Transcription:
Obstructive Sleep Apnea

Maggie McKay: If you continuously have trouble sleeping or the person you live with does, it can really affect your entire life from productivity to relationships and beyond. But sleep apnea could be the cause. And it's more common than you may think with about 200,000 cases a year in the US alone. Today we're discussing obstructive sleep apnea, what causes it, the symptoms, how to treat it, who's most likely to experience it and more.

Our guest is Dr. Ying Yang, a cardiologist at Montefiore St. Luke's Cornwall. Welcome to Doc Talk, presented by Montefiore St. Luke's Cornwall. I'm Maggie McKay. It's great to have you here, Dr. Yang. And as someone whose husband snores all the time, I am very interested in this topic.

Dr. Ying Yang: Thank you for have me here today, Maggie.

Maggie McKay: Of course. First of all, what is obstructive sleep apnea and how does it differ from other types of sleep apnea?

Dr. Ying Yang: That's a very interesting question. Most of the time people sleep at night, they breathe slowly and deeply. However, when patients have obstruction in their airway, they can develop obstructive sleep apnea. Those are the most common cause of sleep apnea in this country. There are other rare causes, that central sleep apnea, but that's something rarely seen and I think we can leave this to a pulmonologist to discuss in the future.

Maggie McKay: And how do you know if you have it? What are the symptoms? And is there a test for it?

Dr. Ying Yang: I, as a cardiologist, probably see more sleep apnea patients than a pulmonologist, because most of the patients in their mid age, men coming to see a cardiologist complaining of palpitations at night, poor asleep, shortness of breath, headache, lack of energy, dyspnea on exertion and elevated a blood pressure. Those are the most common symptoms suggesting you have sleep apnea.

Maggie McKay: And is there a test for it?

Dr. Ying Yang: Absolutely, yes. You're going to need to have a sleep study, which nowadays is mostly performed at home in your own bed at your comfort that you can have a machine that monitors your breathing pattern, measuring the oxygen level. And we will know the next day if you have sleep apnea or not.

Maggie McKay: Is that device called a CPAP?

Dr. Ying Yang: CPAP is the machine we use to treat sleep apnea. But for diagnostic purpose, there are machines that we use in the doctor's office that can be given to the patient to do the testing at home.

Maggie McKay: And if someone's claustrophobic for example, and they don't want to have something on their face, is there another way to treat sleep apnea besides the mask, the CPAP?

Dr. Ying Yang: That's a very interesting question. I remember the days when I started dealing with patients with sleep apnea. The mask is massive. It covers the whole face. Most of the patients cannot tolerate. But this has changed significantly over the years. Now, most of the people can use the nasal pillow, that's just only a small device over your nose. And it's not going to cause major compression or discomfort on your face.

Maggie McKay: That's great. So they have alternatives.

Dr. Ying Yang: That's correct.

Maggie McKay: Can sleep apnea affect your heart function? And if so, how?

Dr. Ying Yang: That's exactly the question. And I thank you for asking. That is why I see most of those patients and I send them for further evaluation by a pulmonologist. The reason is, if I leave those patient alone and tell you, "Hey, you have sleep apnea. Leave it alone. If you don't want a CPAP machine, that's okay," I'm not doing you good because overtime, with untreated sleep apnea, patients develop early high blood pressure. They will develop atrial fibrillation, which will lead to heart attack and stroke.

Maggie McKay: Wow. So it could lead to death if untreated.

Dr. Ying Yang: Absolutely, yes.

Maggie McKay: Is sleep apnea, more common in men or women?

Dr. Ying Yang: Sleep apnea is absolutely more common in men, but women can have sleep apnea and they don't have the typical body shape to suggest sleep apnea. So women should also pay attention to their sleep patterns. If they snore and if they have these symptoms during the day, drowsiness, headache. If so, don't hesitate to have it checked out.

Maggie McKay: And why is it that it's more common in men?

