Obstructive Sleep Apnea: Not Just a Snoring Problem!Kristin J. Addison-Brown, PhD Clinical Neuropsychologist
NEA Neuropsychology, PLLC (opening in June in Jonesboro)
We all know someone who snores. Most of us have made fun of someone who snores. We even have phrases in our vernacular to describe snoring: “sawing logs”, “snoring like a freight train”, etc. While it’s all in good fun, ultimately it is important to understand that snoring is no laughing matter.
Snoring is most often associated with a condition called “obstructive sleep apnea” (OSA). In OSA, the airway closes during sleep which causes frequent awakenings as the person struggles to breathe against the blocked airway, which produces the sound we know as “snoring”. By far, the most common cause of OSA is obesity. However, allergies, anatomy, genetics, and alcohol use can also contribute to OSA.
Increasingly, we are understanding that untreated OSA is a contributor to multiple serious medical conditions and events, including stroke, heart disease, heart attack, and even dementia. It is a frequent cause of “adult ADD” (attention-deficit disorder). OSA is also a risk factor for motor vehicle accidents and workplace accidents/injuries, to the extent that many employers (such as trucking companies) require routine screening for OSA. Depression, anxiety, irritability, and low quality of life are also associated with OSA. Therefore, appropriate diagnosis and management is critical for one’s health and safety.
The most common signs of OSA are loud snoring, gasping or choking for breath, and excessive daytime sleepiness. Other symptoms that can be associated with OSA include pauses in breathing, frequent awakenings, sore throat or dry mouth on awakening, headache, fatigue, and attention/concentration or memory problems. Sometimes the bed partner is the best “spotter” of OSA, as the individual is quite often unaware of his or her snoring.
If OSA is suspected, overnight polysomnogram is the optimal method for diagnosis. It will also help to rule-out other sleep disorders or causes of sleep disturbance. Home-based units can be used in extenuating circumstances (e.g., home-bound individuals), but the accuracy of these has yet to be established.
The best treatment for most causes of OSA is the CPAP machine. It acts as a “splint” for the collapsed airway, forcing it open with pressurized air. Other treatments are available, but they are often less successful, more invasive, and/or more costly (i.e., insurance doesn’t pay). Unfortunately, many people are either unable or unwilling to tolerate CPAP treatment. Discomfort is often given as a reason for not using the device, despite several comfort measures available. Often, I find that people are unwilling to even try it due to negative input from family or friends. However, if the device is actually “given a chance” – which can admittedly take a few months- many people report feeling so much better that they refuse to sleep without it!
As a neuropsychologist, I have had the unfortunate experience of diagnosing dementia in individuals for whom untreated OSA has significantly contributed to their decline. I have also seen several people with histories of stroke or heart attack with likely contribution from OSA. These are heartbreaking, and I do everything in my power to educate others to keep this from happening. Fortunately, I have also had the rewarding opportunity of seeing individuals before and after CPAP treatment, with much improvement in their quality of life and objective improvement on their test scores.
The bottomline is that OSA is simply not a condition to mess with. It has serious consequences if left untreated. Yes, the process for both diagnosis and treatment can be unwieldy, but it is well worth it in terms of longevity and quality of life. Please talk with your healthcare provider if you have symptoms of OSA.
Dr. Addison-Brown has worked as a clinical neuropsychologist with NEA Baptist Clinic in Jonesboro, Arkansas, for nearly 3 years. She will be opening a private practice in June- NEA Neuropsychology, PLLC. Inquiries can be sent to firstname.lastname@example.org. As a neuropsychologist, she performs evaluations for diagnosis and management of various neurological and psychiatric conditions, including attention-deficit disorders, learning disorders, dementia, stroke, traumatic brain injury, and depression/anxiety, among others. She also conducts pre-surgical evaluations for bariatric and other surgeries and return-to-work and employment screening evaluations.