SLEEP EASY for a Healthier Heart

TO LEARN MORE ABOUT SLEEP DISORDERS AND THEIR TREATMENTS, CALL (616) 391-3759.

OSA is a common sleep disorder that occurs when a person stops breathing repeatedly during sleep because the airway collapses, preventing air from getting to the lungs. This can happen dozens of times each night, preventing deep, restful sleep and stressing the heart over time.

"OSA is like city driving versus highway driving," explains Nancy Hausman, MD, a sleep specialist with Michigan Medical PC of Holland, who treats patients at Holland Hospital's Center for Sleep Disorders. "Collapse of the airway can be caused by extra tissue on the back of the airway, such as large tonsils, a relaxed tongue that blocks the airway or decreased airway muscle tone. When done repeatedly, this inefficient stop-and-go pattern causes a lot of wear and tear on the heart."

OSA is often seen in people who snore or have pauses in breathing at night. It can cause gasping and choking during episodes, restless sleep, morning headaches from lack of oxygen and excessive daytime sleepiness. The American Academy of Physicians reports that up to 4 percent of the adult population and 10 percent of children have OSA. Heavier people tend to be more at risk for OSA, but it can affect anyone.

Diagnosing the problem
To diagnose OSA, doctors may refer patients to Holland Hospital's Center for Sleep Disorders for a sleep study. The study helps doctors evaluate nighttime breathing problems, unusual behaviors like sleepwalking, leg movements during sleep or severe daytime sleepiness. The Sleep Center recently increased its private rooms from six to 10 to reduce patient waiting lists.

The sleep study involves an overnight stay at the Center for Sleep Disorders, which has hotel-like rooms furnished with cable television, a private bath and an adjustable bed. Patients check in at 7 p.m., are prepped for monitoring and then go about their regular bedtime routines.

"Technicians will hook up patients to monitors that record breathing patterns, brain waves, respiration rate, oxygen saturation and airflow through their noses," explains Jeffrey Hodges, manager of Cardiopulmonary Services at Holland Hospital. "The results are recorded and then sent to the sleep specialist for review."

Breathing (and sleeping) easier
If OSA is confirmed, there are several treatment approaches. Patients can try propping up their heads and upper torsos, or sleeping on their sides instead of their backs. Dr. Hausman says losing weight and getting enough sleep so that you're not overly tired at night can help. For more serious OSA, medical intervention might be necessary.

The most common therapy is continuous positive airway pressure (CPAP), a simple but effective procedure for keeping the airway open during sleep. "CPAP is just simple mechanics," Dr. Hausman notes. "The patient wears a mask over his or her face that blows pressured air through a tube. The pressure keeps the airway propped open but doesn't interfere with breathing in and out. We set the pressure rate so that it's ideal for the patient, and humidity can be added to prevent dryness."

Doctors determine the ideal pressure rate for a patient by conducting a polysomnogram, which indicates when respiratory problems have stopped as well as when OSA occurs.

The CPAP device is a shoe box-size air compressor with an air pump and filter. The units can be rented or purchased at medical supply stores for use at home.

Another treatment option is an oral appliance that the patient wears to bed. The custom-fitted mouthpiece forces an underbite that opens up space behind the tongue to clear the airway. Surgery to remove excess tissue or enlarged tonsils that might constrict breathing also may be beneficial for some patients.

The bottom line is that if you're not sleeping well, talk to your doctor. Sleeping disorders such as OSA should be diagnosed and treated early to head off more serious heart problems later in life.

"If you're excessively tired, fall asleep easily during the day or can't sleep, mention it to your doctor," advises Hodges. "Most people don't think to mention sleep problems to their physicians and many times doctors don't ask, 'How are you sleeping?' But OSA can lead to an increased risk of heart failure, high blood pressure and stroke, and it should be addressed."

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