The most disruptive symptom tends to be the loud snoring associated with obstructive sleep apnea (OSA).

Many deny that they snore, because they are embarrassed or  they truly don’t believe that they are capable of making such irritating noise without being aware of it. In this case, it is difficult for a bed partner to cope with the disruption.

Undiagnosed sleep disorders increase the risk for serious health problems, such as diabetes, heart disease, obesity, stroke and death. Although it can a little embarrassing at first, it is extremely important for you or the one you love to seek treatment for a sleep disorder. Not only will your overall health improve, but your cognitive functioning and reaction times will also improve.

Questions to the readers: If your partner snores or tosses and turns and disrupts your sleep, how do you cope?

If your partner was unwilling to visit a sleep doctor, how did you convince him or her to go?

Please leave your answers/tips as comments.

According to the American Academy of Sleep Medicine, CPAP is used to keep your airway open as you sleep by providing you with a steady stream of air pressure.  It keeps your tissues in your throat from collapsing and thereby ensures that you get the oxygen you need.

Results of the study show that while weight loss and surgery to remove tissue in the throat  may sometimes effectively treat sleep apnea, the evidence behind these treatments isn’t as strong as that which supports the usage of CPAP, according to the team from the Tufts Medical Center Evidence-Based Practice Center, which prepared the report.

About 12 million Americans are known to have obstructive sleep apnea, and it’s likely that millions more are undiagnosed, according to the AHRQ. The condition, caused by the repeated collapse and blockage of the upper airway during sleep, leads to a cessation in breathing that usually occurs many times through the night typically 5-100 times per hour!

The main symptoms of sleep apnea are loud snoring and feeling very sleepy during the day. Although, many patients, even those with severe OSA, can deny daytime sleepiness. Your bed partner may notice periods when you stop breathing during sleep. Other symptoms may include tossing and turning during sleep, frequent awakenings during the night, waking up with a headache, and feeling irritated and unrested.

According to the Center for Disease Control (CDC) Obstructive sleep apnea can lead to high blood pressure, heart disease, diabetes and increased risk of accidents because of daytime fatigue.

Anyone from age 2 to 92 can suffer from obstructive sleep apnea. It was commonly thought to be a disorder of over-weight, middle-aged men, but sleep specialists are revising their opinion. Thin people often have a long narrow pharynx and that predisposes them to sleep apnea. Children have tonsils that are large relative to their small throats and they can have sleep apnea that leads to symptoms of ADHD, learning difficulties and psychiatric problems such as depression. Pregnant women often develop snoring and sleep apnea and there is ongoing research into the dangers this might pose to mothers and their unborn children.  Post-menopausal women have the same risk as men.

If you are sleepy during the day despite adequate sleep time, then sleep apnea should be investigated, especially if you’re told that you snore or stop breathing at night. Studies report that anywhere from 4 percent-24 percent of men suffer from OSA, and 2–15 percent of women. Both sexes over the age of 65 have a rate of 20–25 percent.

Only a sleep specialist can determine if you are suffering from OSA, and what the best method of treatment is for you.  Contact Northshore Sleep Medicine at 847.674.3600 if you believe you or your bed partner are suffering from Obstructive Sleep

The study involved 308 children between the ages of 4 and 10. Children’s sleep time was analyzed for a week via wrist monitors. Researchers recorded Body Mass Index (BMI) which is a measurement of weight and height.  They also tested  levels of glucose and insulin in some of the children.

Results showed that obese children got less sleep and experienced more variations in their sleeping patterns compared to children of average weight.

Researchers concluded that children who sleep for less time and have irregular sleep schedules are at the greatest risk for health problems.

According to the CDC, childhood obesity has many serious consequences, including increased risk for cardiovascular disease, diabetes, and asthma. Overweight and obese children are also at a higher risk for becoming socially stigmatized and developing low self-esteem, which can hinder academic and social functioning.

Many children fail to get the sleep they need because of poor sleep hygiene, or bad habits at bedtime; however, the child may be suffering from an undiagnosed sleep disorder such as obstructive sleep apnea.

