The struggle with sleep apnea

Carol Waldemayer is breathing and sleeping a lot easier these days.

Jill Pickett

Dr. Elisa Garcia, director of the Sleep Center at Hardin Memorial Hospital, speaks about sleep apnea and the treatment for the condition during an interview Monday in a sleep study room at the hospital in Elizabethtown.

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Jill Pickett

Carol Waldemayer, a patient advocate at Hardin Memorial Hospital, shares her experience with the Sleep Center at the hospital in Elizabethtown. She was diagnosed with sleep apnea after a study at the facility.

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Jill Pickett

Ray Bragg, manager of respiratory care and sleep at Hardin Memorial Hospital, explains the symptoms of sleep apnea and the method of diagnosing at the facility in Elizabethtown.

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The Elizabethtown resident was diagnosed with sleep apnea roughly three years ago and has been receiving treatment ever since, the benefits of which have transformed her life for the better.

Waldemayer, a patient advocate at HMH, sought treatment after she woke up numerous times in the middle of the night gasping for breath. Other nights, she snored so loud she interrupted her own slumber.

Waldemayer quickly realized a pattern had formed and something was wrong.

“After about six times, I went to the doctor,” she said.

Through an evaluation from a nurse practitioner, she was recommended for a sleep study evaluation at Hardin Memorial Hospital’s Sleep Center. During the study, the center’s staff monitors everything from brain to muscle movement to determine what type of condition a patient is suffering from. In Waldemayer’s case, they found she stopped breathing more than 100 times during a roughly eight-hour period and her legs moved during the first four hours of the study.

“That’s kinda scary,” she said of the results.

Waldemayer is one of many patients treated at the Sleep Center for sleep apnea, which can afflict adults and children.

The center has the capability to treat about 1,000 patients per year and about 75 percent of those patients are treated for sleep apnea, said Ray Bragg, manager of respiratory care and sleep at HMH. Bragg said there are two major types of sleep apnea, central and obstructive, with obstructive being the more common. There also is mixed sleep apnea, a combination of the two.

Central sleep apnea occurs because the brain does not send signals to breathe, while obstructive sleep apnea occurs when breathing stops because the airway is blocked, Bragg said.

The airway can be blocked for numerous reasons, such as excess tissue in the back of the airway, including large tonsils; a decrease in the tone of the muscles freeing the airway; or the tongue falling and blocking air flow, he added.

After Waldemayer’s study concluded, she was diagnosed with restless leg syndrome and sleep apnea and returned to the Sleep Center for another night to be fitted with a mask under Continuous Positive Airway Pressure therapy, which splints open the airway and allows a continuous flow of air to circulate. Bragg said CPAP therapy is the most common treatment, but physicians also utilize Bilevel Positive Airway Pressure, which has two pressure settings.  

Bragg said patients can use other methods, such as medications, surgery, weight loss and oral or dental appliances to treat the condition. A patient also can use elements of “sleep hygiene,” such as creating and sticking to a routine bed time each night, he said.

Waldemayer said some of her siblings have been diagnosed with sleep apnea but she never thought it would afflict her until the nightly battles for sleep began and she found herself dragging through the daytime.

“(I) just never felt rested,” she said.

Once she was fitted for a mask and started undergoing CPAP therapy regularly, she noticed a quick turnaround and credits the Sleep Center and its staff for changing her life.

The rooms where sleep studies are performed feature décor similar to a typical bedroom with a welcoming bed and wooden furniture. Bragg said they try to accentuate the setting to put patients at ease.

“We try to make the situation as comfortable as possible because they’re going to be attached to a strange apparatus in a strange room,” he said.

According to documents obtained from HMH, obstructive sleep apnea affects about 4 percent of middle-aged men and 2 percent of middle-aged women and most OSA sufferers are not being treated. Obstructive sleep apnea, according to HMH, is as common as adult asthma.

If left unchecked, it places a person at greater risk for strokes, heart attacks and an increase in diabetic markers, such as elevated blood sugar levels, Bragg said.

There also is the danger of people falling asleep driving or working, Bragg added.

Signs and symptoms of sleep apnea are varied, he added, but can include headaches, dry mouth, irritability, fatigue, restless sleep, excessive sleepiness or fatigue during daytime hours and lack of focus or concentration. In children, the condition is primarily exhibited through hyperactivity, he said.

Dr. Elisa Garcia, director of the Sleep Center, said one of the largest red flags for sleep apnea is loud and frequent snoring. Garcia said the symptoms are often brought to a doctor’s attention by a spouse who has been awakened by the snoring and noticed pauses in breathing.

Waldemayer said those who pinpoint symptoms of sleep apnea should seek medical attention.

“You probably are not sleeping or getting the rest you need and over time this can take a cumulative toll on your health, your work and your family,” she said. “I was constantly trying to get energy during the day to keep myself going.”

Marty Finley can be reached at (270) 505-1762 or mfinley@thenewsenterprise.com.