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Posted: December 31, 2008

Sleep Apnea: Serious Disorder as Common as Diabetes

Worth a Closer Look as We Age

For too many of us, sleep just isn’t what it used to be. That extra time it takes to fall asleep, frequent night awakenings, and those frustrating wee-hour-of-the-morning risings may easily be chalked up to age-related changes and daily stress.

The decline in sleep over time is likely to have negative results including daytime sleepiness, an inability to focus or concentrate, and even depression. If you suspect there may be more to your or your parent’s sleep issues, it’s worth your while to be screened for sleep apnea, a serious, yet highly treatable, sleep disorder.

Obstructive sleep apnea (OSA) is the most common form of sleep apnea. It occurs when breathing is briefly and repeatedly interrupted during sleep for 10 seconds or longer due to a blocking or narrowing of the airway in the mouth, nose, or throat. Hundreds of these episodes can happen in one night -- and the person affected doesn’t even realize it.

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This is truly scary stuff for anybody, but more so for caregivers who not only have their own sleep concerns but also worry about their loved ones. The good news is that diagnosis and treatment will result in improved quality of life and the prevention of unnecessary health and safety risks.

More Prevalent with Age

Sleep apnea is as common in this country as diabetes, affecting more than 18 million Americans. It is highly prevalent in people over age 60, yet it is more difficult to diagnose in this population. Perhaps because the elderly expect some type of sleep disruption, and may already be suffering from other health issues, symptoms of sleep apnea often go unnoticed.

When the body stops breathing, even briefly, it is starved of oxygen. This may lead to life-threatening problems such as high blood pressure, heart attack and stroke. Oxygen deprivation also affects the immune system, contributes to poor mental and emotional health, causes irritability, and slows reaction time.

Add these issues to an aging body and mind and sleep apnea is as overwhelming as it is confusing. How is a caregiver to know which symptoms are the result of sleep apnea and which are due to Mom’s existing health issue or are a part of Dad’s normal age-related decline?

For many, just getting a parent evaluated may be a challenge. Ask Joanne Spring of Richmond, Virginia, who recognizes the telltale loud snoring of sleep apnea in her 85-year-old mom. Mom’s “claim to fame is that she has never been to a doctor for a check-up.” The determination and resolve in those words doesn’t get any clearer. Joanne says, “I don't think I could talk my mother into going to a doctor, let alone going for a sleep study, and believe me, I have tried.”

Caregivers Can Spot Signs

Yet, caregivers are in the ideal position to observe sleep activity and report it to a physician. Listen for the hallmark of sleep apnea -- loud and excessive snoring likely interrupted by pauses followed by stuttered gasps for breath. Other typical symptoms include sleepiness, fatigue, frequent need to urinate during the night, unintentional napping, and cognitive dysfunction.

Sleep-related complaints, cardiovascular disease, depression, and traffic accidents could also be signs of sleep apnea. Elderly patients with the disorder, in particular, tend to complain of bed wetting and frequent need to urinate, cognitive impairment, eye conditions and repeated falls.

Though the risk of sleep apnea increases with age, studies are turning up positive results for elderly sleep apnea sufferers. One recent study shows they actually may live longer than their non-sleep apnea counterparts. Conducted by researchers at the Technion-Israel Institute of Technology in Haifa, Israel, mortality rates of elderly patients with no sleep apnea and varying degrees of sleep apnea were compared over 4½ years. Surprisingly, those with sleep apnea had a mortality rate one-third that of the general population.

There’s more exciting news in that the main treatment for sleep apnea was found to improve cognitive functioning in patients with Alzheimer’s disease who also suffer from OSA. Considering a staggering 70%-80% of people with dementia also have sleep apnea, this will largely improve quality of life for Alzheimer’s patients and their caregivers.

How It’s Treated

The treatment is called CPAP, a device worn as a mask that blows air at sufficient pressure to maintain an open airway. Studies showed significant cognitive improvement in these patients, suggesting that doctors consider CPAP treatment for its Alzheimer’s patients who have OSA. Dr. Jody Corey-Bloom, co-author of the study, said, “Any intervention that improves cognition in patients with Alzheimer’s disease is likely to result in greater independence for the patient and less burden on their caretakers.” Earlier results from the study showed that CPAP reduced daytime sleepiness, a common complaint of Alzheimer’s patients and their caregivers.

CPAP does not come without issue, however. Chris, who lives in Athens, Georgia, has had many a frustrating night with his CPAP. “Between the headaches, the itchiness of the mask, the heat and the constant need to be aware of whether the mask is leaking, there are times in the middle of the night when I just want to rip the mask right off my face and just run out of the bedroom.” Yet, he says it’s not always that way, and the reality is he wakes up feeling rested and with more energy. “I've made this commitment because my health is important to me.”

Not everyone is as driven. Shortly after her own diagnosis last year (sleep apnea can be hereditary), Joanne Spring discussed the effects of the condition on various health issues with a co-worker. Joanne recommended a sleep study to her 57-year-old co-worker who was both obese and a snorer, two signs of sleep apnea. Her co-worker wanted no part of it after seeing the mask and CPAP. A few months later, “She nodded off, as she often did. But this time she did not wake up,” said Joanne, adding: “It was too much trouble to wear a mask to sleep.”

A good night’s sleep is vital. A little attention to the risk factors and symptoms of sleep apnea can lead to the diagnosis and treatment of a disorder that will bring positive results immediately. And the first step is a simple screening that can make all the difference in the quality of life of both caregiver and loved one.

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Lori Zanteson is a California-based freelance writer. She specializes in topics related to families and can be reached at lorizanteson@verizon.net.

Resources:

National Sleep Foundation

American Sleep Association

American Sleep Apnea Association

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