Spouses who snore may be spouses at risk.
But if you can’t get your spouse to go to a sleep lab, there’s another way.
Dr. Volkan Sumer of ICPR Family Practice, 1491 Valle Vista, Pekin, says his practice now offers the option of an in-home sleep evaluation as an alternative to spending the night in a sleep lab.
Sumer said, “Snoring indicates a sleep disorder of some kind. If you are heavier, you have an increased chance of having sleep apnea. Obesity is becoming more of a problem in this country. One suggestion when people come in saying their husband or wife is really bothered by the spouse’s loud snoring, and the patient is overweight, is for them to lose weight.” Snoring occurs when the pharynx “falls back on itself and air passes through the small airway, and that’s when you hear snoring. Air is being forced through to keep that tissue open,” said Sumer.
People who suffer from sleep apnea also experience loud snoring that is interrupted by frequent episodes of obstructed breathing (or obstructive sleep apnea). Serious episodes can last more than 10 seconds and occur more than seven times an hour. That amounts to anywhere from 30 to 300 such events per night. Other symptoms of obstructive sleep apnea include always feeling tired, trouble concentrating or staying awake, waking up with headaches, waking up with a gasping sensation, waking up with a dry throat, experiencing restless sleep, depression, frequent trips to the bathroom at night, heartburn, excessive sweating at night, decreased libido, or rapid weight gain.
Sumer said that sleep apnea is directly correlated to diabetes. If sleep apnea goes undiagnosed it could lead to serious health risks including “added risk levels for stroke and cardiac disorders. Episodes of obstructed breathing can also cause the heart to pump harder and reduces blood oxygen levels.”
Sleepers go through cycles. Dr. Sarah Zallek is the medical director of the Illinois Neurological Institute Sleep Center at OSF Saint Francis, director of Illinois Neurological Institute Neurology at OSF Saint Francis, and a teaching physician at the University of Illinois College of Medicine.
Zallek said there are three stages of Non Rapid Eye Movement sleep. The first is considered light sleep. It is typically very short and occurs at the beginning of the night. Only 5 percent of sleep is spent in this stage. The second stage is part of light sleep but is deeper than the light sleep stage. A majority of NREM is spent in this stage.
The third stage is deep sleep. While someone is in this stage, it is hard to wake them. Less than 20 percent of time asleep is spent in deep sleep. Young children spend more time in deep sleep than adults do.
Rapid Eye Movement sleep is part of a healthy sleep cycle. “REM is especially important for memory and cognition and without it we are not as able to process information. It is activated by new learning. It doesn’t make us feel more awake, though. To be refreshed we need continuous sleep so we go through the sleep cycle. If you have sleep apnea, you’ll have interrupted sleep,” said Zallek.
Sumer, too, stresses the importance of getting a good night of sleep and that “we really need REM sleep. You might sleep until the alarm sounds in the morning, but if you’re not getting deep sleep, you’ll feel tired or sluggish during the day.”
There is a spectrum of sleep apnea. People might have mild, moderate, or severe sleep apnea. “People may actually stop breathing in the middle of the night and not know it unless someone tells them or they participate in a sleep study,” said Sumer.
That is just what Paul Hauck, 69, discovered in 1993. Hauck decided to visit his physician after feeling “really run down.” Hauck drove a truck for 41 years and now works part-time for Peoria Charter Coach as a bus driver so a good night’s sleep is important. He participated in a sleep study at Methodist Hospital. Hauck said, “It started at 10 p.m. and they told me I should be tired when I came in and I did. I was tired. I was in a room with a TV camera pointed at me. I was hooked up to wires and was told they would be watching me from another room.”
Hauck fell asleep within an hour. After being asleep for an hour he was awakened because he stopped breathing 60 times. Hauck said, “They told me I tried to wake myself up 60 times in an hour and I snored pretty bad. It was dangerous for my health. They talked to me about a surgical method or offered for me to try a C-PAP (Continuous Positive Airway Pressure) that night. I didn’t care too much for the surgery option so I chose the mask. They showed it to me, put it all together, and had me try it. I wore it and went to sleep rather quickly.”
At 6 a.m. Hauck the sleep lab people woke him up and told him that he went into REM sleep and that his oxygen levels went from 50 percent when he began the sleep study to 93 percent.
“I was way down there. They asked me how I felt. I said, ‘I feel great!’ I jumped up and I was ready to go. I hadn’t felt that good when I woke up in the morning in a long time. They told me I might have to adapt to using the mask. I’ve heard others say it’s too hard to get used to. That’s totally ridiculous,” said Hauck.
Since using the mask style C-PAP, Hauck has switched to using the nose pillows design. He switched when he decided to grow facial hair. “I needed to be fitted for it but there are many designs. If you need to go and talk to these professionals, don’t hesitate. They were professionals. I had no problems,” said Hauck.
Prior to the newest technology which allows for at home sleep diagnostics, patients were sent to a sleep lab either in a hospital patient room or at an out-patient facility for sleep studies. The patients were monitored all night in an unfamiliar setting, said Sumer. There were wires connected from the patient to machines and someone watched the patient all night, explained Sumer. Those surroundings can make it difficult for the patient to sleep.
ARES is “essentially a device we give you for the night. You wear it on your head and the monitors are on your head. It gives us a lot of information like in the hospital setting but with the convenience of being at home. It measures pulse rate, neurologic brain waves, it can tell us which stage of sleep you’re in, and oxygen levels. There is also a microphone to measure the volume of snoring. There is a gyroscope to tell us how much time you spend on your back, on your left side, your right side and how much you snore in each position. It can tell us if you stop breathing and how many times a night that happens and how many times it happens in each sleep position. It’s really amazing. It’s a nifty little device. Then you bring it back in the morning and we plug it into a computer for an official reading and it gives a detailed report,” said Sumer.
Sumer has used the device himself. He reported that he could lie comfortably in any position and that it felt like a visor and not a helmet. He said it was a snug fit but not too tight.
The device is geared solely toward diagnosing sleep apnea. By participating in the sleep study, however, Sumer said it could alert him to other things in which case he would recommend seeing a neurologist or other specialist.
Zallek said an in-home sleep evaluation is not for everyone.
“It records a limited amount of information. It is broadly used but is not for everyone. A whole sleep comprehensive profile is important.” Patients who are sent to Zallek for a consultation may or may not need to be tested, but most do. Her office sees many children for sleep disorders as well. Zallek said that most of the time when parents bring in a child, it is because the child is doing something “funny” in his/her sleep. She added that surgery is done routinely with children for sleep apnea by performing a tonsillectomy. Adults, too, may need surgery.
There are a few options for non-surgical treatments. Patients with sleep apnea wear a C-PAP mask that forces air continuously.
Sumer also said that some dental clinics have oral devices patients can wear in their mouths to make the lower jaw protrude to help prevent sleep apnea.