Does your spouse insist on sleeping in a different room?
That may seem to be the realm of marriage counseling, but pulmonary specialists at Tanner Clinic say it’s actually a tell-tale sign of sleep apnea.
Snoring doesn’t always mean sleep apnea, but all sleep apnea sufferers snore — loud, jagged and impossible to ignore.
“If the spouse sleeps in another room, that’s a good indicator that we should have him tested,” says Brady Tucker, a physician assistant (PA-C) in Tanner Clinic’s pulmonary division.
Apnea is a chronic condition that keeps you up at nights — literally. The muscles that open your airway to breathe don’t work, and your brain wakes you up when it gets the signal you’re not breathing.
And generally the snorer is not the only one it disturbs. Plenty of spouses can attest to this common cycle — the sleeper stops breathing; then, after a silent few seconds, gasps with a snore loud enough to shake the bed.
Brady says he’s often seen the snoring causes stress to the family and on relationships. “If you can’t sleep, and the reason you can’t is because your partner is snoring and keeping you up all night, that could be a major cause of stress,” he said.
The other primary sign of sleep apnea is daytime sleepiness. That’s because the sleep apnea never really lets you get into a deep sleep.
Obstructing breath — and sleep
Sleep apnea comes in two types: obstructive sleep apnea and central sleep apnea.
The most common type is obstructive, which as the name describes, is a blockage of some kind in the upper airway that keeps the sleeper from taking adequate breaths.
Sometimes the obstruction is caused by the physical state of the body — there may be a mass of tissue in the neck, pressing down on the airways. Other times it’s caused by inflammation, such as that provoked by asthma.
Much less common is central sleep apnea, caused by what Brady describes as a “disconnect” between the breathing center and the brain stem. “Your brain stem fails to tell your muscles to initiate a breath,” he explains.
Like central sleep apnea, obstructive sleep apnea result in restless nights.
He explains that when we fall asleep, our muscles relax, including those in the back of the throat. If you have a lot of mass on your neck, the airway can collapse and form an obstruction. Then, he says, “The brain senses that you’re not getting the oxygen you need and causes you to wake, so you go through restless sleep cycles where as soon as you get into restful sleep, your oxygen level drops and your brain kicks in and wakes you up.”
This pattern can repeat itself five to 30 times or more each hour, all night long.
Sleepy patients shouldn’t drag feet
When helping a patient who’s dragging or snoring, Brady, as well as Dr. Gary Alexander, who heads the pulmonary department, often sends patients to the Tanner Clinic Sleep Disorders Center. There, monitors track the sleeping patient’s breaths, brain waves and snoring habits — even leg movements that might indicate restless leg syndrome.
“We try to get an accurate picture of sleep architecture to see whether you follow normal stages of sleep,” he said.
Often that patient suffers from such daytime fatigue that “they feel they’re too tired to get along,” said Brady. These individuals “struggle with excessive daytime sleepiness to the point where it infringes on their work habits or overall function throughout the day.”
That fatigue, he adds, “is one of the big indicators there might be an underlying obstructive process that causes restless sleep cycles.”
In less severe cases, the pulmonary experts begin treatment with measures as simple as a dental appliance that shifts the jaw forward to open up the airway, or Breathe Right nasal strips, an over-the-counter product that hold the nose passages open.
Patients requiring more advanced remedies may be prescribed the CPAP (continuous positive airway pressure) machine, which Brady says is “basically an air stint to diminish the obstruction and keep the airway open.”
‘What can I do to feel better?’
For people with central sleep apnea, there’s VPAP (variable positive airway pressure). This machine “actually senses when you don’t initiate a breath and can aid in initiating that breath for you,” said Brady.
The most common question patients ask, says Brady, is “What can I do to feel better?”
He recommends that people who daily fight the symptoms of sleepiness get checked out. “If you’re going day after day where you’re not getting enough sleep and it’s affecting your ability to function, there’s no reason to wait.”