Search

Updated: Nov 13, 2019


It is estimated that 22 million Americans suffer from sleep apnea, with 80 percent of the cases of moderate and severe obstructive sleep apnea undiagnosed.









If we accept the reports that a minimum of 80% of Sleep Apnea is undiagnosed, then only 20% is actually addressed in any fashion.


The undiagnosed may fit into these categories:


1. Patients have no idea that such a thing as Sleep Apnea exists.

 Hard to believe it but there are such people.

2. They know about, but have no idea that they suffer from, Sleep Apnea .

“Isn’t snoring normal?”  “Doesn’t everyone wake up 4-6 times a night?”

3. They know they have the symptoms of Sleep Apnea but are in denial.

I know a smart lawyer who insists sleep apnea does not exist. He tells me that I am “just as bad as [his] wife” who listens to him snore and gasp for breath every night.

4. They know they have problems but refuse to do anything about it.

Some have heard horror stories about CPAP machines and simply do not want to take action. They need to learn about the oral appliance therapy (OAT).


5. Misdiagnosed Sleep Apnea.

There is a lack of knowledge of sleep apnea among many health professionals. It is very difficult to get these people to want to be screened and diagnosed by just telling them that something is wrong. It is necessary for them to “see” it for themselves and for them to adopt a top down approach – of their own volition.The best way to do this is to educate them in the most simple, effective, non intimidating and cost effective way – we can show them films of OSA victims having sleep events.  We must find a way to get them diagnosed and filmed and then show them their results. This is an massive education deficit issue.


Sources

American Sleep Apnea Association  http://www.sleepapnea.org/i-am-a-health-care-professional.html

Indy Star, Lauran Neergaard, http://www.indystar.com/articles/9/186972-5719-052.html

Detroit Free Press, Bill Dow, http://www.freep.com/news/health/sleep2e_20041102.htm

7 views0 comments

Updated: Dec 12, 2019

According to an article in the European Respiratory Journal, “Obstructive sleep apnea occurs in 50% of females aged 20-70 years. 20% of females have moderate and 6% severe sleep apnea.” 

Swedish scientist Dr. Karl Franklin and his team set out to find out how prevalent sleep apnea is among women and how often symptoms occur. Out of a population-based random sample of 10,000 women between the ages of 20 and 70 years, they gathered data on 400 of them. The test group were given questionnaires which included several questions regarding their sleeping habits and sleep quality. They also underwent overnight polysomnography.


WOMEN ARE LESS LIKELY TO BE DIAGNOSED FOR SLEEP APNEA

Women with sleep apnea are less likely to be diagnosed compared to men. In studies of patients registering for evaluation for sleep apnea, the ratio of men to women has sometimes been extremely lopsided, with 8 or 9 men diagnosed with obstructive sleep apnea (OSA) for each woman found to have OSA. However, we know from studies in the general population that the actual ratio is likely to be closer to 2 or 3 men with OSA for each woman who has the condition.


Women make up about 45 percent of sleep study referrals and most sleep studies are still done to screen for sleep apnea.


WHY ARE WOMEN LESS LIKELY TO BE DIAGNOSED FOR SLEEP APNEA?

First, there is an unfortunate predefined notion of the make-up of a sleep apnea patient. The stereotype is a middle-age, overweight or obese male. Physicians may not be thinking of this OSA diagnosis when the patient is female. Second, women may present with slightly different symptoms than the “classic” symptoms of snoring, witnessed breathing pauses at night and excessive sleepiness during the day.


Instead, women may present with fatigue, insomnia, disrupted sleep, chronic fatigue and depression morning headaches, mood disturbances or other symptoms that may suggest reasons other than OSA for their symptoms. Because these symptoms are not specific for OSA, women may be misdiagnosed and are less likely to be referred to a sleep study for further evaluation. Another problem is that women with sleep apnea have more subtle breathing disturbances and are more likely to have REM-related apneas, so they may be tougher to diagnose.






SOME DIFFERENCES IN SYMPTOMS BETWEEN MEN AND WOMEN

Sleep apnea in females is related to age, obesity and hypertension but not to daytime sleepiness.


The “classic” symptoms of OSA are snoring, witnessed apneas and daytime sleepiness, but women may not experience these things. Weight gain, depression, waking up gasping for breath, hypertension, and dry throat in the morning may be tip-offs for women that they may need an evaluation.


