How Important is Sleep Anyway?

By Tamela Thomas, Wellness Manager

Our country is sleep deprived. Sleep deprivation reduces our productivity, increases our likelihood for accidents, and weakens our immune systems. Sleep isn't just about rest; it is a critical time for the body to repair itself, rebuild tissues and release hormones. Although it is different for everyone, the rule of thumb is we need between 7-1/2 and 8-1/2 hours each and every night.

This month's article is about one of the more common sleep disorders: sleep apnea. More than 18 million Americans have sleep apnea. It's characterized by one's breathing stopping many times during sleep and the body responding by waking up to start breathing again. Hence, your "sleep" is not restful. Many people have this condition yet do not know it; they simply have no explanation for why they feel so worn out all of the time.

Dr. Pat Hamner writes this month's article and gives us in-depth information about sleep apnea, including how to go about getting screened and ultimately treated, even here at the WAC.

So, do you have sleep apnea? Take an interactive sleep quiz, at www.nwsleep.com.

Would a Good Night's Sleep be a Breath of Fresh Air?

By A. Pat Hamner, Jr, MD

Many of us feel certain we've slept soundly through the night yet we wake up tired or simply run out of steam midway through the day. If this sounds familiar, you might be surprised to learn you may have a condition known as sleep apnea. A lack of daytime energy, an inability to concentrate, nodding off while driving, daydreaming at work and severe snoring are all familiar occurrences to those who unknowingly experience sleep apnea.

One in 25 of us suffer sleep apnea; roughly as many as have asthma or diabetes. Yet doctors at a recent meeting of the American Academy of Sleep Medicine learned that 85% of people who suffer sleep apnea remain undiagnosed.

You might ask why so many people are unaware that this common problem is dramatically harming their health, wellness and quality of life—The answer is that many who have sleep apnea are unaware of what is happening to their breathing while they are asleep.

While much remains unknown about sleep, we do know that during normal sleep the human body is in a relaxed state with a lowered heart rate and a lowered rate of respiration. Simply put, the body uses this downtime to rebuild and re-energize itself.This state of relaxation and lowered respiration is what triggers sleep apnea. Apnea means a brief cessation of breathing, often for only 15-30 seconds. As the body relaxes during sleep and breathing becomes shallower, the airway in a person's throat can close off preventing normal breathing. When this occurs, certain brain and body functions are aroused to cause the body to start breathing again. Although these arousals create brain and physical activity to bring about the resumption of breathing, the person rarely awakens completely and may be unaware of these interruptions in their sleep. These interruptions can occur hundreds of times each night, resulting in poor quality sleep.

The effect of sleep apnea on an individual can be considerable. Repeated incidents of apnea throughout the night create sleep deprivation. This sleep deprivation diminishes an individual's ability to perform cognitive tasks. In fact, the effect of sleep apnea is comparable to alcohol impairment as a leading cause of accidents while operating motor vehicles and heavy equipment. Recent medical studies have shown that the physical stress placed on the body by episodes of sleep apnea can also cause sexual dysfunction, high blood pressure, stroke, heart disease or even sudden death. Recent reports in medical literature show that 30% of those with hypertension have sleep apnea.

Since sleep apnea is a newly understood disorder, it often goes undiagnosed because of lack of awareness by physicians. The task of identifying a sleep apnea sufferer is often left to one's bed partner who may have observed the affected person snore or stop breathing. Currently, the delay in diagnosis is estimated to be more than 5 years from onset of the problem. As public awareness of sleep apnea increases, timely diagnosis and treatment should become more common.

Tests to diagnose sleep apnea are simple, accurate and noninvasive. An individual first completes a brief standardized and validated questionnaire that helps the individual and their sleep medicine specialist determine whether a sleep study is appropriate. If it is, the overnight sleep study will monitor their sleep to see if the features of sleep apnea are present.

A sleep study involves monitoring an individual's physiologic data (including eye movement; leg movement; EEG or brain wave activity; ECG or cardiac activity; respiratory effort; and airflow). Electronic sensors placed on the patient's skin, like those used for an electrocardiogram, collect the data that comprises the polysomnogram. A bedside data collection unit reads these sensors and transmits the data to a computer monitored by a sleep technician in an adjoining room. A physician specially trained in the diagnosis and treatment of sleep disorders evaluates the data and makes a determination.

If sleep-related breathing cessations are present to a significant degree, CPAP (Continuous Positive Airway Pressure) may be prescribed to control the disorder. CPAP involves the use of a small nasal mask connected to a CPAP machine. The CPAP machine delivers positive air pressure to the upper airway preventing the airway closure that causes sleep apnea. When the airway remains open during sleep, sleep is not interrupted by the short arousals to resume breathing. Although there are other forms of treatment, including surgery, CPAP remains the gold standard of initial treatment throughout the world due to its effectiveness and noninvasive nature.

Many patients with sleep apnea find their condition may significantly improve through lifestyle changes such as reducing caffeine and alcohol intake, establishing a regular sleep schedule and improving overall fitness through weight loss. CPAP users quickly find themselves more rested with substantially more energy during the day and with no downside risk of medication side effects or surgery. If this energy is channeled into an improved lifestyle and fitness regimen, sleep apnea will often improve to the point where use of CPAP can be discontinued.

Traditionally, sleep studies have been performed in a hospital or clinic setting. For many people, these unfamiliar settings are not conducive to restful sleep and can make it difficult to obtain reliable data. Likewise, studies performed in the home very often result in poor data due to lack of continuous monitoring.

Northwest Sleep Wellness Center has teamed with the WAC to offer Members the latest in diagnostic technology while providing an enjoyable and effective sleep study experience. This innovative format is the first to integrate medical therapies such as CPAP with the European Spa approach to treating the disease. In the WAC/NSWC program, a sleep wellness client is first treated to a relaxing transition from their hectic day: a massage at the Spa at the WAC followed by dinner at Torchy's. Afterward, the client retires to their private room at the Inn at the WAC where a sleep technician prepares the client for the overnight sleep study. The client then enjoys a restful night in a private, deluxe room as the sleep technician monitors the client's data from an adjoining room.

The next morning, the client awakens and prepares for their day ahead as early as desired. After enjoying breakfast, they are free to go about their business. Later in the day, after the sleep data has been fully reviewed by a board-certified sleep physician, the client is contacted by phone for a discussion of the study results and an appropriate course of treatment.

If you or a loved one is concerned about a sleep disorder, stop losing sleep over it—Take advantage of our WAC/ NSWC partnership by contacting the Wellness Center at 206.839.4780 and we will be happy to arrange an evaluation.