How have you been sleeping?
The stress of the past year has given us all reasons to toss and turn, and that can have serious effects on our health.
Has your sleep partner noticed that you’re not sleeping, or snoring more than usual? Do you have a headache when you wake up, or feel tired during the day? Dr. Avinder Minhas from the Surrey Sleep Clinic says these are common signs of obstructive sleep apnea.
Two kinds of sleep apnea
Apnea is a pause in breathing, and it’s considered significant if it lasts for more than ten seconds at a time and occurs more than five times an hour.
- Obstructive sleep apnea: A pause in breathing caused by a temporary throat obstruction. People with OSA are often noisy sleepers (snoring).
- Central sleep apnea: A pause in breathing that happens when your brain doesn’t send the proper signals to your diaphragm at the right time.
Dr. Minhas says most people who have sleep apnea have obstructive sleep apnea. Central sleep apnea is very common if you have heart problems (Cheyne Stokes respiration) or neurological problems, and if you take opiates (Biot’s respiration). More than 30 per cent of people with heart failure and atrial fibrillation and those on opiate treatment have central sleep apnea. These patients are also at increased risk for obstructive sleep apnea. It is crucial to receive the appropriate diagnosis and treatment.
“Patients with central sleep apnea won’t respond to regular treatment, which usually involves sleeping with a CPAP machine. It may work for some patients, but it can also make the central apnea worse — sometimes worsening the problem tenfold.”
Some doctors wrongly prescribe CPAP machines for central sleep apnea without doing a proper assessment, or referring patients to a sleep lab like the Surrey Sleep Clinic for further tests. And that can have serious consequences.
“Sleep disorders should be dealt with scientifically, not blindly,” Dr. Minhas says.
Know the risks
While central sleep apnea is generally less common, the risk is much greater among patients who have heart disease or use opioids like oxycodone, methadone, etc.
“The data shows that people who use prescription opioids have a high risk of dying in their sleep, even on a stable dose. Is it because of central sleep apnea? It’s hard to know, but it’s important that people recognize these risks,” Dr. Minhas says.
For those with severe obstructive sleep apnea, the risk of falling asleep while driving is very high, which is one of many reasons it’s important to seek treatment instead of just ‘toughing it out.’
“Seeing a specialist helps patients receive an accurate diagnosis, and it also helps with treatment compliance,” Dr. Minhas says. “It’s so important to do the proper follow-up, to make sure patients are able to stick to their treatment plan.”
Surrey Sleep Clinic services are funded by MSP with a physician referral. On your first visit you’ll meet with a physician to discuss your symptoms. If needed, you may be referred to the Sleep Lab for further testing.