Written by Darrel Drobnich, President, American Sleep Apnea Association
For more than twenty years, a small but dedicated group of sleep professionals and advocates have been working to bring sleep into the mainstream of public health. It’s been a tough and under-funded slog, but these efforts are starting to have real pay offs in getting the data and recognition we need as organizations such as the Centers for Disease Control and Prevention, all while organizations such as the National Geographic and celebrities such as Arianna Huffington and others help raise awareness. Hopefully, with new and growing partners we will be able to address many of the systematic issues that remain, especially related to obstructive sleep apnea (OSA).
Sleep problems, whether in the form of medical disorders or related to work schedules and a
24/7 lifestyle, are ubiquitous in our society. It is estimated that sleep-related problems affect 50 to 70 million Americans of all ages and socioeconomic classes. Sleep disorders are common in both men and women; however, important disparities in prevalence and severity of certain sleep disorders have been identified in minorities and underserved populations. Despite the high prevalence of sleep disorders, the overwhelming majority of sufferers remain undiagnosed and untreated, creating unnecessary public health and safety problems, as well as increased health care expenses. This can be viewed as a failure of traditional healthcare system.
Sleep science and federal reports have clearly detailed the importance of sleep to health, safety, productivity and well-being, yet studies continue to show that millions of Americans remain at risk for serious health and safety consequences of untreated sleep disorders and inadequate sleep, due to a lack of awareness, community interventions, and inadequate screening. Unfortunately, despite recommendations in numerous federal reports, there is still a lack of epidemiological data, large clinical trials and no on-going national educational programs regarding sleep issues aimed at the general public, health care professionals, underserved communities or major at-risk groups. We must change this paradigm if we are to meet the challenges of a growing and aging population. I believe that patients acting as “disrupters” will have to help lead this change especially in the area of sleep apnea.
One of the most devastating sleep disorders is obstructive sleep apnea, a prevalent chronic sleep and breathing disorder characterized by repeated stops or near stops of breathing during sleep due to collapse of the tissues in the airway. These breathing episodes last 10 seconds or more, and cause repeated sleep disruptions and oxygen desaturations that lead to important health consequences. OSA affects 17% of adults and over 25% of older adults, with rates increasing in association with the obesity epidemic. Sleep apnea aggregates in families, affects all age groups, and disproportionately affects minorities and those from poor neighborhoods. Sleep apnea requires immediate and ongoing therapy because it lowers blood-oxygen levels and disrupts sleep, and is associated with some of America’s other most pressing health problems including hypertension, heart disease, stroke, heart failure, atrial fibrillation, diabetes, and early mortality and results in an increase of depression, anxiety, cognitive issues, erectile dysfunction, irritability, daytime sleepiness and motor vehicle crashes.
Sleep apnea affects people of all ages and genders. However, there are factors which may put some at greater risk including:
• A family history of sleep apnea
• Being overweight
• Having a large neck (17 inches or greater for men, 16 inches or greater for women)
• Being 40 years of age or older
• Having a small upper airway
• Having a recessed chin, small jaw or a large overbite
• Smoking and alcohol use
Symptoms of sleep apnea:
• Loud snoring
• Morning headaches and nausea
• Gasping or choking while sleeping
• Loss of sex drive/impotence
• Excessive daytime sleepiness
• Irritability and/or feelings depression
• Frequent nighttime urination
• Concentration and memory problems
If you have a sleep problem like sleep apnea, you should ask your physician refer you to a sleep lab or clinic where you will participate in a sleep study either in a clinic or at home. Don’t give up until your primary care or other physician understands your concerns and makes the proper referrals.
People with chronic health issues or just people in general need to take charge of their well being and ask questions and demand answers whether it’s in healthcare, research or access to care. Groups like the American Sleep Apnea Association and People for Quality Care are working together to further empower patients and other stakeholders through programs like Sleeptember.org and the SleepHealth Mobile App Study.