People often fail to realize that small children, as well as pre-teens and adolescents can suffer from a wide variety of sleep disorders, ranging from sleep apnea to night terrors.  Common symptoms of sleep disorders in children include

• excessive daytime sleepiness (EDS)
• disturbed, fragmented sleep
• sleep walking and talking
• confusional arousals
• sleep enuresis (bed wetting)
• snoring or heavy, labored breathing
• difficulty concentrating, paying attention and remembering
• depression and/or anxiety

According to the American Academy of Sleep Medicine (AASM), children who are not getting the sleep they need may have developmental or behavioral problems. The AASM recommends the following guidelines for sleep times in children:

• Infants (3 to 11 months): 14 to 15 hours
• Toddlers: 12 to 14 hours
• Preschoolers: 11 to 13 hours
• School-age children: 10 to 11 hours

Obstructive Sleep Apnea occurs when you regularly stop breathing for 10 seconds or longer during sleep. It can be mild, moderate, or severe, depending on the number of times in an hour that your breathing stops (apnea) or becomes very shallow (hypopnea).

Common symptoms of OSA include loud snoring, daytime sleepiness, unintentionally falling asleep during the day, fatigue and un-refreshing sleep and insomnia. OSA is also induced with increased risk for high blood pressure, heart disease, obesity, diabetes and stroke.

CPAP, a device used to keep the airway open in order to help patients sleep better at night while you sleep, is the most common, and most effective, treatment for OSA.

The study compared the effects of a treatment with CPAP compared to placebo treatment in 59 adults diagnosed with OSA on self-reported measures of fatigue and energy.

Results show that CPAP treatment significantly decreased fatigue and increased energy after three weeks of treatment.

Authors of the study claim that these findings are significant, as they emphasize the importance of complying with CPAP therapy.

According to the American Academy of Sleep Medicine, OSA can occur in men and women of any age, but it is most common in obese, middle-aged men. A strong relationship exists between obesity and OSA. We estimate that 80% of people with OSA are overweight or obese.  However, I see patients every day in my clinic who are quite thin, but have horrible apnea usually because they have small, narrow throats.  The disorder is easily diagnosed with an overnight sleep test.

The study involved 472 people between the ages of 18 and 75 years with clinically diagnosed asthma. Participants had received treatment for their asthma condition at the University of Wisconsin tertiary-care clinic between the years 2007 and 2009.  All subjects completed the Sleep Apnea Scale of the Sleep Disorder Questionnaire to assess the severity of OSA symptoms and the Asthma Control Questionnaire to assess the quality of asthma control.

Previous studies have found that patients with undiagnosed OSA may continue to have difficulty controlling their asthma symptoms, even if they are receiving optimal care.

Results of the study show that 80 (17 percent) of patients had asthma symptoms that were not well controlled, and 109 (23 percent) were at high risk for OSA. Researchers found that after controlling for factors that are known to affect asthma control (such as obesity), patients at high risk for OSA were 2.87 times more likely to have poorly-controlled asthma compared to patients who were at low risk for the sleep disorder.

These findings suggest that treatment of OSA in asthma patients may lead to improvement in the treatment of asthma symptoms.

Patients who are at high risk for OSA should undergo a polysomnogram with a sleep specialist in order to determine the severity of their condition and determine the best course of treatment. The most common treatment for OSA is continuous positive airway pressure (CPAP) therapy, which uses a device to push a steady stream of air through a mask in order to open a patient’s airway while they sleep.

My Asthma patients often fear that CPAP will worsen or exacerbate their Asthma, and so I like to share research such as this to reassure them that most likely treating their sleep apnea with CPAP or with other methods will help them have fewer Asthma attacks.

Sleep experts believe that enforcing a strict bedtime routine to ensure children get the sleep they need may reduce ADHD symptoms, but it will not eliminate them. Research shows that sleep problems are not a cause of ADHD, though sleep deprivation or inefficient amounts of sleep does increase symptoms.  Undiagnosed pediatric obstructive sleep apnea can cause such sleep disruption, usually with the parents’ awareness, that children can have daytime symptoms that mimic ADHD or other learning problems or even psychiatric disorders.

