Sleep walking and sleep apnea

I remember as a child having episodes of sleepwalking. It really didn’t seem to bother me much until I woke during a walk in the middle of night in another room in the house. It was very disorienting to slowly realize that you don’t know where you are. My parent didn’t seem concerned assuming that I would just outgrow it and I did. I wondered whether my other sleep problem, which is sleep apnea, might have something to do with that.

According to Science Daily “Nearly 1 in 10 patients with obstructive sleep apnea also experience "parasomnia" symptoms such as sleepwalking, hallucinations and acting out their dreams” which seems strange to me considering how little sleep folks with apnea get but there is a study from Loyola University Chicago Stritch School of Medicine to back it up.

Sleepwalking occurs during the “deep sleep” stage of sleep. What causes it is unknown but it might be because of mental disorders, medications, fatigue and alcohol. The majority of cases happen to children. Folks would do sleepwalk have their eyes open and they may do a number of routine activities around the house, although they wouldn’t remember them later.

A recent study has suggested that nearly 30 percent of folks in a study have had some kind of sleep walking occurrence as an adult or child according to webmd.com. These numbers have dramatically increased over the past 30 years.

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Sleep apnea and the NFL

Sleep apnea has become a major health risk for an ever growing segment of the population. Why now? There are a couple reasons such as sleep disorders and sleep apnea in particular has gotten a lot of press over the years as health in general is being closely watched. Lack of sleep can lead to more problems than just being tired. Another health issue that is connected to sleep apnea is being overweight. The excess pounds are a major contributing fact to sleep apnea where fat in the face and neck areas can cause blockage in the back of the throat. One group of folks that seem to be affected by this is NFL players.

 According to a story on ABC GMA “A new medical study finds that up to one-third of NFL players have sleep apnea, a disorder that creates serious health risks and increases the chance that players will not get a good night's sleep before they hit the gridiron.”

That is mind boggling but certainly believable considering excess weight is a big part of sleep apnea. Being over 300 pounds isn’t out of the norm for a lot of players especially line men. And having a large thick neck along with being heavy also ups the odds of getting sleep apnea.

It seems certain that the league is taking sleep apnea very seriously considering all the health risks that are involved for the players.

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What is Titration?

The most common treatment for sleep apnea is using a CPAP machine where air is pushed through a tube into your throat to keep your airway open. While it sounds rather simple there are quite a few issues that are involved with this process with the biggest being the comfort of wearing a mask at night and having air forced into your throat. Not everyone can get used to the mask but many do. What does get a little tricky is how much air pressure is taken through the mask. This is called titration.

If you think that you have sleep apnea your first step should be to your general practitioner who will send you on to a sleep specialist, who are typically ENTs or pulmonologists (respiratory doctors). If the sleep specialist thinks that you may have sleep apnea then they will set up a sleep study which will determine whether you have sleep apnea or not.

In my case the first sleep study was just to determine if I had sleep apnea whereas some folks have a split study where the second half of the night the sleep technicians put a CPAP mask on you.  The technicians will monitor your sleeping or lack of it from another room. They can also adjust the amount of air that is going through your CPAP mask. Hopefully at the end of the study the sleep techs will have enough information to send to your doctor to recommend a titration setting on the CPAP machine.

If you do decide to try the CPAP machine the titration rate will be adjusted for you by a sleep tech. usually a nurse or someone who specializes in CPAP setting will come out to your house with the CPAP and set it up for you.

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How fast is sleep apnea’s damage?

Some illnesses bring on health problems right away whereas others might go undetected for quite a while. I used to wonder where you would put sleep apnea, does it have an immediate impact on you or does it take a while.  If you consider that there are a lot of folks that have sleep apnea and don’t even know it you would think that severe health risks would arise after some time. In a recent article in Science Daily they go over a study that showed how quickly sleep apnea can affect the body.

The study looked at the effect that sleep apnea had on a group of middle aged men who had obstructive sleep apnea and their conclusion was that even a mild form of sleep apnea can cause problems in the cerebral vessels which may lead to a stroke.  What is really frightening is that the cerebral vessels may be altered after 30 days!

That has to be awfully scary for anyone who has had sleep apnea it should also be “wakeup call” for those who think that they might have sleep apnea but they haven’t been tested.  If the present is any indication the number of people with sleep apnea will continue to rise causing an incredible health risk in the future.

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Provent nasal patch and sleep apnea

Last year on a post I wrote about a new device that helps those with mild to moderate sleep apnea the Provent Nasal Patch. It seems that the device has been getting more popular and more press since it was approved in 2008 by the FDA.

The idea behind the Nasal patch is quite simple. A plug is put in each nostril and there is adhesive to hold them in place. The device is referred to as an EPAP or expiratory positive airway pressure which in essence causes pressure through exhalation this forcing the upper airway to become open. The patches are also disposable. There are been studies that show the device to be highly effective for more information on subsequent studies go to the National Institute of Health’s page on the device and study.

As you can imagine not everyone is suited for this type of device although it might not be as cumbersome as a CPAP mask and probably not as effective.  I don’t know if the insurance companies are covering yet it would probably be best just to check with your health care provider.

The company that makes it refers to it as Proventtherapy, check out their website for further information.

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My father had sleep apnea also

Your family’s health history especially your parents can be a great indicator of potential health problems down the road. In my own case my father had heart disease and died from a heart attack, it wasn’t really surprising to find out that heart problems ran in his family. This information has been golden for me because I have made sure that my cholesterol and blood pressure has been in the normal range for quite a few years.  But there are some illnesses like sleep apnea where you wouldn’t think that heredity would play a part in it, but it does. Unfortunately my father had sleep apnea and so do I.

Of course there is more than one factor that leads to sleep apnea; probably the main one is being overweight. When you put on the extra pounds some of them end up on your face and neck which in turn contributes to the blockage of the airway in the back of the throat. I’m not sure that being overweight is caused by heredity but some folks seem to think so.

The possible connection with regards to sleep apnea between my father and me is the shape of our faces. That seems strange but the shape of one’s face can cause sleep apnea. If the face is round and big this somehow can cause a blockage in the back of the throat. There seems to be some validity in that because his face was round like mine. What was also strange was that he wasn’t overweight at all.

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Sleep apnea and mandibular advancement splint

Last week I was discussing sleep apnea and surgeries and how they are usually reserved for those who have tried the CPAP and it doesn’t really help them. I received a comment from Thomas Bishara, DMD about the mandibular advancement splint (a device that I can’t remember if I had heard about before or not)

Here is the comment…

I treat Obstructive Sleep Apnea (OSA) and primary snoring patients. The mandibular advancement splint is a popular non-surgical approach to snoring/OSA treatment.

The American Academy of Sleep Medicine recommends oral appliance therapy as the first line therapy for mild and moderate OSA. Patients with severe OSA should try CPAP first. If patient is found to be CPAP intolerant, they should be fitted for a MAS.

We also use combination CPAP/MAS to reduce the CPAP pressure and make using CPAP more comfortable. Many patients have tried the surgical route with mixed results, Thanks for your post

The mandibular advancement splint sounds interesting of course like the Dr. said it is only for mild to moderate obstructive sleep apnea. Any time you can find a non-surgical device to help with sleep apnea you should consider it. I looked at Wikipedia and I found a picture of the device. Although it doesn’t appear to be very comfortable looking it still may be worth a try.

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