A Snorer’s Alarming Affliction: Sleep Apnea

1964
By Jay Cook
A good nights sleep is one of the necessities of ensuring a safe, healthy, productive day. Whether it’s operating heavy machinery or just navigating daily life, for a person with sleep apnea there is no guarantee for a full and uninterrupted night’s sleep.
In September, a NJ Transit train engineer was at the helm when his train went full-speed through a wall at the Hoboken Terminal, killing one person and injuring 100 more. According to his lawyer, the engineer recently discovered he was likely suffering from sleep apnea.
This sleep disorder, according to the National Sleep Foundation, affects 18 million Americans.
“It would be uncommon for a sleep apnea patient to get up in the morning and feel good the way they’re supposed to, the way that everybody else feels,” said Adrian Pristas, M.D., the medical director of the Sleep Medicine Program at Meridian Health. “The problem is, there’s no way to measure that.”
Pristas, who has been studying the field of sleep and its many disorders with Meridian Health since 1998, said that sleep apnea is much more common than most people think.
“Sleep apnea is a relatively common disorder of breathing that occurs during sleep where the posterior air way collapses during certain stages of sleep and causes a cessation of breathing for at least 10 seconds or more,” he said.
Generally, the causes of sleep apnea vary across the board. Having a neck size over 16 1⁄2 inches, obesity, menopause, pregnancy and genetics are all triggers that can result in sleep apnea.
“People are born with a predisposition commonly that their soft palette is low-hanging in the back of their throat, so that’s why it kind of runs in families,” Pristas said.
Of the potential health problems that stem from sleep apnea, the most serious can be heart attack, stroke, high blood pressure, blood clots and diabetes.
Diagnosis of the sleep disorder can be tricky as well. The only way to go about that is through a sleep study, when a night’s sleep is monitored – either at home or in a sleep lab.
Once diagnosed, there are a multitude of treatments available to patients ranging from devices to surgeries.
The most common tool that helps treat sleep apnea is Continuous Positive Airway Pressure, otherwise known as the CPAP machine. The device funnels a steady stream of air into the user’s air passage, helping to ensure that the soft palette in the back of the throat does not collapse.
Pristas, who believes that CPAP therapy is the “gold standard” of sleep apnea treatment, says that finding the right mask and system is key to its success.
“I always compare it to a shoe size,” he said, noting that the mask has to fit well. “Otherwise it’s either uncomfortable or ineffective.”
If the CPAP device is something that a patient deems uncomfortable or unsuccessful, there are a few newer alternatives to finding that elusive, uninterrupted night’s sleep.
For example, a dentist can provide an oral appliance, which is molded perfectly to fit the user’s mouth. Also, an obstructive device called “Inspire” has hit the markets, and follows a different model than in the past.
“That is kind of like a pacemaker that gets implanted underneath your skin and towards the back of your tongue, and that, believe it or not, works by remote control,” Pristas said. “When you turn it on, it tenses muscles in such a fashion that it keeps the airway open.”
An uvulopalatophar yngoplasty, other wise known as UP3 surgery, removes a portion of the patient’s soft palette, which effectively opens their airway. Pristas says that this surgery can yield some pain in the following days, and the results are not always predictable.
Just like Pristas’ shoe-size analogy, 55-year-old Middletown resident Cathy DaPrato has tried on many a device, and is still in the market for the right fit.
“There were so many symptoms,” said DaPrato, who said her husband and family told her she snored loudly and was diagnosed with the sleep disorder in 2013. “Every time that I fell asleep, I would always find myself waking up by choking – I was choking and gasping for air – that was the main thing.”
While in the entertainment business as a singer, she has had to change her lifestyle due to the sleep disorder which she believes she has suffered from for years.
Instead of the late-night shows and long drives home, DaPrato has turned into a day-time performer who performs at senior citizen homes and similar venues throughout the day. After struggling with the CPAP therapy for about a year, she could not find a comfortable-fitting mask and began looking into alternatives.
When she discovered that a dental appliance was costly and not covered by her insurance, she started researching online for less expensive options and found VitalSleep – an FDA-cleared anti-snoring mouthpiece. They too have various styles, and through trial and error, she found the one that worked best for her.
Now DaPrato said that instead of waking up every 10 minutes, VitalSleep has helped her limit interruptions to every couple of hours.
“The sleep apnea is tough because during the day, I have bouts where the tiredness just overcomes me and I have to kind of fight through it if I can’t take a quick nap,” DaPrato said.
On the medical end, Bayshore Community Hospital in Holmdel and Riverview Medical Center in Red Bank – both Meridian Health entities where Pristas is based – are looking to become trailblazers for modern sleep studies in the Northeast.
“Bayshore and Riverview have been attempting to become the regional center, and because of that, we have a regional sleep lab at the two hospitals that have six beds at each center, so we can do six studies a night,” said Pristas.
With more studies being conducted and the number of treatment options increasing, that never-ending exhaustion and fatigue stemming from sleep apnea patients can hopefully be on the decline.
And for those weary about a sleep study or embarrassed about their snoring habits, just take notes from DaPrato.
“It’s been proven that this interrupted sleep, because we’re not breathing properly, will lead to several types of medical issues,” she said. “So people should approach it the same way they would if they needed to take medication for any serious medical condition.”