Special to IFN
Have you ever been accused of sawing logs while you sleep? Do you sometimes wake up more tired than when you went to bed?
Dr. Jeffrey Brink, otolaryngologist at Iredell Ear, Nose and Throat, breaks down sleep apnea causes, symptoms, risks and treatments. As an otolaryngologist — or ear, nose, and throat physician as it is more commonly known, Brink treats everything from ear and throat infections, to swallowing problems, thyroid issues, neck masses, nasal and sinus problems, hearing loss, and, of course, sleep apnea.
“Sleep apnea is a sleeping disorder where you pause breathing while sleeping,” Brink explained. “The adverse effects come to the body because of oxygen deprivation during those pauses, causing strain on the heart.”
If left untreated, sleep apnea can cause high blood pressure, heart disease, heart attacks, strokes,
diabetes and depression, among other medical concerns.
“Think about when you were a kid and you’re swimming from one side of the pool to the other, holding your breath the entire time. When you come up for air, you’re gasping, and your body is screaming for oxygen. This is what happens while you’re sleeping with sleep apnea.”
Sometimes, sleep apnea can be due to sleep position.
“If people get themselves in an adverse position, that may be when they start to snore or start to pause breathing. Some people can’t sleep on their back while others can’t sleep on their sides. Sometimes, weight can cause serious problems due to the compression of the chest or airways.”
Around 40 percent of people who snore have undiagnosed sleep apnea.
“When patients come in and say, ‘I’ve got this snoring problem,’ I start to ask questions like ‘Do you have daytime sleepiness and fatigue? Do you notice decreased memory and concentration? Are you excessively irritable? Do you wake up gasping for air or choking?’ ”
The most common method of diagnosing sleep apnea is a sleep study, also known as a polysomnogram. Some are done in a sleep lab, some are done by yourself at home, and some sleep study companies will even come to your house to set up a sleep study. This tests for obstruction, which is an event where you are struggling to breathe and hypopnea, where you hold your breath. These are both considered pathological breathing events.
“I like a study that tells patients how many snores per hour, how loud their snoring is, and where it’s coming from,” said Brink.
Being over the age of 50, being male, underlying medical conditions such as a history of stroke or diabetes, pregnancy, obesity, and even uncommon anatomy such as a large neck or tongue are all risk factors of sleep apnea. Alcohol, sedatives, and tranquilizers can also relax the throat muscles, contributing to sleep apnea.
“Taking certain pain medicines can suppress your respiratory drive. Essentially, you don’t want to breathe because you’re just too comfortable.”
Children with large tonsils can also be at risk.
“Not only do children with sleep apnea snore, but they’re restless sleepers if they’re trying to get a breath,” Brink said. “Parents will say their child looks like they’re trying to arch their back and open their airway while they sleep. That’s to increase the space so they can better move the air.”
Allowing sleep apnea to go untreated can cause serious indirect consequences due to strain on the heart and other organs.
“High blood pressure, heart failure, large heart syndrome, and cardiomyopathy can lead to early stroke. Type 2 diabetes can be a secondary side effect.”
Fortunately, there are options if you are diagnosed with sleep apnea.
“The gold standard of treatment is a CPAP, or a Continuous Positive Airway Pressure Mechanism. It’s a tiny machine with forced air that you wear over your nose, over your mouth, or both. It expands your airway while you sleep so you can’t collapse or obstruct.”
Some individuals are intolerant of the CPAP machine. This could be due to claustrophobia, excessive movement, or they are physically uncomfortable wearing the machine. Alternatives to the CPAP machine include oral appliances, tongue retaining devices, and surgical treatments.
Brink is one of the only providers in the area to provide hypoglossal nerve stimulation therapy, commonly known as Inspire.
“Inspire is an implantation of a pulse generator. It’s like placing a pacemaker on the right side of your chest. A pulmonary probe detects whether you are creating pressure within the pulmonary cavity, aka taking a breath. If you don’t create that pressure, the generator then stimulates an electrode attached to the nerve that moves your tongue and pushes your tongue out of the way.”
The success rate of this procedure is high with 91 percent of recipients liking the device more than their CPAP. Not everyone is a candidate for this procedure. Talk to your doctor about what’s best for you.
Outside of medical intervention, lifestyle changes such as weight loss, changing your sleeping position, quitting smoking and alcohol, and refraining from sedatives, tranquilizers, and opioids can help with sleep apnea. Some individuals claim success with acupuncture and chiropractic care.
Diagnosing and treating sleep apnea can’t be taken with a one-size-fits-all approach. Talk to your doctor about a referral to Iredell Ear, Nose & Throat.
LEARN MORE
Dr. Brink and his qualified team are accepting new patients. Iredell Ear, Nose & Throat is located at 740 Bryant Street in Statesville. Visit Iredellent.com or call 704-878-6272.
About Iredell Health System
Iredell Health System includes Iredell Memorial Hospital; Iredell Davis Medical Center; Iredell Davis Behavioral Health Hospital; Iredell Mooresville; Iredell Home Health; Iredell Wound Care & Hyperbaric Center; Community and Corporate Wellness; Occupational Medicine; the Iredell Physician Network and more. Iredell Memorial Hospital is the largest nonprofit hospital in Iredell County. The comprehensive healthcare organization has 391 licensed beds; more than 2,000 employees; and has approximately 365 healthcare providers representing various specialties. Centers of excellence include Women’s and Children’s; Cardiovascular; Cancer; Surgical Services and Wellness & Prevention. The health system’s Iredell Mooresville campus is home to the area’s only 24-hour urgent care facility, as well as an ambulatory surgery center, imaging center, rehabilitation services, and physician practices. The mission of Iredell Health System is to inspire wellbeing. For a comprehensive list of services and programs, visit www.iredellhealth.org.