Repeatedly Strangled While Sleeping: Sleep Apnea’s Dangers
Don’t think for a second that the typical patient with sleep apnea is a fat man with a thick neck.
Thin young women can be diagnosed with this often misdiagnosed and very common condition.
In fact, it’s estimated that 25 percent of the population has obstructive sleep apnea, and that millions of people go through life having no idea that they have this condition.
Even kids can have obstructive sleep apnea.
Causes are plenty and not always tied to body weight or age.
Causes of this common and under-diagnosed condition include drinking alcohol before bedtime, smoking, large tonsils, large adenoids, a big tongue base, naturally excess throat tissue, a small jaw and a narrow airway.
And of course, obesity and a short thick neck are major risk factors as well.
Obstructive sleep apnea is strongly linked to serious illnesses including heart disease, high blood pressure and stroke.
In addition, “People with sleep apnea are more likely to develop insulin resistance even if not overweight,” says Daniel Rifkin, MD, a sleep medicine expert at the Sleep Medicine Centers of Western New York.
“With this condition, cells don’t respond as well to the hormone insulin, which can lead to type 2 diabetes.
“Sleep apnea can cause decreased oxygen to the optic nerve, which can result in nerve damage.” This can then lead to glaucoma.
“Sleep apnea has been linked to fatty liver disease,” continues Dr. Rifkin. “The severity of the liver disease often corresponds with the severity of the sleep apnea.
“A lot goes on in the brain during sleep. One of those things is the consolidation of memories. With apnea-interrupted sleep, you may have memory problems.”
Untreated sleep apnea mimics other conditions including ADHD, age related cognitive decline, tension headaches and stress.
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.
Top image: ©Lorra Garrick
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Can You Have Sleep Apnea Without Daytime Symptoms?
Have you been convincing yourself that you can’t possibly have sleep apnea because you don’t have daytime symptoms?
There is a possibility that you have sleep apnea even if you’re not sleepy during the day or experience other daytime symptoms such as morning headaches and trouble concentrating.
When a sleep study (polysomnography) indicates anywhere from five to 15 disrupted breathing events per hour, the diagnosis is mild sleep apnea.
Even in the absence of daytime symptoms.
“Yes, it’s possible,” says Daniel Rifkin, MD, a sleep medicine expert at the Sleep Medicine Centers of Western New York.
“Years ago, we always thought sleep apnea had to be associated with daytime sleepiness.
“In fact, according to certain health insurances, we couldn’t even treat patients unless they were sleepy.
“However, as we learned more and more, we realized that obstructive sleep apnea can have multiple ‘phenotypes’ or presentations.
“Some patients might have mild disease and have profound daytime sleepiness, and others with severe disease and almost no sleepiness at all.
“Those without daytime sleepiness, for example, might have greater cardiovascular risk.”
Compliance with a CPAP Machine
Shutterstock/Oleg Golovnev
If someone has significant daytime symptoms (fatigue, frequent grogginess, often feeling a need to nap, falling asleep on the job), they are more likely to adhere to CPAP therapy, when compared to someone with no daytime symptoms.
Nevertheless, many physicians recommend CPAP therapy for those diagnosed with even mild obstructive sleep apnea even in the absence of daytime symptoms.
Other sleep medicine doctors question the value of CPAP for those with asymptomatic mild obstructive sleep apnea — if for no other reason, there’s less likely to be compliance in such individuals.
Adherence should be taken into account, says a paper in the Journal of Clinical Medicine.
AHI is the apnea hypopnea index. Its associated numerical value refers to the average number of these events per hour of sleep.
Hypopnea refers to inhaling against resistance created by a partially rather than completely obstructed airway.
An AHI of five to 15 means mild sleep apnea.
Over 15 to 30 is moderate OSA, and over 30 is severe OSA.
Someone with mild OSA is not likely to be compliant with CPAP.
It is not known whether the cardiovascular risk of untreated mild OSA — for which there are no daytime symptoms — is lower than for untreated mild OSA with daytime symptoms.
People with asymptomatic mild OSA may abandon the idea of CPAP therapy once they learn that studies about cardiovascular risk in untreated mild OSA are not conclusive.
The JCM paper states that cohort studies of death rates with CPAP therapy suggest that only those individuals with an AHI greater than 30 (severe OSA) have a reduced mortality.
The JCM also points out that for mild OSA with daytime symptoms, non-CPAP alternatives may be effective.
These include weight loss, changing sleep position and a mandibular advancement device custom made by a dentist.
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: Depositphotos.com
Source: ncbi.nlm.nih.gov/pmc/articles/PMC2564770/
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How to Tell You Might Have Obstructive Sleep Apnea ??
Don’t count yourself out from having sleep apnea just because you don’t have daytime symptoms and are lean, buff and young.
Sleep apnea is one of those conditions for which millions of people could be walking around totally clueless that they have it. Including women.
