Sleep Apnea Often Goes Undetected

From the Publishers of the New England Journal of Medicine

Sleep apnea, a common and debilitating disorder signaled by loud snoring, often goes unrecognized, according to researchers who say better diagnosis and treatment would cut the risk of accidents, heart attacks, and strokes.

Sleep experts reviewed charts of 752 patients who came to a Walla Walla, Washington, clinic and found that although 114 complained of symptoms relating to sleep, only six were suspected of having a sleep-related condition, and only two were provided with a take-home diagnostic machine that measures sleep patterns.

The experts then trained local physicians in recognizing and treating sleep disorders and launched a public awareness campaign. In the subsequent two years, referral for testing increased eightfold to 2.1 percent of all clinic patients, according to the report in the February 24 Archives of Internal Medicine. Of 360 patients tested, 81 percent showed a sleep-related breathing disorder. Most of these had sleep apnea, which occurs when throat muscles relax so much that they close in on themselves and obstruct the upper airway as a person enters deep sleep. After a few seconds without breathing, a person with apnea gasps for air and is jolted into a lighter level of sleep, and the cycle begins again. This occurs repeatedly throughout the night, leaving the person deprived of deep sleep. The results, says co-author Eric Ball, MD, include sleepiness, an increase in industrial and auto accidents, and an elevated risk of heart attack and stroke. Treatment, in addition to weight loss if necessary, involves a breathing device that opens the airway with pressurized air.

Sleep-related breathing disorders most frequently strike overweight, middle-aged men, but more than one fourth of the Walla Walla cases were women, and one was a four-year-old child.

If you recognize the symptoms—loud snoring, interruptions in breathing during sleep, and excessive daytime sleepiness—ask your physician for testing or contact a sleep specialist.

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