Sleep Apnea and Disordered Sleep Syndromes

It’s no secret that America does not sleep well!

Pre-crisis levels of 50% of people suffering from difficulty falling/staying asleep are probably underestimates in this climate of health crisis, economic crisis, and the Holiday Season.

In addition, the medical establishment has moved Sleep Apnea and other sleep disorders from a typical board question to a highly diagnosed condition.

Personally, I have never seen a negative sleep study but even overdiagnosis does not negate the serious conditions associated with sleep apnea.

Still the most common reason a diagnosis is made is a spouse or partner who tells the doctor that their significant other snores very loudly and then stops breathing for noticeable periods of time.

That in and of itself does not make the diagnoses nor does the absence of those things negate the diagnosis.

Simply put the older you get the more likely you are to have a positive diagnosis. In 50-70 year olds it hovers between 9% and 17% for women and men respectively. But right now, the over 70 population is undertested.

One of the more serious issues is Right Sided Congestive Heart Failure due to over stressing the Right side of the heart to push blood through under oxygenated blood and some less clearly defined hormonal conditions.

It’s also inflammatory suggesting a role for things like fish oil. The studies done use the “Omega 3 Index” which means something completely different than my version. The common version refers to how much Omega 3 is in the red blood cell membranes.  This is not a great surrogate for the amount in the tissues of the body which is where many of the beneficial effects have been shown. Once again the use of an inferior measurement allows for clouding and confusion.

The best index is ALWAYS going to be the Omega 6/3 ratio since the ratio defines the relative deficiencies rather than the absolute amounts.  You can order this as a home test from Amazon!

Inflammation is associated with changes in neurocognition, mood, behavior, cardiovascular function and metabolism and as you might have guessed telomere loss and pre mature aging!

There are many newly recognized causes of sleep apnea.  These include age related loss of tissue elasticity in the upper airway, the use of more volatile organic solvents in home construction and barro sinusitis where a person has a heightened sensitivity to wings in barometric pressure due to the anatomy of their sinuses and the “holes” that drain and connect them.

Central causes located in the brain are rarer but as you might guess are associated with psychoactive drugs and meds as well as chronic high dose alcohol.

Since this is a treatable condition with things like CPAP and BiPAP you should not ignore this risk of premature aging if you suspect you may have this,’

Like ALL sleep disorders including the more common “disordered sleep” which is not falling or staying asleep or waking up a lot (yes prostate enlargement and caffeine consumption at night are risks!) the most common symptom, but the least specific is increased and excessive sleepiness during the day.  This is to be distinguished from falling asleep at inappropriate times which is more diagnostic of narcolepsy but can occur with sleep apnea.

One of the questions I get asked is can I take SWEET SLEEP if I have sleep apnea.  There are no studies to negate or support this but common sense suggests that if you are on CPAP and are monitored by a sleep physician it should not be a problem. That being said most sleep docs would say “absolutely not” based on the same amount of science that has been done on OTC sleep aids and sleep apnea- none!

That said always consult your sleep specialist if you have a question.

Moving on: most people simply have temporary or longer-term disordered sleep due to all kinds of things that I’ve talked about at length before including stress, prior addiction to sleep aids, melanopause (lower natural melatonin levels secreted by the brain with aging), alcohol use, caffeine use, poorly planned long naps during the day etc.

Caffeine use bears special mention.  A lot of people tell me, “NO DOC! It’s not caffeine because I don’t drink coffee after 4pm. Usually the caffeine crash happens then so this is when most people have their second cup.

It is not the case in all people but a large number of people who wake up at night who DO consume afternoon caffeine are slow metabolizers and experience a “second pass” effect in the middle of the night. It’s suspected this is not actually a true “second pass” phenomenon but more like a restoration of depleted ADP levels (caused by caffeine), leading to a wide awake feeling after waking up in the middle of the night.

IF this is you try reducing or quitting your afternoon coffee or subbing it out with green tea or Guayasa.

Again, by far most people will be able to take Sweet Sleep no problem since its all natural and drug free nonprescription.

It’s a great place to start, especially during the stress of the holidays!

Dr Dave

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