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Your Pressing Questions about Sleep Apnea Answered
July 30, 2020
Weill Cornell Medicine, in conjunction with the 92Y, presented a full-day summit about mental health for the public. Throughout the day, experts from Weill Cornell Medicine shared their insights about the many different factors that contribute to our mental health — including sleep.
During one session, Dr. Maria Suurna joined Dr. Daniel Barone to answer some of the most important questions about sleep and sleep apnea.
Dr. Suurna is an otolaryngologist (ear, nose, and throat doctor) specializing in sleep surgery at Weill Cornell Medicine, providing evaluation and surgical treatment for snoring and obstructive sleep apnea. Dr. Barone is the Associate Medical Director of the Weill Cornell Medicine Center for Sleep Medicine and the author of Let’s Talk About Sleep. As a neurologist and sleep specialist, he diagnoses and manages patients with a variety of sleeping disorders.
Sleep is highly complex. Poor sleep may be the result of anxiety, depression, medications, a poor diet, too much alcohol or caffeine, bad sleep hygiene, or another cause. For many others, however, sleep apnea is the reason for their poor sleep. This disorder causes your breathing to start and stop, over and over, throughout the night. If you snore and never feel well rested—even after a full night of sleep—you may have sleep apnea.
Learn more about insomnia, how you can improve your sleep hygiene, and the connection with mental health.
What is sleep apnea?
Dr. Suurna explained, “Sleep apnea is symptomatic obstruction of the airway during sleep.” The American Sleep Apnea Association estimated that 22 million Americans suffer from sleep apnea, with up to 80 percent of cases being undiagnosed.
The obstruction causes you to stop breathing repeatedly at night. In most cases, you are not aware that you have stopped breathing because sleep apnea doesn't cause you to fully wake up.
“For whatever reason, people have sleep apnea when they go to sleep, they lose their neuromuscular tone and the airway starts to obstruct,” she detailed. “We are still trying to figure out why.” Men over 40 are most likely to develop sleep apnea, but younger men, women of all ages, and children also suffer from this disorder.
There are several different types of sleep apnea:
- Obstructive sleep apnea, the most common type, occurs when your throat muscles relax too much during sleep
- Central sleep apnea occurs when your brain doesn’t send the proper signals to the muscles that control breathing
- Complex sleep apnea syndrome occurs when you have both obstructive and central sleep apnea
Sleep apnea is the most common sleep disorder treated at the Weill Cornell Medicine Center for Sleep Medicine. The team has helped many patients improve their sleep and quality of life.
How is sleep apnea harmful?
In the short term, sleep apnea causes your body to respond quickly to their airway closure. This causes your heart rate to go up, your blood pressure to go up, oxygenation levels to go down, and may cause you to wake up.
“Your body gets ready to fight or flight,” explained Dr. Barone. “And this process is happening over and over and over again, all throughout the night when you are supposed to be resting.” You will wake up feeling that you did not rest well, your bed partner may complain of you snoring or making sudden movements while sleeping.
In the long term, sleep apnea can cause serious health problems, including memory loss, difficulty concentrating, weight gain, impotence, headaches, high blood pressure and other cardiovascular diseases. It can also lead to accidents, such as car crashes.
Should I see a sleep specialist?
Both Dr. Suurna and Dr. Barone suggested focusing on improving your sleep hygiene as much as possible to promote better rest. Try to go to bed at the same time and make your bedroom as calm and comfortable as possible. “Do something that we used to do a hundred years ago,” Dr. Barone recommended. For example, shut off all backlit devices, listen to music, read a book with a lamp, meditate, pray.
If this does not help enough, Dr. Suurna recommended paying very close attention to your body and what your bed partner says. “Bed partners often are the ones to alert to problems,” said Dr. Suurna.
A sleep specialist, including those at the Weill Cornell Medicine Center for Sleep Medicine, will help you by carefully evaluating all the different factors of your sleep. A sleep specialist can determine what is causing the issues with sleep, if you should undergo a sleep study, or if you would benefit from care from a psychiatrist, registered dietician, or other specialist.
“I think a personalized, individualized approach to sleep issues is the key,” asserted Dr. Suurna.
What is a sleep study? How can it help sleep apnea?
There are several different types of sleep studies, including a home sleep study, day sleep study, or a comprehensive overnight sleep study. All of these studies are intended to gather objective data about your sleep to better understand your sleep disorder and tailor treatment to improve it.
“It’s a little bit artificial,” explained Dr. Suurna. “It’s not exactly always in the home setting. And you actually have monitors attached to you that measure your sleep, oxygen saturation, respiration rates, brainwave activity.”
Patients often express concern about the sleep study, fearing that they won’t be able to sleep with the monitors. Dr. Barone explained that he tells his patients, “If there is something there objectively, we’ll find it, even if you don’t have a ‘great night’ or a ‘normal night.’”
The data from a sleep study can help your sleep specialist determine if you have sleep apnea and then create a more personalized treatment plan to help you sleep better.
How is sleep apnea treated?
Both Dr. Barone and Dr. Suurna asserted that there are many different treatment options for all sleep disorders, including sleep apnea. The key is finding the right treatment for your specific condition.
For some mild cases, sleep apnea can be improved with lifestyle changes—quitting smoking, achieving a healthy weight, or managing allergy symptoms better.
Continuous positive airway pressure (CPAP) or other airway pressure machines help many people sleep better. These machines keep the airway open during sleep. These machines, “pressurize the air, blow it into the nose, into the mouth, and stent the airway open, preventing it from collapsing,” explained Dr. Suurna.
Dr. Suurna specializes in treating people with obstructive sleep apnea who have not had any relief from nonsurgical treatments. Surgical treatments can help correct physical abnormalities or structures that can obstruct the airway and prevent breathing at night. For example, large tonsils, a nasal septum, or polyps in the nose can cause issues.
There are many, innovative ways of managing complex sleep apnea with surgical treatments. “But, again,” asserted Dr. Suurna, “the treatment has to be individualized. Some people are surgical candidates and some people are not. And that’s our job to figure out who’s going to be the right person for what type of treatment.”
Dr. Suurna also warned that underlying depression or anxiety, when untreated, can make it harder for sleep apnea treatment to be beneficial. “Anxiety and depression and other psychiatric issues make it very, very difficult to actually comply with the treatment,” she explained.
The good news is that all types of sleep apnea, anxiety, and depression can be treated with a personalized approach: a careful examination and diagnosis, followed by treatment tailored to your specific condition.
If you believe you have sleep apnea or another sleep disorder, you do not need to live with the discomfort, sleepiness, and negative side effects. Using evidence-based medicine based on the latest research, sleep medicine specialists can help you sleep—and live—better.