Age Matters: Family members can be first to notice symptoms of sleep apnea.

— Austin, Texas

I have found repeatedly that a concerned spouse leads to the diagnosis of sleep apnea more frequently than the patient complaining about the condition themselves.

This syndrome is one of a group of diseases that directly affects family members as much as the patient and sometimes in an unexpected fashion. The result is that a member of the family opens a dialogue about a complaint that results in a diagnosis.

In my opinion, SA is the silent underpinning of many chronic diseases in our country, ranging from diabetes to heart disease. It has been estimated that upwards of 20 million patients have SA. Many believe that it’s a disease of the elderly, but it occurs most often in those between the age of 40 and 50. Factors increasing the risk are being overweight, being African-American or having a first- or second-generation family member with the disease.

Snoring is a symptom of the condition, in which a patient can stop breathing anywhere from 10 seconds to upwards of 30 seconds per episode before starting to breathe again.

The result is daytime fatigue and a cascade of compensations our bodies use to deal with it. Over time, these compensations can lead to a growing list of serious complications, including heart disease, strokes, diabetes, weight gain and even accidents while at home or on the job due to the excessive sleepiness.

When diagnosing this condition, we recognize two main types: the more common obstructive sleep apnea and the less common central sleep apnea. OSA occurs when the airway is blocked by enlarged tonsils, the tongue or other tissues due to obesity. CSA is a neurological condition in which the brain doesn’t send out the appropriate signals for the control of respiration.

There are things a patient can do to help the situation. However, let me stress that alcohol hurts more than it helps. A drink before bed may make the patient feel sleepy at first, but studies show it will prevent the quality sleep needed. What’s worse is that it will also relax the tissues in the back of the throat, making it easier to block the airway. The same goes for sleeping pills.

The good news is that losing weight can decrease the size of tissues at the back of the throat blocking the airway. Stopping smoking can decrease the inflammation of those tissues, which also contributes to their size.

Sleep position plays a role, as well, as those who sleep on their backs have gravity pulling those tissues downwards, again blocking the airway. Sleeping on one’s side, positioning pillows or using a foam wedge to rest against, alleviates this problem. I have also seen patients use an oral orthodontic mouthpiece to maintain an open airway with good effect.

During the course of your evaluation, you will be referred to a sleep center for a test called a polysomnogram. Following this test, you and your doctor will have a good idea of the problem and what to do about it.

If sleep apnea is the diagnosis, treatment centers on a delivery of oxygen methodology called continuous positive airway pressure. This device forces a steady flow of oxygen into the airway, effectively keeping it open. CPAP takes a little getting used to, but over time and with successful use, it is an effective means of dealing with moderate to severe sleep apnea. Once the breaking-in phase is complete, patients have reported feeling much better in as little as one week.

Let me assure you that it is well-worth the investment in time and effort to get a good night’s sleep.