How to diagnose and treat sleep apnea
Dear Savvy Senior: What can you tell me about sleep apnea? My husband, who's 60, has become such a terrible snorer that he wakes himself up at night, and he keeps me up, too. — Sleepy Shelly
Dear Shelly: If your husband is a loud snorer who wakes himself up during sleep, he probably needs to be tested for sleep apnea, a dangerous disorder that affects around 22 million Americans — and many don't even know it.
Sleep apnea is a disorder that causes a person to stop breathing during sleep, dozens and even hundreds of times during the night for up to 30 seconds at a time.
Left untreated, it can cause extreme daytime sleepiness and contribute to a host of serious health conditions like high blood pressure, heart attack, stroke, congestive heart failure, diabetes, depression and gastroesophageal reflux disease.
In fact, it's estimated that every year about 38,000 Americans die in their sleep from a heart attack or stroke because of sleep apnea.
But the good news is that sleep apnea is very treatable, and most insurance companies, including Medicare, cover it.
Who has it?
There are three types of sleep apnea: obstructive, central and mixed. Of the three, obstructive sleep apnea is by far the most common. It occurs when the throat muscles relax during sleep, blocking the airway.
While anyone can have it, sleep apnea is most common in people who are overweight, male, middle-aged and older. For women, the risk rises after menopause.
The symptoms include loud snoring (however, not everyone who snores has apnea), long pauses of breathing, gasping or choking during sleep and daytime drowsiness.
But because most of these symptoms happen during sleep, most people don't recognize them. It's usually the person they're sleeping with who notices it.
To help you get a handle on your husband's problem, the American Sleep Apnea Association has several quick diagnostic tests he can take at sleepapnea.org — click on "diagnosis and treatment." If you suspect a problem after taking these tests, he should try some self-help measures, including:
Sleeping on his side or stomach: This will help keep his airways open. To promote side sleeping, there are products available that can help like the Rematee Bumper Belt (antisnoreshirt.com) and Sona Pillow (sonapillow.com).
Losing weight: Excess body weight, especially around the neck, puts pressure on the airway, causing it to partially collapse. Even a slight weight loss may help.
Avoiding alcohol and sleeping pills: These can relax the muscles in the back of his throat, interfering with breathing.
If his problem persists, make an appointment with his primary care doctor or a sleep specialist who will probably recommend an overnight diagnostic sleep test, which can take place at a sleep center (see sleepeducation.com) or at home using a portable device.
If he is diagnosed with apnea, the most commonly prescribed treatment is a continuous positive airway pressure (CPAP) device. This involves sleeping with a snorkel-like mask that's hooked up to a machine that gently blows air up your nose to keep the passages open.
Another less invasive treatment option is Provent therapy (proventtherapy.com). This is a small, disposable patch that fits over each nostril to improve airflow. A 30-day supply of these prescription-only patches costs $65 to $90, but, unfortunately, it's not currently covered by insurance or Medicare.
If the CPAP or nasal patches aren't an option, an oral appliance that fits into the mouth like a removable mouth guard or retainer may be the solution. Oral appliances work by positioning the lower jaw slightly forward to keep the airway open during sleep.
If these don't work, there are also a variety of surgical options available to help keep the throat open and prevent blockages.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC "Today" show and author of "The Savvy Senior" book.