Dr. Ying Yang: That's a good question. I do not know. But I think general speaking, it's related to the size of the neck and to the crowdedness of the throat.

Maggie McKay: Is there a surgery you can have to get rid of it for good or does it ever last a lifetime?

Dr. Ying Yang: Doctors have thought about this many years ago. And we had tried all kinds of surgeries, but nothing proven effective. Therefore, the only treatment that we recommended nowadays for sleep apnea is the CPAP machine.

Maggie McKay: And there's no medicine?

Dr. Ying Yang: There's no medication. There's really no surgery.

Maggie McKay: Is it something you maintain or can you ever get rid of it permanently?

Dr. Ying Yang: That's really depending on what's the cause of the sleep apnea. Most of the time, we're seeing sleep apnea in patients with obesity. So weight control is definitely the first thing to go. However, there is a significant amount of patients that there is no weight-related issue, it's an anatomy-related issue. It basically means their airway is crowded. Their neck is crowded. Therefore, they can develop sleep apnea without a weight issue.

Maggie McKay: And besides losing weight, are there other ways to prevent it?

Dr. Ying Yang: Not really.

Maggie McKay: Is there any correlation between those people who snore and those who have sleep apnea? For instance, are you always a big snorer if you have sleep apnea?

Dr. Ying Yang: Generally speaking, patients who snore may or may not have sleep apnea. But patients with sleep apnea almost always snore because of the airway obstructions.

Maggie McKay: How much does lifestyle come into play with people who have obstructive sleep apnea?

Dr. Ying Yang: It's very, very important to control your weight. If your BMI is above 35, you do have increased risk of developing sleep apnea. So exercise regularly. Weight control is the very first thing we discuss with any patient with diagnosed sleep apnea.

Maggie McKay: Are there signs of sleep apnea that a patient could be aware of?

Dr. Ying Yang: People who wakes up frequently at night, feeling they may need to go use the bathroom, thought they have prostate problems. They kick a lot, we call it restless leg syndrome. If they snore heavily, they wake up in the morning with a dry mouth, sore throat and headache in the morning or they feel drowsy during the day, low energy, having difficult to concentrate, feeling they're having difficult to memorize things, feeling shortness of breath with exercise. Those are all the signs of possible sleep apnea.

Maggie McKay: And Dr. Yang, there's a new chin device that some are calling revolutionary when diagnosing sleep apnea. What's that about?

Dr. Ying Yang: The whole idea of sleep apnea is around the neck area. There's obstruction. So the air cannot get into the lungs freely. So anything that can open up the airway is the treatmeant. Same thing as the idea we talked earlier about, to do an operation, open up the airway and the path, as this chin-lifting device is try to see without any invasive procedure, are we able to lift up or open up your airway. But it is depending case by case. Most of the time, it doesn't work.

Maggie McKay: So is there anything else you'd like to add that we didn't cover about sleep apnea?

Dr. Ying Yang: I would say, try to avoid any heavy alcohol use or any sleeping pills if you know you have sleep apnea because that can worsen your sleep condition at night. And get tested and get treated as soon as possible.

Maggie McKay: And what kind of doctor do you go to first if you think you have it?

Dr. Ying Yang: The pulmonary doctor is the one you go to have a sleep study.

Maggie McKay: All right. Thank you so much for sharing your knowledge with us. We appreciate your time and this has been so helpful and educational.

Dr. Ying Yang: Thanks for having me, Maggie.

Maggie McKay: Again, that's Dr. Ying Yang, a cardiologist at Montefiore St. Luke's Cornwall. Thank you for listening to Doc Talk, presented by Montefiore St. Luke's Cornwall. For more information about sleep medicine, please visit montefioreslc.org. That's montefioreslc.org. And please remember to subscribe, rate and review this podcast and all other Montefiore St. Luke's Cornwall podcasts. If you found this podcast helpful, please share it on your social channels. And be sure to check out all the other Doc Talk episodes. Until next time, I'm Maggie McKay. Be well.