Sleep apnea, and other sleep disorders, can have serious consequences if not treated. Not getting proper sleep can negatively impact your health in so many ways. It can affect your job, your personal relationships, and impair your ability to operate a motor vehicle safely.
Listen as Matt Rees, Supervisor, Sleep Disorders Center at Hendricks Regional Health, discusses the importance of quality sleep and the treatments available to help you finally get a good night's sleep.
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Do You Suffer from Sleep Apnea? There is Help
Featured Speaker:
Matt Rees
Matt Rees is the Supervisor at the Sleep Disorders Center at Hendricks Regional Health. Transcription:
Do You Suffer from Sleep Apnea? There is Help
Melanie Cole (Host): Sleep apnea and other sleep disorders can have serious consequences if not treated. Not getting proper sleep can negatively impact your health in so many ways. My guest today is Matt Rees. He's the supervisor at the Sleep Disorder Center with Hendricks Regional Health. Welcome to the show, Matt. So, first tell the listeners what is sleep apnea?
Matt Rees (Guest): Yes, so the most common type of sleep apnea is called “obstructive sleep apnea” and it's actually caused by an obstruction in the back of the throat during the night while you sleep and that obstruction, typically, is the tongue, the tonsils, the uvula, that little punching bag in the back of your throat. Those will all kind of fold together, or can, and completely obstruct the airway and cause a lot of loud snoring, gasping for breath. What this does to your sleep, though, is while you're fighting for breath, and you don't know it because you're asleep, it constantly interrupts the sleep cycle and keeps you from getting into the deeper stages of sleep where the body shuts down and gets the good rest. Instead, you kind of ping-pong back and forth in the lighter stages of sleep and it just doesn't make for a good night's sleep.
Melanie: So, would you know if you had sleep apnea, or is it usually a loved one or somebody who shoves you into a doctor or sleep disorder center because they say "I'm sick of this and your snoring"? Tell us symptoms of it.
Matt: Yes, exactly. It's usually your spouse can tell you because there can be a lot of tossing and turning, a lot of loud snoring. Snoring's usually the big first cue. Now, some people can sleep through terrible sleep apnea all night long and not even know it's going on and that's where a spouse comes in handy, but some people actually physically wake up gasping for breath and so, they can tell that there's something going on at night that's not quite right. Now, as far as how it impacts you during the day: difficulty concentrating, increased irritability, all those symptoms of just being groggy and tired. Some people get so tired that they'll fall asleep while they're driving. That's where sleep apnea gets really dangerous. We have people who have apnea so bad they can fall asleep during a conversation. So, that's kind of what you start to look for as far as daytime symptoms.
Melanie: No kidding? And, those are pretty much good red flags, Matt, for people.
Matt: Yes, absolutely.
Melanie: Now, we hear a lot in the media about various treatments for sleep apnea. Now, first, actually, go back. Are there some risk factors? Is there something? Is it genetic? Is it mainly people that are overweight or eat late? Are there some things that contribute to it?
Matt: Yes, typically with obstructive sleep apnea, weight is to blame. It doesn't have to be a lot of weight, either. It can just be 15, 20 pounds overweight and by the time we get to middle age, a lot of us have packed on that much extra weight, so it's a big problem in my age group. I'm in my 40s, so. Anyway, not only do we gain weight around our middle, but we gain it around our face, too, and that can make the airways smaller, so weight gain is typically to blame. Now, some people can have anatomical features that just make them prone to sleep apnea. A big jaw and tongue, a skinny neck; those combined can cause problems, and large tonsils. Typically, those folks, though, they have had sleep problems their whole life. When it's weight related, generally, people can remember a time when "I didn't snore. I slept pretty good, and now things have changed." Well, let's look at the weight change and see if that's the reason.
Melanie: So, now we're looking to diagnosis, and people hear about sleep studies and sleep disorder centers where they're supposed to go. Can you go to a sleep study and get a decent enough sleep that you guys can see whether or not we're getting a good night's sleep? I mean, can people sleep in sleep studies?
Matt: Yes, absolutely. Yes, we bring you to a strange place in a hospital, have you sleep in a strange room, put a bunch of wires on you and we say "Sleep like you do at home." Sounds impossible, but people do sleep pretty well. It's rare that we have somebody that doesn't sleep at all during the night. We try to get 7-8 hours of sleep but, generally, if we can get over the four-hour hump, we've got enough data to at least get a diagnosis going. So, yes, people do come here, they sleep pretty well. Here at Hendricks, and a lot of other sleep centers, though, we try to make it more like a hotel room. You're not going into a hospital room, you're not going into a hospital bed, we have nice select comfort queen-sized bed, you can adjust it to whatever you want. It's like spending the night in a hotel.
