The Dangers of Sleep Apnea Among Older Americans

As we’ve detailed in prior posts, obstructive sleep apnea poses a number of dire secondary health effects, up to and including a reduced life expectancy. Now a new study underscores the serious impact that untreated sleep apnea can have on older Americans.

The University of Florida College of Medicine conducted a study of more than 9,000 adults aged 50 and above, which looked at a range of factors, including the presence of OSA, any treatment received, and a range of demographic data, including socioeconomic status. (For you statistics junkies, please note that this is a robust sample size, and quite sufficient to generalize across wider populations.

The results of the study are concerning, to say the very least. More than 76% of the individuals included in the survey were rated as possibly having undiagnosed sleep apnea. That’s three out of every four individuals in the study. Separately, more than 10% of those in the study had been diagnosed with obstructive sleep apnea, but were not receiving treatment.

The potential dangers of this are profound, particularly for older Americans. As noted, untreated sleep apnea can lead to a range of serious side effects, including:

If you’re playing along at home, you’ll notice that these conditions are already a problem for people in their 50s and beyond, meaning that untreated sleep apnea puts them at greater risk.

Why is sleep apnea reaching epidemic proportions among these older cohorts? The study speculates somewhat, but one reason that was highlighted is the lack of public awareness. Simply put, middle-aged folks are unaware of the dangers of untreated sleep apnea. But one other reason: the cost involved. In many cases, simply getting diagnosed can be a challenge.

This is one reason that Dr. Krish offers an at-home sleep study. It’s vastly cheaper than a conventional clinic-based sleep study, and it’s way more convenient.

Source: UF College of Medicine study finds sleep apnea in older adults needs more attention (UF Health press release)

You’re a middle-aged man. And you’re in good shape. You’re not overweight, you stick to a healthy diet, you don’t smoke, your alcohol intake is minimal, and you work out regularly.

But you have obstructive sleep apnea.

Turns out, that one strike against you is enough to cause cognitive decline. A new study examined men aged 35 to 70 who had been diagnosed with mild to severe sleep apnea, but were otherwise healthy. A separate control group was also recruited, made up of men who were healthy and hadn’t been diagnosed with OSA. Both groups were given a battery of tests.

The study found that the group of men who suffered from untreated sleep apnea experienced reduced mental function in areas such as impulse control, judgment and recognizing the feelings of others. The study also showed that the men with obstructive sleep apnea had reduced attention spans, executive functioning and short-term visual recognition memory.

Possibly worst of all? The study also demonstrated that those cognitive deficits rose with increasing severity. In other words, the worse the sleep apnea, the more extreme the cognitive decline.

As we’ve shared in other blog posts, untreated sleep apnea is strongly correlated with a number of other conditions, including heart disease, stroke and glaucoma, alongside a range of psychological disorders like depression and anxiety. But it was long believed that the cognitive decline associated with sleep apnea was due to one of those related conditions, such as type 2 diabetes. But according to this study, that’s just not the case. Sleep apnea is enough to cause cognitive decline in otherwise healthy individuals – there aren’t any other associated conditions to blame.

If you think you’ve developed obstructive sleep apnea, it’s time to stop suffering. Contact us today for an at-home sleep study.

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We’ve detailed how untreated obstructive sleep apnea can contribute to a host of issues ranging from cardiovascular disease to glaucoma to generalized brain damage.  Now add anxiety to the list.

Sleep apnea is a sleep disorder characterized by interrupted breathing while asleep, ranging from excessive snoring all the way to periods of not breathing at all. This can have all kinds of highly damaging psychological side effects, such as increased anxiety.

  • Sleep disruption: Sleep apnea can cause repeated awakenings during the night, which can lead to poor sleep quality and daytime sleepiness. This lack of restful sleep can contribute to feelings of anxiety, as the body is not able to fully recover and recharge during the night.
  • Hypoxia, or a lack of oxygen in the body, is a common feature of sleep apnea. When oxygen levels in the body drop, it can trigger a stress response, leading to feelings of anxiety and panic.
  • Brain changes: Sleep apnea can also lead to changes in the brain, including alterations in the levels of neurotransmitters like serotonin and dopamine. These changes can contribute to mood disorders like anxiety.
  • Poor concentration: Sleep apnea can also lead to poor concentration and memory problems, which can exacerbate anxiety symptoms.

It’s worth noting that anxiety can also be a risk factor for sleep apnea. Anxiety can lead to changes in breathing patterns and increased muscle tension in the upper airway, both of which can contribute to sleep apnea.  In fact, we’ve gone so far as to use the Generalized Anxiety Disorder-7 screening test as part of our intake for new patients.  If a patient is diagnosed with obstructive sleep apnea, tools like the GAD-7 can help us to understand how severe it is from a psychological perspective.

Sleep apnea and anxiety can feed off of one another in really bad ways.  If you think you’re suffering from sleep apnea, contact us and get tested.  

