O'Brien: So, obstructive sleep apnea is something that occurs while you're sleeping, and what happens is the muscles in your upper airway relax and that tissue collapses. That causes a blockage in your airway when you're sleeping. And when you have sleep apnea, that happens repeatedly throughout the night. When this occurs, the oxygen levels in your blood decrease and those repetitive drops in the oxygen are dangerous to your body. Some people have severe cases, meaning that happens 30 or more times every hour.

Host: Wow, that is severe. I didn't realize it was happening that much for some folks. And I have heard, of course, that it's dangerous and we're going to kind of get to that. But what are the risk factors for sleep apnea?

Emily O'Brien: So, common things that are risk factors for sleep apnea include being overweight, but not everybody that has sleep apnea is overweight. I have many people that are of normal body weight that have sleep apnea. Other things that increase the risk are if you have a large neck size, if you have high blood pressure, people with a family history have an increased risk of sleep apnea. And then, anytime you are taking sedatives, that can be sedatives such as medications that you're prescribed, but also alcohol is a sedative and those things tend to worsen sleep apnea.

Host: Yeah. And what are the symptoms of sleep apnea? And do folks know if they're experiencing it?

Emily O'Brien: Many people do not recognize the signs of sleep apnea. They may be told by a significant other that you're snoring. Sometimes people do realize that's a risk factor for sleep apnea. Other people don't realize that snoring is associated with sleep apnea. But certainly, that's one of the more common reasons why we see patients in referral is they've been told that they snore. Other things are just having daytime tiredness. Sleep apnea can cause significant daytime tiredness, and people often don't recognize that their tiredness may be coming from sleep apnea, not feeling refreshed in the morning. Even having morning headaches are also a sign that you may have sleep apnea. Awakening frequently in the night to go to the bathroom is another sign. If you're having difficulty concentrating, memory loss, irritability, that can be related to sleep apnea. And then of course, in addition to your bedroom partner noticing snoring, they may also be noticing pauses in your breathing or that in the night, you're making choking or gasping sounds. All of those would be reasons to seek out testing for sleep apnea.

Host: Yeah. So, let's talk about the testing. So, maybe folks have, you know, started to put together a list of, as you say, the signs and symptoms and begin to sort of connect those dots, right? So, let's say they come in, you know, how do you diagnose obstructive sleep apnea? Is it always sort of a sleep study kind of thing, either someplace else or in their own home? How does that work?

Emily O'Brien: Yeah. So, the diagnosis of obstructive sleep apnea is based on sleep study findings. A sleep study is called up a polysomnography. And for most people, that does involve an overnight stay in the sleep lab. And while you're there, they will hook you up to sensors that monitor your brain waves, your heartbeat, your breathing, and your movements while you're sleeping. This provides us a pretty complete look at your sleep throughout the night and what's happening while you're sleeping. Some people are eligible for this type of testing at home. And when you wear it at home, you receive the monitor from the sleep lab and that collects data while you sleep. It does give us less information than in the sleep lab, but some people who have fewer other medical problems are the best candidate for the home sleep test. Otherwise, we prefer you to spend the night in the sleep lab.

Host: Yeah, wondering, generally speaking, you know, is there a range of treatment options or is it once somebody's diagnosed with sleep apnea, besides maybe cutting down on the risk factors, is CPAP kind of the go-to?

Emily O'Brien: Yeah. CPAP is the first line treatment for obstructive sleep apnea, and it is the recommended treatment for most patients. And the CPAP that you're talking about, you're right, that's a machine that you have at home and you wear at night when you're sleeping. The CPAP does blow air pressure, and that air pressure keeps the airway open while you're sleeping because like we talked about earlier, sleep apnea is when your airway collapses at night when you're sleeping.

There are some other options if your sleep apnea is on the more mild range and you've not been successful at using the CPAP. And some of those other options include appliances that a dentist fits you for that moves your jaw forward and opens the airway at night. There are some surgical options that reduce the extra tissue in your throat, but some of those do have limited success in treating sleep apnea.

Host: Yeah. As you say, the CPAP is first line, the gold standard, if you will. You mentioned, you know, when we talked about the signs and symptoms and all of the negative effects of not getting a good night's sleep. So, what can we do to help folks, you know, to help them, to teach them? For all of us, what do we need to do to promote healthy sleep?

Emily O'Brien: Yeah, that's very important. Healthy habits can definitely improve your ability to fall asleep and stay asleep, and there are many behaviors that you can do during the day that have a major impact on your sleep. Some healthy sleep habits that I recommend to everybody include keeping a consistent sleep schedule. Make sure you're setting a bedtime early enough that you're giving yourself the opportunity to get at least seven to eight hours of sleep each night. Another important thing is if you go to bed and you don't fall asleep in 20 minutes, get up, get out of bed, and do a quiet activity such as reading. Have yourself a relaxing bedtime routine. Make sure your bedroom is quiet, cool and dark. You want to turn off electronic devices at least 30 minutes before you're going to try to go to bed. And even just things throughout the day, exercise regularly, avoid caffeine in the afternoon and evening, limit alcohol use and just fluid intake in general before you go to bed.

Host: Yeah, it does seem that there's things we can do. And those nights when I have a bad night's sleep and I think back, "Well, maybe it was that, you know, cup of coffee too close to bed. Maybe is that I fell asleep with my phone in my hand." You know, I think, in other words, we do some of this stuff to ourselves. And as you say, there are things we can do in terms of, you know, right before bed, the bedtime routine, during the day and so on. So, let's say folks, as we wrap up here, you know, that they want to reach out to you, that they're checking off a bunch of things on the list, that they think maybe they have sleep apnea or certainly want to have a sleep study to find out, how can they get ahold of a sleep specialist at Genesis?

Emily O'Brien: Yeah. So, that's easy. If you want to talk to a sleep specialist about getting sleep testing, you can have your primary care provider send over a referral just to Sleep Medicine, and we'll get you set up an appointment with one of our sleep specialists to talk about what sleep testing might be the most appropriate for you.

Host: Yeah, that's perfect. So much of how we perform during the day, how we function during the day has to do with our sleep. And there is help out there. So if folks are, you know, as you say, not waking up refreshed, if they're foggy during the day, if they're sluggish during the day, there's probably a cause for that. And it may or may not be how they're sleeping, but certainly this is something we could have addressed, to do the sleep study, find out for sure if CPAP is indicated, great. If not, what else can we do? So, thanks so much for your time today. You stay well.

Emily O'Brien: Thanks. You too. Have a great day.

Host: And for more information, go to genesishcs.org/services-search/sleep-medicine. And thanks for listening to Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. If you found this podcast to be helpful, please be sure to tell a friend and subscribe, rate and review this podcast and check out the entire podcast library for additional topics of interest. I'm Scott Webb. Stay well.