Make Excuses for Excessive Napping and Deny Sleep Apnea?
Do people say you nap too much?
Do you make excuses such as being awake but closing your eyes just to rest them?
Do you justify naps due to your age or stress?
NOTE: This isn’t about the so-called power nap of only 20 minutes.
This is about frequent, lengthy naps that take the person away from family activities or opportunities to be productive, active or involved.
Common Excuses for Napping: Falling Asleep During the Day
“I need to lie down for my back.”
“I need to rest my feet; they’re aching from work.”
“I was awake the whole time; my eyes were just strained.”
“I was awake the whole time; I was listening to the show.”
“I got up three times overnight to use the toilet.”
“I was bored.”
“Long naps are healthy.”
Unfortunately, sometimes a spouse will support the napping, a la “Your father works hard all day. He deserves a good long nap whenever he wants.”
The napping even occurs on vacations, enough so that family members may wonder how anyone could sleep so much on a vacation.
“Wake up! Wake up to the dangers of untreated sleep apnea and recognize that excessive daytime sleepiness and the tendency to doze off easily in quiet situations during the day is a typical symptom,” says Daniel Rifkin, MD, a sleep medicine expert at the Sleep Medicine Centers of Western New York.
“Not only can the treatment of obstructive sleep apnea improve your health in so many ways, but its effect on quality of life can be astounding.
“I even had one patient that said to me, ‘Dr. Rifkin, I don’t know if I should thank you or shoot you!’
“Of course I asked why, and he said to me he now knows that he could have been a better husband, employee and even a better father if he was diagnosed with his sleep apnea sooner in life.
“He sadly recalled falling sleep after dinner almost every evening when all his children wanted to do was spend time with him. Don’t be that dad!”
What about aching joints?
Certainly, many people do have back or knee pain, or aching feet from being in bad shoes all day at work.
The solutions are to stay fully awake while treating the condition with therapeutic exercise, hotpacks, hot soaks, coldpacks, a massaging tool or stretching.
If you’re compelled to lie down or recline and close your eyes due to grogginess, even if there’s an ice pack on your knee or hotpack against your back, then you must not ignore the possibility of obstructive sleep apnea.
A fully wide-awake person who had a good night’s sleep is not going to want to go to sleep just to rest their aching feet or throbbing knee.
Stop Making Excuses for Your Naps: You Might Have Sleep Apnea!
If a body part is in pain, this will not cause drowsiness or the inability to keep one’s eyes open.
Lying down and falling asleep whenever there’s some pain is highly suspect for sleep apnea.
As for telling people you were wide awake the whole time you had your eyes closed, what’s your reason for snoring during that time?
And if repeated trips to the toilet really DID short you on sleep, then hear this: Untreated sleep apnea often causes buildup of urine overnight!
This is because the negative pressure in the thorax, caused by struggling to get air through an obstructed airway, fools cells in the heart into thinking there’s fluid retention.
These cells send a signal to the kidneys to make urine to expel the imagined fluid.
If a family member expresses concern over your excessive napping, listen to that person patiently and do not blow them off.
Keep quiet as they voice their worry, especially if they toss in some information about obstructive sleep apnea.
Your next step is to discuss this with your physician.
Dr. Rifkin is board certified in both neurology and sleep medicine. He also treats insomnia, RLS and narcolepsy.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
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Diagnosed with Sleep Apnea in Old Age: Is CPAP Worth It?
Are you elderly and have just been told you have obstructive sleep apnea? Can you still benefit from CPAP therapy? Or should you just use supplemental oxygen?
If your primary care doctor believes you’re too old to benefit from a CPAP machine, and that you should have only supplemental oxygen during sleep, you’ll want to really rethink this recommendation — even if you’re over 90.
“Supplemental oxygen is not a therapy for OSA,” says Dr. Nancy Foldvary-Schaefer, DO, MS, and Director, Sleep Disorders Center, Cleveland Clinic.
“It does not keep the airway open.”
Supplemental oxygen, delivered through a nasal cannula, will elevate the level of oxygen in the blood, and therefore, throughout the entire body.