Women who are obese, pregnant women, and post-menopausal women all have a greater risk for OSA. Finally, women with the endocrine disorder, polycystic ovary syndrome, are more likely to have sleep apnea even after controlling for weight and should seek clinical evaluation.


THE DIFFERENCES BETWEEN OSA AND HYPERTENSION IN WOMEN AND MEN

Obstructive sleep apnea is a significant risk factor for heart disease . The prevalence of hypertension in people with sleep apnea ranges between 30-70 percent and is similar in men and women. However, when taking body mass index (BMI) into consideration, some gender differences emerge: men with OSA who are markedly obese (BMI > 37) have a two-fold higher risk of hypertension than obese women with OSA.


THE DIFFERENCES BETWEEN OSA AND DIABETES IN WOMEN AND MEN

Women with OSA tend to be more obese and have lower AHI  than males; however, studies have also suggested that women may have a higher mortality.   OSA is associated with an increased risk for the development of type 2 diabetes independent of obesity.


Women who are obese, pregnant women, and post-menopausal women all have a greater risk for OSA. Finally, women with the endocrine disorder, polycystic ovary syndrome, are more likely to have sleep apnea even after controlling for weight and should seek clinical evaluation.


COMMON SLEEP APNEA MISDIAGNOSES

Women are often diagnosed in error with one of the following conditions, rather than sleep apnea.


  • Anemia

  • Cardiac or pulmonary illnesses

  • Depression

  • Diabetes

  • Fatigue from overwork

  • Fibromyalgia

  • Hypertension

  • Hypochondria

  • Hypothyroidism

  • Insomnia

  • Menopausal changes

  • ObesitySources

Dr. Karl Franklin, European Respiratory JournalGrace W. PienMD, MS, assistant professor of medicine, divisions of Sleep Medicine and Pulmonary and Critical Care at the University of Pennsylvania School of Medicine.

Nancy A. Collop , MD, medical director at Johns Hopkins Hospital Sleep Disorders Center and associate professor of medicine at Hopkins’ Division of Pulmonary and Critical Care Medicine in Baltimore, Md .

Fiona C. Baker, PhD, sleep physiologist, Center for Health Sciences, SRI International, in Menlo Park, Calif.

Anita L. Blosser, MD, with Duke Primary Care at the Henderson Family Medicine Clinic in Henderson, N.C.

9 views0 comments

One of the most common symptoms of Obstructive Sleep Apnea (OSA) is Gastro-Esophageal Reflux Disease (GERD)

Have you ever awakened in the middle of the night choking on acid because you’ve inhaled it and can’t breathe? You try taking in a breath and all you get is a burning in your throat and lungs. You try to expel it but it takes many tries and coughing, burning, burning. You panic,  thinking,  “Am I going to die?”  You possibly could if you hadn’t woken up! HOW DOES OSA CAUSE GERD?

During the cessations of breathing the body will increase its efforts to take in air. Abdominal contractions are exaggerated and increase until breathing resumes. The contractions squeeze the stomach and force acid up the esophagus. The efforts to breathe also increase a negative pressure in the esophagus which also pull up acid.

Secondary effects of Obstructive Sleep Apnea, resulting from the GERD, are esophagus and larynx damage, aspiration pneumonia, permanent lung damage, tooth erosion, and tooth sensitivity.


GERD CAN EAT YOU AWAY GERD, or Acid Reflux, is a digestive disorder affecting the lower or reflux esophageal sphincter (LES), the muscle connecting the esophagus and stomach. The LES is a high-pressure zone that acts as a barrier to protect the esophagus against the back flow of gastric acid from the stomach. Normally, the LES works something like a dam, opening to allow food to pass into the stomach and closing to keep food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the LES relaxes when it shouldn’t or becomes weak, allowing contents of the stomach to flow up into the esophagus. Overweight people and pregnant women may suffer more heartburn episodes because increased abdominal pressure contributes to reflux. Pregnant women are also more prone to heartburn because the LES relaxes in response to the high levels of the hormone progesterone that occur with pregnancy. Generally, though, GERD is uncommon in people under age 40.   Smoking can irritate the entire GI tract. Frequent sucking on a cigarette causes air to be swallowed, increasing stomach pressure and encouraging reflux. Smoking sometimes also relaxes the LES muscle. 



9 views0 comments
1
2

SLEEP APNEA FAQ