Char Jones is one of those infectiously sweet and soft-spoken people who walks around smiling all day. But a few years ago, a chronic condition dimmed her sparkling smile.
“When I reached mid-life, I felt extremely depressed, I had bone-crushing fatigue and I gained 55 pounds in a four-year period.” Jones explains. “It got to a point where I couldn’t get out of bed anymore, and I was forced to quit my job.”
Over the course of four years, she was misdiagnosed with depression, an under-operational thyroid and a hormone imbalance. But her lethargic symptoms continued and worsened over time.
It wasn’t until her newly-wed husband told her that not only did she snore at night, but she repetitively stopped breathing throughout the night.
Jones adds, “He said he and our two cats counted the seconds until I began breathing again!”
After this awakening conversation, Jones went to her primary care physician, who referred her to a local sleep center.
Jones underwent a sleep test at Cincinnati-based Sleepcare Diagnostics, the largest sleep disorder center under one roof in the U.S. The test revealed Jones’ nighttime breathing halted more than 160 times a night, sometimes for more than a minute at a time. She was soon thereafter diagnosed with obstructive sleep apnea (OSA).
The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central and mixed. According to Virgil Wooten, MD, medical director at both the Bethesda and Good Samaritan Hospitals’ sleep centers in Cincinnati, OSA is the most predominant kind of apnea.
OSA is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked, but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each breathing interruption, or apnea, the brain sends a signal to twitch or move to arouse the body enough for the person to resume breathing.
Nate Utter, physician liaison with Sleepcare Diagnostics, says some patients with severe cases of sleep apnea are unable to arouse the brain enough to start breathing again. In which instances, their hormonal system creates urine. Utter says those patients experience five or six visits to the restroom a night and are usually misdiagnosed with an overactive bladder.
But whether it’s a muscle twitch or a call from Mother Nature, sleep is consequently fragmented and of poor quality for sleep apnea sufferers.
“The repetitive awakenings lead to daytime sleepiness, memory impairment, mood impairment and other cognitive impairments,” says Wooten. “A sympathetic nervous system activation and oxygen level drops also go along with it. Those things can cause a variety of other problems like high blood pressure, cardiac rhythm disorders as well as higher risk of heart attack and stroke.”
Wooten says the series of muscles from the diaphragm on up must be coordinated properly to keep the airways open. Many things can lead to dysfunctional coordination such as jaw structure, airway size, aging and obesity. Weight gain is an increasingly growing problem, Wooten says, because it causes more tissue and pressure to build up around the throat, further aggravating the sleep disorder.
Sleep apnea also has varying effects on different people, especially in certain age ranges. For example, OSA causes sleepiness with adults, but in children it causes hyperactivity and a lack of concentration. “Just right there, most people are inclined to pinpoint ADHD as the problem,” Utter says. “But that might not be the case at all.”
Being correctly diagnosed made a world of difference for Jones. When OSA was pinpointed as her problem, she began Continuous Positive Airway Pressure (CPAP) therapy, which uses a mask and pressurized air to keep her airway open.
Through Sleepcare Diagnostics’ educational sessions, Jones learned how to use the device and found the mask that suited her best. Some facilities hold similar sessions, or send a respiratory therapist to the patient’s home for usage instructions.
Today, after one year of CPAP treatment, Jones is smiling again. “I’m a new woman now. I wake up refreshed and I’m energetic throughout my day,” she says. “I’ve been given my life back.”
Since her misdiagnosis tribulations and fruitful CPAP therapy, growing awareness about sleep apnea and educating the medical field on its symptoms is now a life mission for Jones.
She befriended the facility that took her down the road of her recovery and encouraged Sleepcare Diagnostics to hire her as a women’s healthcare consultant. They did. And since then, she wakes up – refreshed, of course – each day to meet with physicians, OB/GYNs, cardiologists and dentists to tell them about the symptoms of sleep apnea as well as it’s common links to other diseases and risks.
“Educating the doctors is a big thing for us,” says Utter. “Sleep, in the past, hasn’t been looked at in much detail. The mentality of our society is to pinpoint a problem and get a medication to fix it immediately. Sleep apnea isn’t that at all. It’s something you take a while to tailor to you and you live with it for the rest of your life.”
The interplays between sleep apnea and other illnesses is a hotbed of investigation right now. But researchers are just beginning to scratch the surface of the links, risks and treatments of this nocturnal nemesis.
“There’s a lot of focus on sleep problems right now, and my assumption is that there will soon be devices that effectively pace and stimulate the breathing,” Wooten projects. “I think we’re starting to understand the mechanisms of sleep apnea a lot better, so there’s a lot still to be seen in the future of sleep apnea.”
Amy Storer is the editor of TherapyTimes.com. Questions or comments can be directed to editorial@TherapyTimes.com.
