Northwest Community Hospital

WIN 2015

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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17 w w w. s p i r i t o f w o m e n . c o m W I N T E R 2 015 S P I R I T O F W O M E N SHUTTERSTOCK properly, says Dr. Darshana Amin, a neurologist affiliated with Community Medical Center, Toms River, N.J. You may have CSA, OSA or a mix of the two, and all have ties to other health problems. "When you have untreated sleep apnea, it puts you at risk for diabetes and stroke," says Dr. Amin. "Treatment is definitely proven to decrease morbidity and cardiac risk." These ties to cardiac health issues have made doctors much more aggressive about diagnosing and treating sleep apnea, adds Dr. Spencer. In 2007, the results of a 10-year study suggested that people with moderate to severe untreated sleep apnea have a 2.5 times greater risk of stroke than the general population, according to Dr. Rojewski. The potential cardiac issues are generally the same for men and women, although women are less affected by them if their sleep apnea is mild, says Scattarelli. It all comes down to a lack of oxygen in the blood, as well as potential damage to the heart and the lining of the coronary arteries. TREATMENT OPTIONS If you're diagnosed with sleep apnea, your physician will recommend treatment based on the severity of the condi- tion, as well as other health issues. Possible sleep apnea treatments include: • CPAP (Continuous Positive Airway Pressure), a machine used while you sleep to increase pressure in the airway, keeping it from closing during sleep • Dental appliances that pull the bottom jaw forward to keep the airway open • Surgery on the upper airway Most sleep apnea patients respond well to sleep appliances, but "follow-up is the key," says Scattarelli. "We can usually troubleshoot for them and make them more comfortable." Another emerging option for OSA is Inspire therapy, a small, fully implanted system that delivers mild stimulations to airway muscles to keep the airway open and which may be an option for people who can't tolerate CPAP. • P hysician Tom Rojewski likes to make one thing clear about snoring: It's not normal, says the otolaryngologist and sleep medicine specialist affiliated with Genesis HealthCare System in Zanesville, Ohio. In fact, snoring can be a real health concern, primarily because it is one of the major signs of sleep apnea, a con- dition in which breathing repeatedly stops and starts during sleep and which may be connected to cardiac health issues. Sleep apnea is fairly common, occurring in about 30 percent of post-menopausal women and affecting 3 to 5 percent of the population, says Dr. Rojewski. The good news is that sleep apnea is very treatable, and often surgery isn't even required to get patients rest- ing comfortably at night. DIAGNOSING SLEEP APNEA Complaints from a bed partner that you're snorting, gasp- ing or seem to be pausing while you're breathing are a good reason to schedule an appointment with your health care provider. One of the first questions he or she will likely ask is whether you find that you just can't keep your eyes open when your day begins to slow down, perhaps while reading or watching TV, says Dr. Jonathan Spencer, medical director of pulmonary and sleep services at Fremont Area Medical Center, Fremont, Neb. Daytime tiredness and morn- ing headaches are also common signs of sleep apnea. "If you aren't breathing like you're supposed to, your brain will wake up," says Dr. Spencer, which means you aren't getting what's considered restorative sleep. To make a diagnosis of sleep apnea, your physician will use a test called polysomnography, during which electrodes are attached to your skin in several places and monitors record your heart rate and breathing as you snooze in a sleep lab. Although polysomnography hasn't changed much in the past 50 years, according to Dr. Rojewski, what has changed is the approach to sleep studies. Clinics and hospitals are working to make these studies less stressful, and most sleep labs now resemble hotel rooms, says Debo- rah Scattarelli, RN, CNP, affiliated with St. Cloud Hospital Sleep Center in St. Cloud, Minn. Some patients are even able to do a sleep study at home, with sensors collecting information that can be downloaded at the lab. HIGHER HEART DISEASE RISKS An accurate diagnosis is important because there are differ- ent types of sleep apnea. Central sleep apnea (CSA) is different than obstructive sleep apnea (OSA). In CSA, the part of the brain that controls breathing and the drive to breathe isn't working 1. Loud, ongoing snoring that is usually loudest when you're sleeping on your back 2. Daytime sleepiness, especially during quiet moments 3. Morning headaches 4. Problems with memory and concentration 5. Irritability or mood swings 6. Waking up frequently to urinate 7. Dry mouth or sore throat when you wake up Source: National Heart, Lung, and Blood Institute 7 symptoms of sleep apnea

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