Caitlin Whyte: Sleep is so, so critical to our everyday health and wellbeing. I know when I wake up and I'm still too tired, it's not gonna be a good day. So here with us today to talk about sleep and sleep apnea is Sadie Olson, a clinical sleep coordination specialist at Upland Hills health. This is the Inspire Health Podcast from Upland Hills Health. I'm Caitlin Whyte. Well, Sadie to begin our episode today, tell us why sleep apnea is such a big deal. It seems like so many people have it.

Sadie Olson: Yeah, sleep apnea. It is a serious medical disorder and it's characterized by abnormal or interrupted breathing during sleep. So it's where you're partially or fully obstructing in your airway. That's obstructive sleep apnea. A breathing event is where when you're fully, you're partially obstructed. It lasts at least 10 seconds. It could be happening hundreds of times during the night, many times causing little arousals in your brain during sleep.

And this disrupted sleep can cause fatigue throughout the day. It can lead to poor job performance. It increases the likelihood of vehicle and work related accidents, which is huge. Nowadays mental health also suffers. It leads to an increased risk of irritability, moodiness, even depression, very highly linked with obstructive sleep apnea. It can also put a sufferers at risk for high blood pressure. There's actual studies that show that obstructive sleep apnea causes high blood pressure.

Other cardiovascular diseases and conditions can be associated with sleep apnea, stroke, diabetes, metabolic syndrome, and even problems with surgeries. There's about 30 million people in the United States that have sleep apnea. And it's estimated, that's estimated. Only 6 million right now are diagnosed with the conditions. So, it is a big problem, and yeah, a lot of people have it.

Caitlin Whyte: Wow. So it sounds like a lot is going on when an apnea event happens. You touched on this already, but can you get more into the details? What is happening in your body when you suffer from sleep AP?

Sadie Olson: So when you have a sleep apnea event or a breathing event where you're partially, you're fully obstructing in your airway, you're. Oxygen tends to dip. but also your heart rate goes up, your CO2 goes up, and your blood pressure can go up and down during these events.

and what drives people to breathe normal? A normal individual is that co2. If that CO2 is off, that brain does not like that. So imagine you, you pause your breathing and you hold your breath. you're prone to wanna breathe again. That's what's happening during your sleep. But your brain has to wake up in order to tell your body or your airway to open up again and breathe.

So typically people have these, these obstruction like events, and that CO2 is screaming to the brain. wake up. We need to breathe. And typically people snort and kind of move around. They might not realize that they're doing that hundreds of times a night, which it's severe enough when it's happening hundreds of times a night.

And what that does to the body is, Untreated sleep apnea can actually cause high blood pressure. It can lead to increased risk of heart disease. stroke, it's also a very prominent thing when we think.

Drowsy driving. People are, very tired when they have sleep apnea, cuz if you're waking up and having these little mini arousals in your brain, hundreds of times a night, you're bound to be tired. You are not getting the, sound sleep that you should be getting. Your sleep is very fragmented and so that reeks havoc on your hormones, and your cardiovascular system.

So it all comes into play. The reason people have sleep apnea might be the anatomy of their airway, excess weight. even recess jaws are possible increased likelihood of sleep apnea. so the signs are the snoring, the restless sleep, the. people who are very tired during the day, morning headaches are another sign.

and we look at, things like the anatomy of your airway, the size of your neck, weight and height are factors, things like that. So definitely these are all things we look at that can play a role and, be the cause of sleep apnea.

Caitlin Whyte: Interesting. Okay. So when it comes to diagnosis, a sleep study is a great way to learn more about what happens I guess, in your sleep. So what does that study look like? What does a sleep tech look at that could provide some clues to the degree of apnea a patient would be experiencing.

Sadie Olson: Yeah. So typically the gold standard is a, it's called an nocturnal polysomnogram. That's an in lab sleep study. During that test, you're all hooked up to all the equipment that monitors your heart, your lung and brain activity, breathing patterns, arms and leg movements, also blood oxygen, and carbon dioxide levels while you sleep. And so when you're in that slumber in a high tech sleep lab, that looks like a comfortable hotel.

The technologist that's doing this study is in a room nearby. And they record your brain activity and information from your body, from all of that. All of this data that's collected is revealed in the detailed picture of your unique sleep patterns that we look at, including how much time you've spent in light and deep sleep, whether you're receiving enough oxygen, how often you wake up all of these things. We're scoring the sleep study through the night, determining that stage of sleep. If you have any breathing events, we're marking those.