Melanie: So, then, once you've diagnosed somebody with sleep apnea; and again, we hear through the media about c-paps and about some of the treatments for sleep apnea, so, Matt, if you would, speak about those treatments and the adherence to those treatments which would make it an effective treatment?
Matt: Yeah, so nasal c-pap is the most common treatment for sleep apnea and c-pap stands for “continuous positive airway pressure”. It's just this little machine that sits on the nightstand and it's hooked to a mask that you wear over your nose, and what that machine is doing is blowing positive pressure through your nose to the back of your throat and that pressure splints the airway. It keeps the airway open, keeps the tongue where it should be, and the tonsils, the uvula. All of that is separated. And then, you breathe normally, sleep normally. So, that's the number one go-to treatment. It's non-invasive. It works for most people, and it'll quickly get you sleeping better and feeling better, which is the goal we want. Now, once people get feeling better--here's the problem with sleep apnea--when you're tired all the time, it's very difficult to look at the weight end of things, but if we can get you feeling better with c-pap and you want to direct that new energy towards losing weight, then potentially somebody can come off the c-pap. Another common treatment, it's kind of become a nice backup now, and it's getting more and more use, is an oral appliance device. Now, these aren't for everybody. Generally, they do very well with mild to moderate sleep apnea and these are made by a dentist, and not just any dentist, a dentist who's been schooled in sleep medicine. And, what they do is they'll take impressions of your mouth, and then they'll make what kind of looks like a mouth guard that you wear at night, and what it does is it juts the jaw forward just a few millimeters and for some types of apnea, that's enough to open up the airway and solve the problem. So, that's good for folks who can't tolerate c-pap or people who have mild sleep apnea and they want to feel better, but they don't want to have to wear c-pap, that's kind of a backup plan. Used to be surgery was a recommendation and they'd go in and they'd take out the tonsils, the uvula and we kind of called it "ice cream scooping" the back of the throat; they'd use a laser to create scar tissue back there to kind of tighten things up, but it's a lot of surgery to go through and it only had a 50% success rate. So, over the years, that recommendation's kind of tapered off. Now, sometimes, an ear, nose, and throat specialist can look back there and say "Oh, yeah, we can find some room here," and so it might be appropriate for some people.
Melanie: Is there medicational intervention? Because people take sleep medicine all over the country now by the millions and do these kinds of medications to help you get a good night's sleep, do they interfere or do they affect sleep apnea or sleep disorders?
Matt: They can. Just speaking about sleep apnea, if you're taking a medication to help you sleep, and it's knocking you out, then it can mask the problem for you. It won't for your spouse. Anything that's a muscle relaxer, and we're talking about alcohol as well, those will make sleep apnea worse than what it is. So, yes. Different medications will affect you in that way. Right now, there's not really a medication that helps sleep apnea or that can help correct it.
Melanie: And, what about lifestyle changes, Matt? When you tell your patients, you know, after they've gone through that sleep study, what you would like them to do about lifestyle changes and good sleep hygiene? Do any of these things help or affect sleep apnea?
Matt: Yeah, absolutely. Once people get on c-pap, I mean, they're glad that they have it. They're feeling better, but it's not something that everyone wants to sign up for to wear at night, so we encourage patients that it can be a weight issue and you're going to have a lot of energy now that you're on c-pap, you're going to feel a lot better during the day, so if you want to channel that into losing weight, we can probably get you off the c-pap at some point. So, it's a good motivator, as well.
Melanie: Well, thank you. So, in just the last few minutes, just tell us about your team at the Sleep Disorder Center with Hendricks Regional Health and give us your best advice for people that may be suffering from sleep apnea.
Matt: Yes. Well, we just expanded here at the sleep center. We used to be a four-bed lab and now we do six a night, which, for the patient, what that means is, we used to have a two-month waiting list, but now we can get you in in just a few weeks, so that was a big improvement there. We have a fantastic staff and they're excellent at making you feel comfortable. You shouldn't come in here with any anxiety, it's just going to be an easy experience for coming and spending the night in the hospital. As far as getting the ball rolling, if you think you might have sleep apnea, you can go to your family doctor, certainly. Most family doctors can listen to your symptoms and decide whether a sleep study is appropriate, and then go ahead and order one for you. Then we'll get you in here and get it done. But also, we have sleep specialists; we have two here, Dr. Eric DeWeese and Dr. Jesse Lee, and you can just make an appointment with them to be seen by a sleep specialist and they'll do the same thing and get you in here.