When a person is diagnosed with obstructive sleep apnea, the first approach to treatment is generally the continuous positive airway pressure device (CPAP). However, many people quickly find that the CPAP doesn’t work for them – in fact, it has happened enough that “CPAP intolerance” has become a generally accepted diagnosis. So why do so many people end up abandoning the CPAP?

Obstructive sleep apnea occurs when a person’s breathing is repeatedly interrupted during sleep due to the collapse of the airway. The CPAP works by delivering a constant flow of air into the person’s airway by way of a mask worn over the mouth and nose, thus preventing the interruptions in breathing that occur in OSA. Think of it like placing an electric fan in front of a doorway and setting it to run air fast enough that the door can’t close on its own.

CPAP intolerance can occur for various reasons. One of the most common reasons is the mask itself, which may cause skin irritation, pressure sores, or discomfort around the nose and eyes, making it difficult for some people to wear it for an extended period of time. Some users may feel claustrophobic or anxious while wearing the mask, which can further exacerbate the intolerance.

Another reason for CPAP intolerance is the sensation of the air pressure itself. While the CPAP is intended to help people breathe more easily during sleep, some users may find it difficult to adjust to the sensation of the air pressure, which can feel uncomfortable or overwhelming. CPAP machines can also be noisy, and some people may find it difficult to sleep with the sound of the machine in the background.

There are a number of other factors that can contribute to CPAP intolerance:

  • Dry mouth or throat. Wearing a CPAP means a constant flow of pressure into the airway, which means it gets very dried out overnight.
  • Air leaks. If the mask doesn’t fit adequately, the air won’t go into the airway, which defeats the purpose of the device.
  • Some users may experience psychological barriers to CPAP therapy, such as a negative attitude towards the treatment, a lack of motivation to use it regularly, or difficulty adapting to the routine of using CPAP every night.

These are just some of the reasons that Dr. Krish doesn’t prescribe the CPAP for her patients. But the biggest one is quite straightforward: it treats the symptoms without actually providing a cure. A person suffering from sleep apnea can’t use the CPAP for a limited period of time and then find that their snoring stops. Even if the CPAP works for you, it’s your new normal forever.

Yes, the CPAP is a widely accepted treatment for sleep apnea, but it’s not a cure-all. For that matter, it’s not even a cure.

A few weeks ago, we shared a link from Reddit’s AmITheA**hole subreddit about a woman wanting to know if she was in the wrong for snapping at her husband over her snoring. While that post was somewhere between annoying and funny, this one is pretty heartbreaking.

In this post, the redditor in question, u/povao, wants to know if she’s in the wrong for sleeping in a different room than her husband due to his chronic snoring. Reading between the lines, you can tell she would really prefer to sleep in the same room as her husband. But her own health is suffering. She was hospitalized before Christmas, and she has multiple sclerosis and is on disability. And as they have two children, she needs to be firing on all cylinders as much as possible. Suffering sleep deprivation over her husband

So when asked by OP to see a doctor to seek treatment, how does the husband respond? He sidesteps the question, promises to call a doctor but never does, and generally just doesn’t want to deal with the issue.

Well, while he might not want to deal with the problem, OP has been dealing with it every…single…day for the last few years. And as a mother and one suffering from chronic pain, she’s just had enough of being woken up multiple times every night when her husband starts doubling as a chainsaw.

As you might imagine, redditors are piling on the husband in the comment thread, confirming almost in unison that OP is not in the wrong. But as a clinic that specializes in treating obstructive sleep apnea, here’s what we would say to the husband.

It’s a generally accepted principle of life that your right to swing your fist ends where my nose begins. It would be one thing if you were the only one negatively impacted by your particular case of sleep apnea. But you are not. Your wife is also suffering badly due to your chronic snoring. And indirectly, so are your children.

Look, obstructive sleep apnea is really unpleasant. (There’s a reason Dr. Krish left a career in dentistry to specialize in treating it.) But you are responsible for your own health. And given that this particular condition is depriving your wife of fifteen years – who says this is one of the biggest issues she’s faced in your marriage – of a good night’s sleep, it lands on you to find suitable treatment.

Source: AITA for not wanting to sleep in the same bed as my husband? (Reddit)

We’ve highlighted a number of health risks associated with poor sleep, including depression. Now more data has surfaced to back up our claim.

The National Sleep Foundation has released new findings from its annual poll on American sleep habits, this year focusing on the connection between sleep and mental health. Their poll, which was focused on a sample from the general US adult population, found that American adults with good sleep were less likely to have significant depressive symptoms: more than 90% of adults polled who enjoy very good sleep health also reported an absence of elevated depressive symptoms.

Conversely, the poll revealed that almost seven in ten adults who are dissatisfied with their sleep experience mild or greater levels of depressive symptoms. And it doesn’t take much loss of sleep to have it happen: people with difficulties falling or staying asleep just two nights a week have higher levels of depressive symptoms than those without sleep difficulties. Additionally, 50% of all adults who sleep less than the NSF-recommended seven to nine hours experience mild or greater levels of depressive symptoms.