The study analyzed the sleep of 15 children between the ages of 7 and 11 years of age who were diagnosed with ADHD, and 23 children who did not have the disorder. Researchers tracked the amount of time taken to fall asleep, the amount of time the children slept and how much time the children slept in each stage of sleep. Parents also completed questionnaires concerning their children’s sleep habits. None of the children was taking ADHD medication at the time of the study and children were monitored at home in their own beds.

Results showed that children with ADHD slept about a half-hour less, on average than their peers without the condition and spent 15 fewer minutes in REM sleep. The children with ADHD also took longer to fall asleep, were more anxious about sleep, and less likely to get enough sleep.

Although the purpose of REM stage sleep is not completely understood, previous research indicates that it is necessary for the brain to process and sort information.

It is important to create healthy bedtime habits and a steady bedtime routine.  However, a child may need additional help to get the sleep he or she needs. Adjusting ADHD medication may be one solution. If your child continues to have difficulty falling asleep or staying asleep, he or she may be suffering from a sleep disorder. Visit our pediatric website to learn more about sleep disorders in children and to review our pediatric sleep questionnaire to see if your child might have the signs or symptoms of a sleep disorder.

During my lecture I will discuss the association of sleep disorders with impaired glucose tolerance, changes in appetite hormones, diabetes and weight gain/obesity.  There is a growing body of literature that shows a strong  association between short sleep durations and weight gain/obesity.

Research shows that sleep deprivation increases your risk for weight gain and obesity. The Huffington Posts reportsthat sleep restriction has been shown to increase levels of the hormone ghrelin, which makes you feel hungry while also slowing your metabolism. A new area of research focuses on how specific sleep disorders such as Obstructive Sleep Apnea, Insomnia, Restless Leg syndrome may lead to weight gain, either through the short sleep mechanism or other physiologic pathways.

The American Academy of Sleep Medicine claims that at least 40 million Americans have chronic sleep problems, and an additional 20 million experience occasional sleep disturbances. As many as 47 million Americans have metabolic syndrome, which is a group of conditions that are shown to increase the risk of heart disease and stroke and is usually associated with overweight/obesity.

According to the National Sleep Foundation, a study published in the International Journal Obesity found that middle-aged women who suffer from sleep disorders are more likely to have problems with their weight than their peers who get eight hours of sleep per night. Results were unique, in that they demonstrated that sleep problems precede weight gain.

A study published in the May 2010 edition of the journal Sleep found that people who fail to get an adequate amount of sleep (less than six hours per night) tended to weigh more and exercise less. This group was also more likely to prefer fatty foods, snack frequently and eat out more often.

It is important to recognize the relationship between sleep and weight gain, in order to address the epidemic of obesity. Many people do not realize that sleep is as important to good health as exercise and diet. By obtaining seven to eight hours of sleep per night, you are helping your body stay strong, both mentally and physically.

According to a 2005 survey conducted by the National Sleep Foundation, nearly one in four American couples sleep in separate bedrooms. Many of the participants in the study explained that they were choosing to sleep apart from their partner because their sleep is disturbed by their partner’s sleep disorder.

Often, both people in a relationship suffer from serious health problems if a sleep disorder remains untreated. Those who suffer from obstructive sleep apnea(OSA) are at increased risk for stroke, heart disease, diabetes, obesity and even death. Most people, but not all, who suffer from sleep apnea snore  and of course this can greatly disturb their bed partners.

Other disorders that disrupt a bed partner’s sleep include restless leg syndrome, periodic limb movement disorder, insomnia and REM Behavior Disorder (acting out dreams and nightmares).  Loud snoring, restlessness or tossing and turning may keep the unaffected partner from sleeping.

Bedmates of those suffering from a sleep disorder may feel resentment, because they are unable to get the sleep they need. Also many spouses of my sleep apnea patients talk to me about the fear and anxiety that they have at night while they lie there in the bed watching their partners stop breathing. Often, they feel it is their duty to stay awake and watch out for their spouses, for example, by nudging or shaking them in order to get them to breath.

Partners of those suffering from untreated sleep disorders may also be compromising their physical and mental well-being, as sleep deprivation is associated with increased risk for many of the health problems that we see associated with sleep apnea.