Melanie: Thank you so much for being with us today, Matt. It's great information. You're listening to Health Talks with HRH, Hendricks Regional Health and for more information, you can go to www.hendricks.org. That's www.hendricks.org. This is Melanie Cole. Thanks so much for listening.
Do You Suffer from Sleep Apnea? There is Help
Melanie Cole (Host): Sleep apnea and other sleep disorders can have serious consequences if not treated. Not getting proper sleep can negatively impact your health in so many ways. My guest today is Matt Rees. He's the supervisor at the Sleep Disorder Center with Hendricks Regional Health. Welcome to the show, Matt. So, first tell the listeners what is sleep apnea?
Matt Rees (Guest): Yes, so the most common type of sleep apnea is called “obstructive sleep apnea” and it's actually caused by an obstruction in the back of the throat during the night while you sleep and that obstruction, typically, is the tongue, the tonsils, the uvula, that little punching bag in the back of your throat. Those will all kind of fold together, or can, and completely obstruct the airway and cause a lot of loud snoring, gasping for breath. What this does to your sleep, though, is while you're fighting for breath, and you don't know it because you're asleep, it constantly interrupts the sleep cycle and keeps you from getting into the deeper stages of sleep where the body shuts down and gets the good rest. Instead, you kind of ping-pong back and forth in the lighter stages of sleep and it just doesn't make for a good night's sleep.
Melanie: So, would you know if you had sleep apnea, or is it usually a loved one or somebody who shoves you into a doctor or sleep disorder center because they say "I'm sick of this and your snoring"? Tell us symptoms of it.
Matt: Yes, exactly. It's usually your spouse can tell you because there can be a lot of tossing and turning, a lot of loud snoring. Snoring's usually the big first cue. Now, some people can sleep through terrible sleep apnea all night long and not even know it's going on and that's where a spouse comes in handy, but some people actually physically wake up gasping for breath and so, they can tell that there's something going on at night that's not quite right. Now, as far as how it impacts you during the day: difficulty concentrating, increased irritability, all those symptoms of just being groggy and tired. Some people get so tired that they'll fall asleep while they're driving. That's where sleep apnea gets really dangerous. We have people who have apnea so bad they can fall asleep during a conversation. So, that's kind of what you start to look for as far as daytime symptoms.
Melanie: No kidding? And, those are pretty much good red flags, Matt, for people.
Matt: Yes, absolutely.
Melanie: Now, we hear a lot in the media about various treatments for sleep apnea. Now, first, actually, go back. Are there some risk factors? Is there something? Is it genetic? Is it mainly people that are overweight or eat late? Are there some things that contribute to it?
Matt: Yes, typically with obstructive sleep apnea, weight is to blame. It doesn't have to be a lot of weight, either. It can just be 15, 20 pounds overweight and by the time we get to middle age, a lot of us have packed on that much extra weight, so it's a big problem in my age group. I'm in my 40s, so. Anyway, not only do we gain weight around our middle, but we gain it around our face, too, and that can make the airways smaller, so weight gain is typically to blame. Now, some people can have anatomical features that just make them prone to sleep apnea. A big jaw and tongue, a skinny neck; those combined can cause problems, and large tonsils. Typically, those folks, though, they have had sleep problems their whole life. When it's weight related, generally, people can remember a time when "I didn't snore. I slept pretty good, and now things have changed." Well, let's look at the weight change and see if that's the reason.
Melanie: So, now we're looking to diagnosis, and people hear about sleep studies and sleep disorder centers where they're supposed to go. Can you go to a sleep study and get a decent enough sleep that you guys can see whether or not we're getting a good night's sleep? I mean, can people sleep in sleep studies?
Matt: Yes, absolutely. Yes, we bring you to a strange place in a hospital, have you sleep in a strange room, put a bunch of wires on you and we say "Sleep like you do at home." Sounds impossible, but people do sleep pretty well. It's rare that we have somebody that doesn't sleep at all during the night. We try to get 7-8 hours of sleep but, generally, if we can get over the four-hour hump, we've got enough data to at least get a diagnosis going. So, yes, people do come here, they sleep pretty well. Here at Hendricks, and a lot of other sleep centers, though, we try to make it more like a hotel room. You're not going into a hospital room, you're not going into a hospital bed, we have nice select comfort queen-sized bed, you can adjust it to whatever you want. It's like spending the night in a hotel.
Melanie: So, then, once you've diagnosed somebody with sleep apnea; and again, we hear through the media about c-paps and about some of the treatments for sleep apnea, so, Matt, if you would, speak about those treatments and the adherence to those treatments which would make it an effective treatment?