This may sound like a fix for sleep apnea’s desaturation (abnormally low blood oxygen level).
But it’s far from it. As Dr. Foldvary-Schaefer points out, the oxygen flowing through the nasal cannula does not keep the upper airway open.
Only the pressurized air from a CPAP hose will do this.
Shutterstock/Grossinger
The airway that keeps getting blocked from collapsed throat tissue — even if supplemental oxygen is keeping the level at 99% — STILL continues to create other problems, including strain on the heart.
“We published a paper in 2019 in JCSM showing that older adults had comparable functional improvement when OSA was treated with CPAP as younger adults,” says Dr. Foldvary-Schaefer.
Another Study Showed the Same Results
A study in a 2015 European Respiratory Journal focused on CPAP benefits for the elderly.
Untreated sleep apnea in a senior man or woman is a whole separate issue from their advanced age, as far as risk or cause for health problems.
There is a distinction, however, in that in the elderly, three complications of untreated sleep apnea are far more likely than in younger patients:
• Frailty
• Nocturia: overnight trips to the bathroom
• Impaired cognition
The conclusion of the European Respiratory Journal paper is that clinicians should not be any less, or more, aggressive in treating obstructive sleep apnea in old people than in middle aged or young patients.
What about long-term benefits of CPAP in an elderly person?
“Benefits in terms of long-term reduction in cardiovascular events is debatable in old adults,” says Dr. Foldvary-Schaefer.
But there are short-term or immediate benefits to consider.
One of them is nocturia. If overnight trips to the bathroom are reduced, as a result of CPAP therapy, this means a reduced risk of falling and breaking a hip or suffering another injury — especially in an elderly person who’s unstable on their feet even when wide awake.
Another short-term benefit is increased alertness during the day, due to restorative sleep.
This means more alert driving and less daytime napping.
Elderly Person’s Oxygen Level During Sleep Is Low; Apneas Are Witnessed by Family Members
My elderly father’s breathing kept pausing for up to 35 seconds during daytime naps. He also snored and frequently fell asleep while watching TV.
An overnight pulse oximeter revealed desaturation, and he was prescribed supplemental oxygen.
I asked his doctor why he wasn’t ordered a sleep study for obstructive sleep apnea, with the idea that CPAP therapy would then be pursued.
His primary care physician replied that Kaiser Permanente didn’t recommend CPAP for suspected sleep apnea cases over 80 because — as Kaiser assumed — people that old would predictably find the face mask to be intolerable — due to physical discomfort on thin old skin, rather than age-related cognitive decline.
“Compliance is only a problem in cognitively impaired patients who do not cooperate,” notes Dr. Foldvary-Schaefer.
Another Study: CPAP Adherence in the Elderly
A paper in the American Journal of Respiratory and Critical Care Medicine (2016) points out (as does the report above) that studies on CPAP use and benefits in the elderly are few.
Neill et al set out to compare CPAP compliance in people 65+ to that of younger patients.
The researchers found that the “mean compliance in the older adults was similar to younger adults.”
However, the paper then states, “Compliance was highest in the > 75 year old group.”
Presence of diabetes or high blood pressure did not affect adherence, either. Nor did home support.
The study concluded that there was a very favorable one-month CPAP compliance in the elderly when it was “delivered as part of a patient focused protocol focusing on the first four weeks of therapy.”
If an elderly family member is suspected of having sleep apnea, encourage them to undergo a sleep study, even if they’re 95.
If they refuse, encourage a pulse oximeter test overnight. If the result shows low oxygen levels, don’t be afraid to discuss a sleep study and the benefits of CPAP therapy.
Certified by the American Board of Neurology and Psychiatry in Neurology, Clinical Neurophysiology and Sleep Medicine, Dr. Foldvary-Schaefer has treated patients with sleep disorders and epilepsy at Cleveland Clinic since 1995. She has served as a lead investigator on numerous clinical trials.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Depositphotos.com
Sources
erj.ersjournals.com/content/46/1/13
atsjournals.org/doi/abs/10.1164/ajrccm-conference.2016.193.1_MeetingAbstracts.A2851
3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_26-8-2014-17-18-11
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