WHEN a friend, JG, was having atrial fibrillation, his cardiologist told him “You need to get checked for sleep apnea.”
“I told him I sleep like a champ,” JG recalled—but the cardiologist insisted.
When he did get tested and got the results, “I was shocked,” he said. “I was having episodes of not breathing for up to eight seconds about 42 times per hour”—which qualified him as “severe” obstructive sleep apnea.
A Growing Problem
OSA occurs when the airway becomes obstructed during sleep—but the respiratory effort persists, and builds, until the person gasps or jerks, and starts breathing again. Often people with OSA snore loudly, or their bed partner observes them not breathing.
Such a pattern leads to non-restorative sleep and the subject often is hyper-somnolent in the day time—falling asleep whenever they sit down, which can be dangerous when driving. It also predisposes them to diabetes, and multiple adverse effects on the cardiovascular system, like high blood pressure, strokes and atrial fibrillation—like JG was having.
For the sake of being thorough, I should mention there is a far less common “central” sleep apnea caused by a lack of respiratory drive from the brain.
The prevalence of OSA shows up in a formidable 26% of adults between the ages of 30 and 70, according to The National Healthy Sleep Awareness Project. And it seems to be on the increase.
To explain why, I tracked down Dr. Neal Maru with the Mary Washington Sleep Medicine group—a neurologist whose interest was piqued when doing an assignment with an attending in Sleep Medicine during his residency. He found sleep medicine “fascinating.”
The in creasing prevalence, he told me, is partly due to greater awareness and testing. But also because the population is getting older and more overweight. But nasal obstruction, large neck (greater than 17 inches for men) a floppy soft palate, large tonsils and adenoids, or a small jaw with an overbite can also all cause OSA.
People are often unaware and have no symptoms, notes Maru—like JG, appeared to—though when I pressed him, he did admit to falling asleep on the bus on the way to work every day (he said it was the best part of his day), or if he ever flew on a plane.