Ashlee Williams, MD (Host): Do you frequently wake up feeling drained, regardless of how much sleep you get? Or perhaps you struggle with snoring or persistent daytime fatigue? You're not alone. Millions of people are affected by sleep apnea, often without even realizing it.

Welcome to the Healthier You Podcast. I'm Dr. Ashlee Williams. And today, I'm joined by Dr. Keisha Sullivan, a double board-certified Sleep and Family Medicine physician here at Kaiser Permanente. She's here to share expert advice on recognizing the signs of sleep apnea and the latest treatment options, so you can start waking up feeling truly refreshed. Dr. Sullivan, thank you so much for being here today.

Keisha Sullivan, DO: Yes. Thank you for having me.

Host: Okay. So, we always like to start with the basics. What exactly is sleep apnea? And how does it affect the body?

Keisha Sullivan, DO: Sleep apnea is a very serious sleep disorder in which your breathing repeatedly starts and stops over the course of the night. The most common form of sleep apnea is obstructive sleep apnea, and that's when you have a physical obstruction of your airway that causes either a narrowing of the airway or a complete collapse of the airway, causing your brain and your other vital organs not to receive oxygen.

So basically, what happens is when your body does not receive the oxygen needed, your body releases adrenaline to help you wake up, move, reposition, and it's that adrenaline release that causes disrupted sleep, and therefore, affects daytime function. So when your body doesn't receive enough oxygen, it leads to disrupted sleep. And over time, it can cause issues such as high blood pressure, depression, fatigue, heart attacks, and even strokes.

Host: Wow. Pretty scary stuff. So, how do you know if you have sleep apnea? What are the most common signs and symptoms of sleep apnea that people should look out for?

Keisha Sullivan, DO: Some symptoms that you may notice may include loud snoring that's persistence. You may notice that you're waking up multiple times during the night. You may notice daytime sleepiness. Your loved ones may also be concerned because they see long pauses during your breathing or they may hear choking and gasping episodes during sleep.

Host: So, what lifestyle factors can contribute to sleep apnea? Like, who's most at risk for developing sleep apnea?

Keisha Sullivan, DO: Sleep apnea, it's multifactorial, a number of patients are overweight, but that's not always the cause for sleep apnea. It can also be family history. It can be a result of older age. For women, it can be a result of peri or postmenopause. And basically, what happens, especially when it's related to family history, it's anatomy. You know, if you or your loved ones look similar, it could be because you have smaller airways, you can have a deviated nasal septum, a large tongue, chronic nasal congestion, all of those things contribute to not breathing well. And if you don't breathe well, then you're not going to sleep well.

Host: Can you talk a little bit about what treatment options are available? We all know about CPAP and a lot of my patients come in like, "The mask on my face, it's just so much." What are other options that I have to CPAP?

Keisha Sullivan, DO: Yes. So in addition to the CPAP machine, you know, you can also try an oral appliance or a mandibular advancement device. This is something that you put in your mouth during sleep, looks very much so like a retainer. And the goal of the device is to force you to sleep with a slight underbite. And it's this underbite that helps open up the airway behind it, helping you to breathe easier.

You can also try losing weight. If you are able to lose at least 10% of your body weight, this can contribute to lowering your AHI or your apnea-hypopnea index, which we use to determine whether or not you have sleep apnea. You should also try to avoid alcohol and sedatives, anything that's going to relax your muscles, make you drowsy, those things can contribute to sleep apnea.

And if you have allergies or nasal congestion, it would be a good idea to kind of figure out what your triggers are. You know, talk to your doctor, you can see an allergist and, you know, possibly be tested for some of the allergens that may be treating the nasal congestion, which then again will lead to difficulty breathing.

In addition to treatment options, there are some surgical options that you could pursue. This would include seeing an Ears, Nose, and Throat doctor, Head and Neck specialists who could evaluate and possibly treat you for having enlarged adenoids or tonsils. If you have a deviated nasal septum, that could be straightened or a physical obstruction in Your nose, that can also be removed.

On the market currently, there are devices such as the hypoglossal nerve stimulator. This is a device that gets implanted inside your body. And basically, what it does is it senses your breathing. So every time you breathe, the device sends a signal to your tongue or your hypoglossal nerve telling it to contract, and it's that contraction that helps open up the airway behind it, therefore helping to open up your airway. So, these are some other options that can be considered to help in the treatment of sleep apnea.

Host: Wow, technology has very much advanced. Okay. So, say, you're recently diagnosed with sleep apnea, what are the first steps that you take to improve your sleep and overall health?

Keisha Sullivan, DO: So, after being diagnosed with sleep apnea, it's very important to talk to your doctor, to be treated for the sleep apnea, you want to control any factors, you want to adjust anything that is within your control, such as your weight, if you're able to lose some weight, you can try to do that. We want to make sure that you're sticking to a consistent sleep pattern, maximizing your sleep hygiene. You want to basically just increase your overall lifestyle, to help minimize some of the risks associated with sleep apnea. 

Host: Great tips. Well, thank you so much, Dr. Sullivan, for this great information. We learned a lot about sleep apnea, symptoms, and treatments. Here are the top takeaways: One. Sleep apnea is a serious health condition. Sleep apnea causes repeated interruptions in breathing during sleep. Left untreated, this can lead to daytime fatigue, headaches, an increased risk of heart disease, high blood pressure, and strokes.

Two, key symptoms often go unnoticed. Loud, chronic snoring. Gasping for air during sleep and excessive daytime sleepiness are common signs, and many people don't even realize that they have sleep apnea until a partner notices their symptoms.

Three, certain groups are at higher risk, being overweight, of older age, male, and having a small airway or large tonsils can increase your risk, and lifestyle habits like smoking, alcohol consumption can also worsen symptoms.

Four, there are many treatment options. CPAP is a gold standard, but alternatives include weight loss, tongue exercises, and surgical options, including hypoglossal nerve stimulation and devices like Inspire.

Managing sleep apnea is a journey. If you're newly diagnosed or think you have sleep apnea, work closely with your doctor. Follow prescribed treatments, adopt healthy lifestyle habits, and involve your partner. Sticking with treatment can lead to significant improvements in sleep quality and overall health.

For more information from sleep from Our experts, visit kp.org/doctor and listen to more episodes of Healthier You wherever you get your podcast. If you enjoyed this episode, be sure to subscribe and share it with others who may find it helpful. From all of us at Kaiser Permanente, be well.