Sleep should be the time when our body and mind is renewed, refreshed and recharged. During sleep our body is recharged with nutrients and hormones, tissues, organs and systems are rejuvenated and readied for the coming day’s opportunities.
Unfortunately, many of us and those close to us (family, friends, coworkers and employees) do not achieve an optimal quantity or quality of sleep. Reasons for is are many, but among the most common and rapidly increasing is snoring and sleep apnea.
What is Sleep Apnea?
Obstructive sleep apnea(OSA) is a disorder in which breathing is briefly and repeatedly interrupted during sleep. The “apnea” in sleep apnea refers to a breathing pause that lasts at least ten seconds. Obstructive sleep apnea occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. Another form of sleep apnea is central sleep apnea, in which the brain fails to properly control breathing during sleep. Obstructive sleep apnea is far more common than central sleep apnea.
Obstructive sleep apnea, or simply sleep apnea, can cause fragmented sleep and low blood oxygen levels. For people with sleep apnea, the combination of disturbed sleep and oxygen starvation may lead to hypertension, heart disease and mood and memory problems. Sleep apnea also increases the risk of automobile crashes. Sleep apnea can be life-threatening and you should consult your doctor immediately if you feel you may suffer from it.
More than 18 million American adults have sleep apnea. The Wisconsin Sleep Cohort Study estimated in 1993 that roughly one in every 15 Americans is affected by at least moderate sleep apnea. It also estimated that in middle-age as many as nine percent of women and 24 percent of men were affected, undiagnosed and untreated It is very difficult at present to estimate the prevalence of childhood OSA because of widely varying monitoring techniques, but a minimum prevalence of 2 to 3% is likely, with prevalence as high as 10 to 20% in habitually snoring children. OSA occurs in all age groups and both sexes, but there are a number of factors that increase risk, including having a small upper airway (or large tongue, tonsils or uvula), being overweight, having a recessed chin, small jaw or a large overbite, a large neck size (17 inches or greater in a man, or 16 inches or greater in a woman), smoking and alcohol use, being age 40 or older, and ethnicity (African-Americans, Pacific-Islanders and Hispanics). Also, OSA seems to run in some families, suggesting a possible genetic basis.
The symptoms of sleep apnea are many and can occur in various combinations.
- Excessive daytime sleepiness
- Severe Anxiety
- Intellectual deterioration
- Memory and concentration difficulties
- Mood swings/temperamental behavior
- ADD and ADHD symptoms
- Morning headaches/migraines
- Gastric reflux
- Dry mouth
- Sore throat
- Slow metabolism
- Weight gain
- Inability to lose weight
- High blood pressure
- Poor job performance or problems in school
- Mouth breathing
- Restlessness and tossing and turning during sleep
- Decreased sex drive
- Choking/gasping sensation that wakes you up
- Inability to sleep through the night
Why Should You be Interested?
In people with disrupted sleep, worries about work and functioning are common. With little doubt, poor sleep in employees affects work. The cost poor sleep for the employer and our nation’s productivity is high. Lost productivity occurs both from days where individuals miss work (“absenteeism”), but also when individuals are present but less productive (“presenteeism”). A study recently published in SLEEP, the journal of the American Academy of Sleep Medicine, analyzed results from the American Insomnia Survey to evaluate the impact of insomnia (symptom of OSA) on the work place. It found a 23% prevalence of insomnia among employees. Insomnia rates were lower for those over 65, males and with college degrees. For this large sample across employers, insomnia was associated with 7.8 days of lost productivity. The authors estimate the cost in human capital to be $2,280 annually per person. For a large company with 50,000 employees, this productivity loss translates into a cost of over $26 million dollars annually. For a smaller company with 1,000 employees, this would reflect a cost of $524,400.
Studies have shown that patients with undiagnosed sleep apnea had considerably higher medical costs it is estimated that untreated sleep apnea may cause $3.4 billion in additional medical costs in the U.S. An article from Sleep Medicine Review states ” It appears that undiagnosed sleep apnea leads to a roughly two-fold increase in medical expenses in the years preceding the diagnosis and that treating the disease (once it is diagnosed) results in a decrease in these excess costs. It seems clear that sleep apnea increases the actual number of road traffic accidents, which will carry a definite, but unmeasured up to now, economic cost consequence. From the health economic point of view, the best diagnostic strategy is the one with the greater utility (i.e. polysomnography), although it could appear at first sight to be the more expensive one. From the patient’s perspective, sleep apnea results in a given decrease in the possibilities to enjoy life, and its treatment is worth considering, especially if one takes into account that the actual treatment costs are not great. The global image of the health costs related to sleep apnea is still blurred, and further work is required to get the complete and clear picture of the economic consequences of this disease and of its treatment.”
What Should I Do?
For those concerned with the well being of family, friends, coworkers and employees the best course of action is education followed by screening (testing) and finally treatment of OSA and related disorders.