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Ever wonder why you're so tired? You may be suffering from sleep apena. We have Dr. Charles W. Atwood, Jr., MD, who is a board certified pulmonologist and sleep medicine physician at the University of  Pittsburgh Medical Center and the VA Pittsburgh Healthcare System to answer a few very important questions. He directs the Sleep Medicine outpatient clinic at the UPMC Sleep Medicine Center and is the Director for the VA’s sleep disorders program. He is an investigator on research examining the role of home-based sleep apnea diagnosis and therapy and the role of bariatric surgery in treating obstructive sleep apnea. Dr. Atwood is currently the Chair of the American College of Chest Physicians’ Sleep Institute.

Obstructive Sleep Apnea (OSA) is a serious sleep disorder in which a person’s airway collapses preventing air from getting to the lungs. Breathing can stop for 10 second intervals as many as 60 times an hour or up to 400 times a night depriving the brain and body of oxygen hundreds of times each night.

What are the symptoms of OSA?

Most women don’t realize their partner’s loud obtrusive snoring could be the symptom of this serious condition; however one of the most obvious signs of OSA is snoring, gasping or choking for air during sleep. OSA sufferers also have extreme exhaustion and daytime sleepiness with some patients even falling asleep at their desks and behind the wheel. Some less obvious symptoms include depression, irritability and sexual dysfunction.

What are some common misconceptions about OSA?

Most people believe OSA only affects older overweight men; however research has shown OSA directly affects women as well and can interfere with pregnancy and sexual dysfunction. In fact, the National Sleep Foundation estimates that a third of OSA sufferers are women.

Are there other risks associated with OSA?

There are numerous health conditions associated with OSA including obesity, cardiovascular disease, diabetes and stroke. Studies have also shown that the loud and disruptive snoring from OSA can affect the sleep of a bed partner leading to marital stress and unhappiness, and couples affected by OSA often report low marital satisfaction.

Can OSA affect weight loss/gain?

OSA affects the production of Leptin, a hormone associated with body composition, energy and appetite, and OSA sufferers could have elevated levels of Letpin, causing an increased appetite and reduced energy levels. This energy deficiency can kill a person’s desire not only to work out and lose weight, but also to perform even the simplest of day-to-day tasks such as house cleaning, light office work and driving. People who suffer from OSA often feel defeated due to their inability to perform day-to-day tasks and work-out, and instead use high calorie, sugary snacks to provide short term energy boosts. This quick fix only adds pounds and perpetuates the cycle of exhaustion and weight gain.

Who is at risk?

Generally speaking a person with a 17 inch neck or greater, due to obesity or body structure, tends to be at risk for OSA. However, perfectly “healthy” people with large necks or a family history of sleep apnea can suffer from the condition much like an overweight person. In fact, many football players suffer from sleep apnea due to their characteristically large necks. Other contributing risk factors can be the use of alcohol or sedatives which can relax the tissue and muscles surrounding the upper airway, smoking, and aging.

Do I have to stay in a sleep lab?

Staying at a sleep lab can be daunting and inconvenient for people who have family obligations, children or don’t live near a sleep center. Currently, insurance companies only cover treatment for patients who undergo an overnight sleep study in a certified sleep lab; however a recent policy shift in the healthcare industry has made the option of home testing a very real possibility in the near future.

How is OSA treated?

Continuous Positive Airflow Pressure (CPAP) is the most common and effective treatment for OSA. CPAP users wear a mask while sleeping that supplies continuous airflow through the nose, forcing the nasal cavities to remain open. By keeping the nasal passages open CPAP prevents the collapse of the airways that induce an apneic episode. While sleeping with a mask can seem uncomfortable at first, there are a number of things patients can do to maximize comfort including trying differently shaped masks, adjusting the air pressure and adding a humidifier to moisten nostrils.

What if I can’t afford treatment?

OSA sleep lab diagnosis and treatment with CPAP is reimbursed by Medicare, Medicaid and most insurance providers.

Can weight loss be an effective treatment for OSA?

Weight loss is an effective treatment for OSA as it is also helps treat many of the other conditions that OSA patients tend to suffer from such as cardiovascular disease, diabetes and hypertension. However, due to the reduced energy levels from OSA, many people find it hard to lose weight without the assistance of a clinical treatment such as CPAP, which helps a patient gain lost hours of sleep and restore energy levels. Also, since weight loss can be difficult to sustain it is important to note that a person’s OSA can return with the gained weight.

What is a little known fact about sleep apnea?

People who suffer from OSA are often more dangerous behind the wheel than a drunk driver. Untreated OSA robs patients of several hours of sleep per night which is the equivalent of having a blood-alcohol level of 0.10 percent.  Drowsy drivers cause more fatalities per accident than drunk drivers and OSA sufferers are twice as likely as those without OSA to have a car crash.

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