Jim Polson was having trouble staying awake
during the day and his blood pressure was dangerously
high when he sought medical help to treat severe sleep
apnea eight months ago.
Surgery 16 years ago had
failed to correct Polson's sleep apnea disorder, which
grew increasingly worse over the years. The
48-year-old Hopedale, Ill., police officer even
recalled falling asleep on a number of occasions while
driving his car home from work.
"I would wake up when my car went over the rumble
strips in the side of the road," Polson said. "I would
come home from work and fall asleep within minutes. My
wife was urging me for years to go back to the doctors
to see if there was anything else they could do, but I
was stubborn. I didn't think I needed help. But it got
so bad I finally decided to do something."
Obstructive sleep apnea - repeated collapse of the
airway during sleep - is a debilitating,
life-threatening problem that affects at least 9
million Americans. Studies have shown that sleep apnea
contributes to high blood pressure and increases the
risk of a stroke and heart attack. And persons with
sleep apnea are likely to have damage to blood vessels
that can lead to heart disease.
Polson was evaluated for sleep apnea at OSF Saint
Francis Sleep Disorders Center, one of several sleep
disorder centers in the area.
"It's considered abnormal for a person's breathing
to stop more than five times an hour while sleeping,"
said Dr. Sarah Zallek, medical director for the OSF
sleep disorders center.
When Polson was tested at the sleep center during
an overnight study, he stopped breathing more than 120
times an hour while asleep.
"They also told me my blood pressure was at stroke
level," the police officer recalled.
Polson was diagnosed with severe sleep apnea.
Zallek explained that when a person is awake, throat
muscles keep the throat open and air flowing into the
lungs.
"When a person is asleep, everyone's muscles relax,
narrowing the airway by half," the doctor said. "With
people with sleep apnea, the throat relaxes to the
point it collapses and blocks the airway. When this
happens, the brain awakens the body to get you
breathing again. This is repeated throughout the night
hundreds of times in severe cases. It results in poor
quality of sleep and a drop in the oxygen level in the
blood."
In the sleep lab, Zallek has seen sleep apnea
patients stop breathing from 10 seconds to over two
minutes. Body fat is the biggest contributing factor
to the disorder, Zallek said. Fatty tissue builds up
in the throat and makes its harder to keep the throat
area open when asleep. More than half of the people
who have sleep apnea are overweight, and most snore
heavily.
"But by no means is fat the only cause of sleep
apnea," the doctor said. "It can affect persons who
are thin. It affects all ages and both sexes, although
men are twice as likely as women to have the problem.
Children ages 2 to 8 are at special risk because of
enlarged tonsils."
In addition to a buildup of fatty tissue, sleep
apnea can be caused from a person's uvula - the tissue
that hangs from the middle of the back of the roof of
the mouth - being too long. People with small jaws or
those with overbites are also at risk of having sleep
apnea.
Symptoms of sleep apnea include loud snoring,
morning headaches, high blood pressure, rapid heart
rate, restless sleep, feeling irritable, memory loss
and frequent urination at night. In addition to an
increased risk of heart attacks and strokes, sleep
apnea sufferers are at greater risk of accidents at
work and in their vehicles.
"We don't think sleep apnea causes diabetes, but it
makes diabetes harder to control," Zallek added.
Treatments include surgery to remove tonsils and
adenoids, if they are blocking the airway. Another
type of surgery is one that removes the uvula and part
of the soft palate. The latter surgery is not very
effective, Zallek said.
"Removing the uvula and shortening the soft palate
works in about a third of the cases at best," the
doctor said.
Another treatment is an oral appliance to position
the lower jaw forward to help keep the airway in the
throat open while sleeping. The most common and
effective treatment is CPAP (continuous positive
airway pressure), a machine equipped with a face mask
that blows air into the throat at a certain pressure
level.
"CPAP is the standard of care with most people with
sleep apnea," Zallek said. "The air pressure props the
airway open. It's a very effective treatment. I would
say it's 99 percent successful in people who use it.
If the machine is not set for the proper pressure or
face comfort, many people, unfortunately, won't use
it."
Zallek said early CPAP machines were noisy - the
sound of a vacuum cleaner - and uncomfortable. Today,
they are quiet, light weight and super soft, according
to the doctor. For the past eight months, Polson has
been wearing the CPAP mask every night at bedtime.
"I have to admit it took me a little time to get
use to it," the police officer said. "For me, it's
been very successful. I have so much more energy. I'm
not sleepy anymore, and my blood pressure is back to
normal. Recently, my wife and I took an eight-hour
trip in the car and I never once got tired. I'm
feeling great, and my wife is sleeping better, too. It
would scare her to wake up and see that I wasn't
breathing. She would then shake me awake."
Polson also has lost 30 pounds, down from 260. He
hopes to lose enough weight that someday he may not
need to wear the mask anymore.
"If I don't use machine, I don't sleep well,"
Polson said. "Not long ago the power went out in
Hopedale. I couldn't use the machine that night. My
wife said I was back to the same old routine - my
breathing would stop and I was snoring loudly."
A study within the past two years has found that
treating sleep apnea may have the added benefit of
helping patients lose weight. Sleep deprivation, for
whatever reason, reduces the amount of a hormone
called leptin, which plays a role in regulating weight
by suppressing a person's appetite.
"Leptin makes you feel full when you eat," Zallek
said. "People with sleep deprivation have less leptin.
After treating sleep apnea, the amount of leptin goes
up, which can help a sleep apnea patient lose weight."
The OSF Saint Francis Sleep Disorders Center is a
comprehensive clinic equipped with hotel-style rooms
for overnight sleep studies. The rooms have private
bathrooms, televisions, large beds, desks and
recliners to make the patients feel at home and give
them the best chance for a good night's sleep. A
technician monitors a patient's sleep patterns, heart
rate, amount of oxygen in blood, snoring, body
movements and breathing.
Since its beginning five years ago, Zallek's sleep
center has examined 10,000 patients for all kinds of
sleep problems, the majority of which were diagnosed
with sleep apnea.
"A great deal of people who suffer with sleep apnea
go undiagnosed," Zallek said. "Most people aren't
aware of how serious the problem is. And most people
don't know there are effective treatments."
Polson said he regrets not seeking medical help
sooner. He urges anyone who snores and suffers sleep
deprivation to have a sleep study done.
"I'm living proof that it can make you a new
person," he said.
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