Many people in Douglas County have sleeping issues and may be undiagnosed with sleep apena. How to test for it, and what you can do to treat it, was the topic of a radio interview recently on CHI Mercy Health’s Talking Health radio program on News Radio 1240 KQEN.
Host Lisa Platt interviewed Debbie Langdon from CHI Mercy Health Sleep Center about how the center helps people who may have a sleeping disorder.
The following is an edited version of that interview.
Lisa: What kinds of factors lead to sleep issues?
Debbie: Some of the symptoms of sleep apnea are fatigue, restlessness, insomnia, difficulty concentrating, loud snoring, people that are waking up in the middle of the night thinking they have to use the restroom, when in reality that’s the body’s defense mechanism to wake them up because they’re not breathing.
Lisa: What is sleep apnea?
Debbie: It’s a cessation of airflow, so you’re either not having any airflow at all, which is total obstruction, or you have a hypothnia, which is a narrowing of the airway — causing very little breath to go in and out of the body and oxygen levels decrease. That’s called obstructive sleep apnea.
There’s also a central sleep apnea which is a component that basically comes from the brain, where the brain isn’t triggering the body to take a breath. That’s usually because of medications, heart issues, strokes, heart attacks and things like that.
Then there’s a combination of mixed sleep apnea, which is basically a combination of obstructive along with the central component and those are usually cardiac patients.
Lisa: What happens at The Sleep Center?
Debbie: A patient will spend the night in the lab to complete a sleep study. Then the following day, the staff will score their study, looking for respiratory events, snoring, oxygen levels going down, restlessness, any behavior disorder where people are acting out their dreams or anything like that.
Then we will send the study to our reading physicians for their review and that report gets sent back to the doctor who ordered their study.
During the day, we review home sleep studies, but most of the activity is in the evening where we see anywhere from two to six patients Monday through Friday and some Sundays.
Lisa: What are some of the symptoms besides snoring?
Debbie: Having a hard time concentrating, headaches from the oxygen, desaturations, restlessness, irritability. Sometimes people will have diabetes and have sleep apnea as an underlying factor, because when you’re body’s not getting that oxygen it needs, you get into a fight-or-flight mode and it affects your insulin levels.
Sometimes diabetes will go along with that and also if you have some kind of heart palpitations with Afib, sometimes that’s a good indicator that you have sleep apnea as well. Heartburn with acid reflux tends to be hand-in-hand with sleep apnea.
Lisa: What can happen to you if you don’t treat the sleep apnea?
Debbie: It’s not good for your heart. Your heart gets angry if it doesn’t have the oxygen it needs. Then you start falling into some kind of Afib or arrhythmia. Diabetes goes hand-in-hand with sleep apnea, and headaches because of lack of oxygen to the brain. All of your vital organs need oxygen and if you’re depriving your body of oxygen at night, it’s not going to feel healthy, you’re not going to feel rested, you’re not going to have energy and your quality of life will go down.
Lisa: Is the only way to test for sleep apnea, to go to the sleep center, or is there another way to determine it?
Debbie: If you suspect you have sleep apnea, you should talk to your primary care physician. There are screening tools they can use to help determine if you would benefit from a sleep study.
Lisa: What does the sleep study entail?
Debbie: We monitor EEG activity, which is your brain wave. That way we know when you’re asleep, what stage of sleep and when you’re awake, and also when the brain’s having an arousal, whether that’s from not breathing, from light or sound, from snoring, leg movements and things like that.
We attach some leads on the neck, which is a snore microphone so we know when they are snoring and how severe the snoring is, light, moderate or severe. We have some cannulas that you put in the nose, just like an oxygen cannula.
It basically measures how much air is flowing through the nose and the mouth. When they’re breathing normally we’ll get a nice waveform. When they hold heir breath and we get an apnea event, we get a flat line and know they’re not breathing.
Patients will have a probe on their finger to let us know what their oxygen level is. So there is quite a bit and it is intimidating when people walk in and see all the wires that we’re going to put on them. But it’s painless, and they just need to get in a comfortable position and not worry about all the wires and try to do the best they can to fall asleep.
Lisa: Tell us what a CPAP does?
Debbie: CPAP stands for continuous positive airway pressure, so when you breathe in, the pressure stays at 5 cm, which is at the very minimum we can start with. When you breathe in, you get that airflow in your lungs. The machine continues to blow that 5 cm continuously. When you go to exhale, it doesn’t stop or lower.
So basically, you’re exhaling against that pressure. It’s a good respiratory exercise to keep the airway inflated and blow off the Co2 when you exhale.
Bi-PAP is two pressures. It’s an inspiratory pressure and expiratory pressure. A lot of people with restricted lung diseases will have that, because they can’t get enough muscle tone together to exhale against a stronger pressure. When you breathe in, you get more air and when you go to exhale, the machine will decrease and you can exhale more comfortably.
Lisa: Do most insurances cover the study and the equipment if needed?
Debbie: It often does, but it depends on the insurer. Insurance coverage will also dictate what type of study we do, so depending on what insurance you have or what group you’re in, you can have a home sleep study or in-lab. It just depends on which one your health insurance plan will give prior authorization for.
Lisa: What would you like to tell people about sleep apnea?
Debbie: If you feel like you have sleep apnea, talk to your primary care provider about the symptoms you’re having.