Classic Symptoms of Sleep Apnea
“Snoring (especially loud enough to disturb others), unrestful sleep, morning headaches, daytime sleepiness (especially if you fall asleep inappropriately such as while driving, talking with others, at work) and of course, fatigue,” says Susan L. Besser, MD, with Mercy Medical Center, Baltimore; Diplomate, American Board of Obesity Medicine and board certified by the American Board of Family Medicine.
The person with untreated sleep apnea may be prone to napping a lot but never feeling recharged.
He or she may avoid extended driving trips because they know they’ll become drowsy behind the wheel.
The morning headaches disappear soon after getting out of bed.
You may not have the more overt signs of sleep apnea, such as snoring or excess daytime grogginess.
However, there are nighttime signs that are suspect for untreated sleep apnea.
• Suddenly awakening feeling as though your airway was cut off
• Partner describes snoring as a snorting sound
• Partner describes your breathing as labored or gasping
• Partner says you stop breathing for extended periods
• Partner says your breathing is erratic, shallow and/or comes in rapid waves between long pauses
• Repeated trips to the toilet overnight
If any of the above bullet points applies to you, you should discuss these with your physician and consider the possibility of having a sleep study — which can determine if you have sleep apnea.
In addition to the above points, do any of the following apply to you?
• Scalloped tongue*
• Can’t see throat due to high-arched palate
• Crowded teeth
• Wisdom teeth removal
• Small appearing jaw
• Receding chin
*Scalloped tongue. Check the sides of your tongue. Do you see indentations from your teeth? That indicates a small jaw.
Your dentist can discuss with you the likelihood of sleep apnea if you have any of the oral features listed above.
Dentists view the interior of mouths all day long and can give you very insightful feedback.
Dr. Besser provides comprehensive family care, treating common and acute primary conditions like diabetes and hypertension. Her ongoing approach allows her the opportunity to provide accurate and critical diagnoses of more complex conditions and disorders.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Can Endometriosis Go Away On Its Own Before Menopause?
Ever wonder if your endometriosis will spontaneously go away before you reach menopause?
“Without any medical intervention? It’s quite rare for endometriosis to go away on its own before menopause except during pregnancy,” says Mylaine Riobe, MD, founder of Riobe Institute of Integrative Medicine.
Dr. Riobe, board certified in OB/GYN and integrative medicine, is the author of “The Answer to Cancer.”
Unfortunately, women — at least ones who are not pregnant — can only wish that their endometriosis will resolve on its own.
This condition, sometimes referred to as uterine polyps or uterine overgrowth, begins during the reproductive years.
Endometriosis is one of those conditions — which can cause mild to very severe symptoms — that will never spontaneously resolve in a non-expectant woman.
However, pregnancy won’t cure it, either, because once the pregnancy is over, symptomatic endometriosis will be resurrected.
“The hormones secreted during pregnancy can cause endometriosis to become dormant,” explains Dr. Riobe. So this would only be a very transient relief.
“Some natural interventions may help with endometriosis such as Chinese herbal therapies, acupuncture, homeopathy and biofeedback,” says Dr. Riobe.
“Nutritional interventions include correcting nutrient deficits, a diet rich in vegetables and fruits to encourage healthy detoxification and improved metabolism, avoiding processed foods containing pesticides, artificial hormones and antibiotics.”
These natural approaches may relieve symptoms in some women, but this is not the same as spontaneous resolution of the condition – that is, the overgrowths suddenly receding and then vanishing so that the patient is actually free of this disease.
Medical intervention including surgery can successfully treat this condition.
An Overview on Surgery for Endometriosis
As mentioned, endometriosis will not resolve on its own prior to menopause.
Surgery is often considered when other treatment are not effective or when the condition significantly affects quality of life.
The main goal of surgery is to remove or destroy endometrial tissue while preserving as much healthy tissue as possible.
One common approach is laparoscopy, a minimally invasive procedure that uses small incisions and a laparoscope (a thin tube with a camera) to view and remove overgrowth.
This method is usually employed for diagnostic purposes and treating mild to moderate cases of endometriosis.
For more extensive cases, laparotomy may be used, which involves a larger abdominal incision.
This method is considered when laparoscopy is not suitable or when the endometriosis is widespread.
Excision surgery involves cutting out the excess uterine tissue and is particularly effective for severe cases.
It aims to remove the disease completely and reduce the risk of it coming back.
In extreme cases, a hysterectomy might be performed, which involves removing the uterus and sometimes the ovaries as well.
This option is generally considered when other treatments have failed and the patient does not wish to preserve fertility.
Dr. Riobe has helped thousands of patients overcome difficult illnesses by addressing root causes, not just masking symptoms. The Riobe Method focuses on the prevention of disease, not the prevention of death from disease. She has 20+ years’ experience using integrative techniques to treat diverse patients.
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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