If you have leg kicks, we're marking those. If you have. Abnormal EKG. If you have arousals, we're marking all of that throughout the night. All of that with continuous live monitoring, by that tech, we're able to recreate a report that's then sent to the sleep specialist for interpretation, and that has all the data ready for him or her to interpret. That again includes the total number of arousals the total number of breathing events, lowest oxygen recorded, any abnormalities noted, total number of leg kicks. All of that.

Then we get into a detailed report. And in terms of verifying sleep apnea and how severe sleep apnea is, we take the total number of breathing events throughout the night and average it out. How many times per hour a person has a breathing event. So that gives us the severity of sleep apnea. Or if a person has sleep apnea, it's called an index. It's very common in the sleep world. So in terms of breathing events five and under is considered normal, five breathing events per hour, five to 15 per hour is considered mild sleep apnea.

15 to 35 breathing events per hour is considered moderate sleep apnea. And anything 35 breathing events per hour and over is considered severe sleep apnea. And many a times we're in the severe range with people and they don't realize it.

Caitlin Whyte: Okay. So then what happens after this study? I mean, what do different treatment options look like?

Sadie Olson: Yeah. So once that sleep specialist reviews the study in its entirety, and gets the report to us. They determine the next best treatment plan. Keep in mind that someone who's severe enough on that first night, they come in, they may be treated that same night by the technologist. There's certain protocols we have to follow to determine who gets therapy on the same night, who may have to come back. So some people may have to come back for second night, study for treatment for various reasons. If that's the case, the doctor will interpret the study, and make that determination.

And then the patient will be contacted and go with that plan. There's many times that a patient, we may not have been able to find the right pressure or anything on that same night when they have to come in. So sometimes patients need to come in for a second night for the treatment they may need there's different treatment options for sleep apnea. The CPAP I'm sure many people have heard of that. It's called continuous positive airway pressure, but some people need a little bit different than CPAP. Some people may need special things.

Called BiPAP, where it's a BI level pressure, one pressure breathing in and a lesser pressure breathing out. For whatever health reasons they have or whatever treatment that we go about, they may need this there's we go as far as having like an external ventilator on some patients because they're that complicated or severe. So it really, really depends on the person. And how many nights they may have to come in, and what type of treatment they need. Some people need oxygen, blood in each case is very different. And so it's a progressive approach. Not everybody is just like a one night fixes all type of thing. If that makes sense.

Caitlin Whyte: No, absolutely. Well, as we wrap up here today, Sadie, so many people are using technology to track their health these days with their phones and watches. And this helps even with your sleep. Can you tell us about these devices or apps? There are things we can use at home to kind of track our own sleep.

Sadie Olson: Sleep trackers. They're becoming more and more common. They can provide us with valuable insight and patients with valuable insight as well. It's important to understand what you're looking at. So we encourage people to bring it in if they're questioning it or anything like that, but it basically monitors your sleep patterns for clearer picture of how much quality sleep you're getting, how much sleep you're getting and the quality you're getting. You can use this to help optimize your sleep experience.

A lot of them have coaching ability with it. While the in lab based sleep tests, generally track patterns directly through that brain wave of activity. These sleep trackers tend to rely on sensors to detect other physical signs that give us whether you're sleeping or not. And how well you're sleeping, like heart rate, body movement, and these wearable devices. The sleeper throughout the night measure that data. Other trackers that aren't wearable are like the mattress ones. I'm sure you've seen ads for mattresses that can help track your sleep, or there's some even that are next to the bed and that can collect the information as well.

Some are good quality, some are less quality and all of it goes through, and whatever algorithm that they've developed for that to help analyze and display the results for people. So it does help us as clinicians to see what your sleep's been like at home. And it aids us in getting the whole picture from you, obviously best, like I said, gold standard is an in lab sleep study. Some people kind of know where they're at though with these trackers. And it helps again, give us more information on what you're doing during the night.

Caitlin Whyte: Well, just a wonderful episode, Sadie. Thank you so much for joining me today. Talk to your primary care provider. If you are struggling with getting good quality sleep, ask about the sleep studies available through the heart long and sleep center at Upland Hills Health in Dodgeville, Wisconsin. This has been the Inspire Health Podcast from Upland Hills Health. I'm Caitlin Whyte. Be well.