Matt: Yeah, so nasal c-pap is the most common treatment for sleep apnea and c-pap stands for “continuous positive airway pressure”. It's just this little machine that sits on the nightstand and it's hooked to a mask that you wear over your nose, and what that machine is doing is blowing positive pressure through your nose to the back of your throat and that pressure splints the airway. It keeps the airway open, keeps the tongue where it should be, and the tonsils, the uvula. All of that is separated. And then, you breathe normally, sleep normally. So, that's the number one go-to treatment. It's non-invasive. It works for most people, and it'll quickly get you sleeping better and feeling better, which is the goal we want. Now, once people get feeling better--here's the problem with sleep apnea--when you're tired all the time, it's very difficult to look at the weight end of things, but if we can get you feeling better with c-pap and you want to direct that new energy towards losing weight, then potentially somebody can come off the c-pap. Another common treatment, it's kind of become a nice backup now, and it's getting more and more use, is an oral appliance device. Now, these aren't for everybody. Generally, they do very well with mild to moderate sleep apnea and these are made by a dentist, and not just any dentist, a dentist who's been schooled in sleep medicine. And, what they do is they'll take impressions of your mouth, and then they'll make what kind of looks like a mouth guard that you wear at night, and what it does is it juts the jaw forward just a few millimeters and for some types of apnea, that's enough to open up the airway and solve the problem. So, that's good for folks who can't tolerate c-pap or people who have mild sleep apnea and they want to feel better, but they don't want to have to wear c-pap, that's kind of a backup plan. Used to be surgery was a recommendation and they'd go in and they'd take out the tonsils, the uvula and we kind of called it "ice cream scooping" the back of the throat; they'd use a laser to create scar tissue back there to kind of tighten things up, but it's a lot of surgery to go through and it only had a 50% success rate. So, over the years, that recommendation's kind of tapered off. Now, sometimes, an ear, nose, and throat specialist can look back there and say "Oh, yeah, we can find some room here," and so it might be appropriate for some people.
Melanie: Is there medicational intervention? Because people take sleep medicine all over the country now by the millions and do these kinds of medications to help you get a good night's sleep, do they interfere or do they affect sleep apnea or sleep disorders?
Matt: They can. Just speaking about sleep apnea, if you're taking a medication to help you sleep, and it's knocking you out, then it can mask the problem for you. It won't for your spouse. Anything that's a muscle relaxer, and we're talking about alcohol as well, those will make sleep apnea worse than what it is. So, yes. Different medications will affect you in that way. Right now, there's not really a medication that helps sleep apnea or that can help correct it.
Melanie: And, what about lifestyle changes, Matt? When you tell your patients, you know, after they've gone through that sleep study, what you would like them to do about lifestyle changes and good sleep hygiene? Do any of these things help or affect sleep apnea?
Matt: Yeah, absolutely. Once people get on c-pap, I mean, they're glad that they have it. They're feeling better, but it's not something that everyone wants to sign up for to wear at night, so we encourage patients that it can be a weight issue and you're going to have a lot of energy now that you're on c-pap, you're going to feel a lot better during the day, so if you want to channel that into losing weight, we can probably get you off the c-pap at some point. So, it's a good motivator, as well.
Melanie: Well, thank you. So, in just the last few minutes, just tell us about your team at the Sleep Disorder Center with Hendricks Regional Health and give us your best advice for people that may be suffering from sleep apnea.
Matt: Yes. Well, we just expanded here at the sleep center. We used to be a four-bed lab and now we do six a night, which, for the patient, what that means is, we used to have a two-month waiting list, but now we can get you in in just a few weeks, so that was a big improvement there. We have a fantastic staff and they're excellent at making you feel comfortable. You shouldn't come in here with any anxiety, it's just going to be an easy experience for coming and spending the night in the hospital. As far as getting the ball rolling, if you think you might have sleep apnea, you can go to your family doctor, certainly. Most family doctors can listen to your symptoms and decide whether a sleep study is appropriate, and then go ahead and order one for you. Then we'll get you in here and get it done. But also, we have sleep specialists; we have two here, Dr. Eric DeWeese and Dr. Jesse Lee, and you can just make an appointment with them to be seen by a sleep specialist and they'll do the same thing and get you in here.
Melanie: Thank you so much for being with us today, Matt. It's great information. You're listening to Health Talks with HRH, Hendricks Regional Health and for more information, you can go to www.hendricks.org. That's www.hendricks.org. This is Melanie Cole. Thanks so much for listening.