Thursday, December 14, 2006

Sleep Test

David is not here. Have you heard of a sleep test? That's what he is doing. I suspect he is not sleeping though. I wouldn't be. The test includes being hooked up to machines via wires. What happens when he wants to turn over? Anyway, his doctor wants to see if he has sleep apnea. I guess approximately 30 million Americans are victims of this sleep disorder with many millions more predisposed and at high risk of developing the illness. For adult males, the odds are about 50/50 that their breathing is not normal when sleeping.

For the record, I think David's breathing is normal while sleeping. However, research shows that it is imperative that anyone who might have this problem or is predisposed, or knows someone they care about who has the problem, should have the clearest possible understanding about it.

So, here we go...

David told his doctor that sometimes he feels like he stops breathing in his sleep. He added that I sometimes wake him up because I think he has stopped breathing. I don't think he told his Doctor that I have an anxiety disorder and I frequently think people stop breathing. I check the kids at least once a night to make sure they are still on the inhale. At the theater the other night (for Flicka!), a kid behind me started coughing. I checked to make sure he was still breathing. It's what I do. I don't know why.

What is Obstructive Sleep Apnea (OSA)?

People with Obstructive Slee Apnea (technical term - don't expect you to understand it) or OSA, as we call it, experience recurrent episodes during sleep when their throat closes and they cannot suck air into their lungs (apnea). This happens because the muscles that normally hold the throat open during wakefulness relax during sleep and allow it to narrow. When the throat is partially closed and/or the muscles relax too much, trying to inhale will suck the throat completely closed and air cannot pass at all. This is an obstructive sleep apnea episode.

Oh my gosh! WHAT?? Is this saying that David's throat is completely closing and air cannot pass at all??

A cessation of breathing must last 10 seconds or more to be called an apnea. Obstructive apnea episodes can last as long as two minutes and are almost always associated with a reduction in the level of oxygen in the blood.

TWO MINUTES??? WHO CAN STOP BREATHING FOR TWO MINUTES??

When an individual is in the midst of an obstructive sleep apnea episode, as long as sleep continues, the apnea continues. It is only terminated and the victim's life is saved by waking up.

LIFE SAVED?? WHAT??

This arousal instantly increases the activity of the muscles of the tongue and throat muscles that enlarge the airway. The victim will be able to breathe and to once again fill the lungs with life-giving oxygen. This cycle may be repeated hundreds of times a night while the sufferer has no idea it is happening.

WHAT A WONDERFUL WAY TO SUFFER - HAVING NO IDEA YOU ARE!

What are the cardinal symptoms?

* Fatigue and tiredness during the day.
YUP, HE'S GOT THAT!

* Loud snoring; if the loud snoring is repeatedly punctuated by brief periods of silence or choking sounds, the individual is certain to have obstructive sleep apnea.
NOPE, RARELY SNORES. OF COURSE, HE'S NOT BREATHING...

Other common features are:
* Obesity - I THINK NOT. POOR GUY IS STARVING...
* Small jaw, thick neck - HOW ABOUT A THICK HEAD?
* High blood pressure - HOW BOUT RAISING OTHER PEOPLE'S BLOOD PRESSURE??
* Restless sleep; the repeated struggle to breath can be associated with a great deal of movement. - NOPE - HE IS OUT WITHIN TWO MINUTES, NEVER TO MOVE AGAIN EXCEPT WHEN KIT KAT WALKS ACROSS HIS HEAD.
* Depressed mood and/or irritability - NO COMMENT.
* Reduced sex drive and impotence - AHHH, NO.
* Snorting, gasping, choking during sleep - WHERE HAVE I BEEN?? I AM THE LIGHT SLEEPER HERE - AIN'T HAPPENING!

Not as commonly reported but may be present:

* Feeling that sleep is strangely unrefreshing - WE HAVE TWO SMALL CHILDREN!
* Difficulty concentrating - I CAN'T STOP LAUGHING...
* A dry mouth upon awakening - I AM GOING TO START CHECKING FOR DROOL.
* Excessive perspiration during sleep - NOPE. EXCEPT WHEN HE FORGETS TO TURN THE HEATING BLANKET OFF.
* Heartburn - AHHH, YES. FINALLY, ONE!
* Rapid weight gain - NOPE - HATE HIM FOR IT!
* Morning headaches - WHAT IF HE IS A MORNING HEADACHE?
* Change in personality - WELL, WELL, WELL...
* Memory lapses - AND HE ACUSES ME OF NOT TELLING HIM ANYTHING!!
* Intellectual deterioration - HE CONTINUES TO HAVE A MIND LIKE A STEEL TRAP!
* Frequent nocturnal urination (nocturia)- THAT SOUNDS BAD, BAD. I DON'T THINK SO IF IT IS WHAT I THINK IT IS.
* Confusion and severe grogginess upon awakening - THAT IS ME!!
* Specially in young children, large tonsils and adenoids. There may be chest retraction during sleep (the sternum and the spaces between ribs pull unnaturally inward when trying to inhale)
HANG ON, I HAVE TO GO CHECK THE KIDS AGAIN!

How serious is OSA?
DANG SERIOUS, OBVIOUSLY!

Depending on the degree of severity, OSA is a potentially life-threatening condition. Someone who has undiagnosed severe obstructive sleep apnea is likely to have a heart attack,
WHAT???
a stroke,
OH, COME ON!
cardiac arrest during sleep,
OH GREAAAATTTTT!
or a harmful accident.
HARMFUL ACCIDENT? THEY LOST ME THERE. WHAT, FALLING OUT OF BED?

In addition, awakening to breathe hundreds of times in a single night causes the victim to become very sleep deprived. There is a constant risk of serious accidents such as falling asleep while driving as well as impaired function in the workplace and in personal relationships.
OKAY, HMMM, THAT COULD EXPLAIN A FEW THINGS...

All of the negative consequences of OSA increase as severity increases. Untreated OSA tends to progressively worsen and sooner or later will result in partial or complete disability and death.
OH MY GOSH!!!

You can do a number of simple things that will convert your suspicions into certainty. The best first step is to involve your spouse or other family member. He or she can audiotape or videotape you while you are sleeping.
THAT SOUNDS LIKE IT COULD BE GREAT FUN!!

The sounds and repeated silences and struggles to breath are highly characteristic.
WELL, MAYBE NOT!

A sleep disorders centeris where David is at tonight for a recommended all night sleep study. This test will absolutely prove the presence or absence of OSA, and perhaps more important, will yield a clear indication of the severity of the problem. The all night test is called a polysomnogram. The following functions are always continuously monitored: air flow, respiratory effort, blood oxygen level, snoring, and body position. Brain waves, eye movements, and muscle activity may also be monitored. The test involves no pain and is covered by insurance. When the test is performed in a sleep disorders center, you are monitored and observed by a sleep technologist, videotaped, and connected to a variety of sensors which are typically placed on your scalp, eyes, nose, finger, chin, chest, abdomen and legs.
TOLD YOU HE WASN'T SLEEPING!!

The most commonly prescribed treatment for obstructive sleep apnea is continuous positive airway pressure (CPAP). The CPAP machine delivers air pressure through a small nasal mask that the patient wears while sleeping. The pressure acts as an "air splint" which keeps the throat open eliminating obstructive apneas and allowing you to breathe normally all night long. Sleep becomes uninterrupted and restorative. For many patients, CPAP therapy dramatically improves their daytime functioning as well as their general health. CPAP is not a cure, but a noninvasive therapy for managing OSA.

OH MY - NOW I DON'T THINK I WILL BE ABLE TO SLEEP EITHER!