Although sleeping together can be difficult when one partner suffers from an untreated sleep disorder, couples may be able to share a bed in peace if the partner receives treatment. Some sleep problems can be eliminated by improving sleep hygiene (making positive behavioral changes), such as keeping technology out of the bedroom and creating a routine sleep habit.

If making changes in your sleep habits does not improve the quality of your sleep, you may be suffering from a sleep disorder. You should visit a sleep expert if your sleep problems persist for more than a month.  Loud snoring, a symptom of obstructive sleep apnea can be treated  through the use of continuous positive airway pressure (CPAP) therapy or with oral devices that advance the jaw and open the airway while you sleep.  According to the American Academy of Sleep medicine’s Sleep Better Blog, marital conflicts caused by sleep difficulties decrease after three months use of CPAP therapy. Doctors may also recommend cognitive behavioral therapy or a prescription sleep aid if insomnia is the problem. As for Restless Leg Syndrome and Periodic Limb Movement Disorder, there are medications that are safe and effective.

Take home message:  whatever sleep problem you or your partner has, a sleep physician can help treat it.  And treating a person’s sleep disorder not only improves the patient’s health outcomes but can play a role in improving in his or her marriage.

According to the National Sleep Foundation, SIDS is the unexpected, sudden death of an infant under one year of age that remains unexplained even after an autopsy and thorough medical investigation. SIDS is the leading cause of death in children between one month and one year of age, and in most cases the infant was believed to be healthy immediately before the death.

Infants between the ages of two and three months of age are at greatest risk for SIDS, and the phenomenon occurs more frequently in males than females. African American and Native American children are more likely to die from SIDS than Caucasian children.

Scientists believe that the cause of SIDS may be a combination of biological, genetic and environmental factors. The American Academy of Sleep Medicine reports that in many cases, the brains of infants who die of SIDS produce lower levels of serotonin, a brain chemical that is critical in regulating breathing, heart rate and sleep.

Although the exact cause of SIDS is unknown, research shows that there are several factors that increase the risk of SIDS, including infants sleeping on their stomachs (prone position), use of soft bedding, sharing a bed with a parent and exposure to second-hand smoke.

In 1994, The National Institute of Child Health and Human Development (NICHD), launched the Back to Sleep campaign, which urged parents and caregivers to place infants to sleep on their backs. Since then, the rate of SIDS dropped by more than 50 percent. Widespread adoption of back sleeping appears to have reduced the occurrence of SIDS, but has not eliminated it.

I am often asked if SIDS is due to obstructive sleep apnea in infants.  Sleep specialists do not think that it is a collapse of the airways that causes SIDS but there have been reports that there is an increase in obstructive sleep apnea in the parents of SIDS infants.

While some nursing homes continue to keep patients on a strict daily schedule, some are drastically changing the way they manage patient care.

Although the regimented schedule ensured patients received their medications properly, it was also extremely disruptive to patients’ sleep.

Sleep deprivation is associated with increased risk for weight gain, diabetes, heart disease, stroke and even mortality. It is also associated with a decrease in awareness, cognition and mood. While these consequences are of great concern in the general population, older adults often already have compromised mental and physical health, and these factors can be particularly dangerous for this population.

According to the American Academy of Sleep Medicine, our sleep needs change with age. As we grow older, people tend to sleep less deeply and wake up more frequently during the night. Many older adults tend to get sleepier earlier in the evening and wake up earlier in the morning.

While many believe that poor sleep is a normal part of aging, it is not. Sleep schedules and habits may change; however, disturbed sleep and waking up tired every day is not considered normal. Older Adults experiencing these problems could be suffering from sleep disorders such as insomnia, obstructive sleep apnea or restless leg syndrome.

Biological and hormonal changes that occur in later adulthood, such as menopause and a decrease in the secretion of melatonin may interrupt sleep. Physical and mental problems and the medication used to treat them may also disturb a person’s sleep.

Older adults who are suffering from sleep problems can take several steps on their own to try to improve their sleep. Some ways to increase and improve your sleep include creating a nightly routine, going to bed and waking up at the same time every day (even weekends) and avoiding caffeine and exercise within 3 hours of bedtime.

If these changes do not improve your sleep, you should contact a sleep expert in order to determine if you are suffering from a sleep disorder.