By Dayaker Gagadam, MD, FCCP
Tucked away in a quiet corner of the medical office buildings of Huguley Memorial Medical Center, you’ll find an inviting bed covered with quilts and fluffy pillows. It might look out of place among high-tech medical equipment, but nevertheless it’s an important diagnostic tool for sleep apnea, which affects as many adults as diabetes or allergies, but is much less known and usually undiagnosed.
People with obstructive sleep apnea stop breathing repeatedly during sleep because their upper airway collapses. Airway collapse may be caused by a large tongue, extra tissue in the airway, or decreased tone in the muscles that hold the airway open. With no air getting into the lungs, oxygen levels drop and the sleep cycle is disrupted.
Sleep apnea is more common in men and post-menopausal women, those who are overweight or have a neck circumference of 17” or more, and individuals with a physical abnormality of the nose or upper airway.
Often the spouse first suspects that a person might have sleep apnea. They hear their partner snoring loudly, tossing and turning, sometimes even gasping or choking during sleep. Other common symptoms include daytime sleepiness, morning headaches, fatigue, memory lapses, frequent urination at night, and depression and irritability.
The health consequences of sleep apnea can be far-reaching, from the strain it puts on the heart to abnormal hormone levels. People with untreated sleep apnea are at risk for high blood pressure, irregular heart rhythms, congestive heart failure, heart attack, uncontrolled blood sugar and stroke. Suffering from fatigue, they tend to have difficulty concentrating and have an increased likelihood of driving or work-related accidents.
“I gave up driving,” explains Carlos B. of Fort Worth, one of my sleep apnea patients. “Before treatment, I could fall asleep anytime I sat down, so my wife took over the driving. After treatment, I’m doing a whole lot better. My kids notice I’m not falling asleep in the day, and my wife doesn’t complain about my snoring.”
Also, poor quality of sleep has an enormous impact on the quality of life. Without a normal sleep cycle, people may feel unproductive and unfocused, and they may be short-tempered or depressed. Some don’t have energy for their families. Snoring may keep them sleeping apart from their spouse.
The first step to determining if a patient has sleep apnea is to conduct a physical examination and get a medical history. If sleep apnea appears probable, he or she will spend the night in our sleep laboratory, where sleep patterns, breathing and heart activity are monitored and recorded. Sometimes we find that breathing may pause as many as thirty times in an hour, lowering blood oxygen to dangerous levels.
If the sleep study indicates sleep apnea, I prescribe a nasal mask. Worn while sleeping, the lightweight mask provides a gentle stream of air that prevents the airway from collapsing. About 90% of my patients find it effective, and they are relieved to treat sleep apnea without medications or surgery.
Another patient, Joe A. of Fort Worth says, “I would wake up feeling like I didn’t get any rest, and I didn’t know why. It’s been more than a year that I’ve been sleeping with the mask from Dr. Gagadam, and it has helped a lot. I feel more rested and have more energy.”
Dayaker Gagadam, M.D., F.C.C.P., the medical director of Premier Sleep Diagnostics, has practiced for eleven years. Board-certified in internal medicine, pulmonary medicine and critical care medicine, his extensive training includes sleep disorders as well as conditions of the lungs. His office, located in Suite 208 of the doctors’ offices at Huguley Memorial Medical Center, may be reached at 817-293-3000.