“One unique aspect of this year’s research was how we combined NSF’s multiple validated measures of the population’s sleep health with an established measure of depressive symptoms to examine the link between sleep health and depressive symptoms in the general population,” said Joseph Dzierzewski, PhD, Vice President of Research and Scientific Affairs at the National Sleep Foundation. “As a licensed clinician, I’d say there’s never been a more important time to think about the strong connection between our sleep and mental health.”

If you’re experiencing severe depression – in other words, if you believe you may be at risk of suicide – seek immediate help. Reach out to the Suicide and Crisis Lifeline by calling or texting 988.

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Obstructive sleep apnea is linked to a range of serious health problems, including cardiovascular disease, glaucoma, and brain damage. Of course, the more immediate problem with sleep apnea is that it leaves you drowsy and fatigued during the day. And as one Maryland resident learned the hard way, failure to get treated can put you on the wrong side of the law.

Some months after being diagnosed with sleep apnea last June, David Allick of Rockville received a letter from the Maryland Motor Vehicle Administration, requiring additional information regarding his diagnosis. Failure to provide the requested documentation, including a letter from his doctor, could result in a suspension of his license.

It turns out that sleep apnea is one of several conditions, including epilepsy and a stroke, that Maryland law states can impact an individual’s ability to receive or renew a driver’s license.

We’re not lawyers, and we have no idea if such a law exists in Texas. But either way, if you’re suffering from sleep apnea, you owe it to yourself and other drivers on the road to get treated. Drive safe out there!

Source: Little-Known Maryland Law Requires People With Sleep Apnea to Report Diagnosis to Driving Authorities (NBC4 Washington)

There’s a popular saying: “Your right to swing your fist ends where my nose begins.” If your partner is suffering from chronic snoring due to obstructive sleep apnea, you suffer from it too on some level, as it impacts you as well as them. So what do you do if your partner’s snoring is reducing your quality of sleep?

In our first blog post in this series, we discussed short-term fixes to address snoring, but as we stated in that blog post, those address the symptoms, but they don’t represent a cure. In our second blog post, we suggested some ways to encourage your partner to remain on their side throughout the night to help reduce the odds of snoring. Again, this can help quite a bit, but it’s not a long-range answer to the underlying problem.

So what are some specific things you can do to address the underlying issues related to chronic snoring?

  1. Encourage your partner to maintain a healthy weight. Overweight individuals often have excess fatty tissue in the neck, which can partially obstruct their airway and cause snoring. Encouraging a healthy diet and regular exercise may help with weight management and reduce snoring.
  2. If your partner smokes, encourage them to quit. Smoking can irritate and inflame the airway, leading to snoring. Quitting smoking may help reduce the frequency and severity of their snoring.
  3. Get specialized treatment to address the underlying cause of your partner’s sleep apnea.

Treatments for Snoring: Your Partner’s Options

Generally speaking, sleep apnea occurs due to the airway becoming blocked or restricted while your partner is asleep. In many cases, it’s because the tissue of the soft palate is loose enough that it drops in front of the airway, constricting your partners breathing and causing them to snore.

To address the challenge of your partner’s airway being obstructed by the soft palate, Dr. Krish offers the NightLase laser treatment for snoring. A gentle laser tightens the tissues of the soft palate to raise it up and out of the way. It’s fast, noninvasive, and produces immediate results.

In many cases, individuals have a naturally constricted airway due to an oral cavity that is too narrow. In response, Dr. Krish can fit your partner with a custom oral appliance. Used in conjunction with myofunctional therapy, the interior of your partner’s mouth can be reshaped over time, opening the oral cavity and creating an open airway. It doesn’t merely address the symptoms: this is a complete cure from snoring.

In conclusion, there are several steps you can take to help reduce or eliminate your partner’s snoring. Encouraging healthy habits and seeking medical treatment for underlying conditions can make a significant difference in reducing snoring.

In our last blog post, we discussed some short-term fixes to address snoring. One of the quickest can be to get your partner to sleep on their sides, but that can be far easier said than done. Even if they start out sleeping on their sides, they can roll on their back in their sleep without realizing it. But there are some things you can do to encourage them to stay on their sides.

  1. Use a body pillow. Encourage your partner to use a body pillow to keep them in a comfortable side-sleeping position. The pillow will physically block them from rolling onto their back.
  2. Sew a tennis ball into the back of his pajama top. This technique can be effective, as the discomfort of the tennis ball can discourage them from rolling onto their back in their sleep.
  3. Try a special pillow: There are specially designed pillows that can prevent them from rolling onto their back. Some have curved shapes that support side sleeping, or others have straps that keep the person in a specific position.
  4. Adjust the bed: If your bed is too soft, your partner may sink into it and roll onto their back. Consider getting a firmer mattress or adding a mattress topper to provide more support for side sleeping.

None of these are long-term fixes for OSA, but they can help your partner reduce the odds of severe snoring in the night.

Coming up in part 3: long-term fixes that you and your partner might consider.