What is Sleep Apnea

Raena Morgan: Dr. Hajal, sleep apnea has been getting a lot of print lately. Is it an old condition or is this something new? Dr. Rizan Hajal: Well, it's an old condition. I mean, everybody knows, our grandparents, our great-grandparents snoring when they're sleeping. Raena Morgan: Like thunder, yeah. Dr. Rizan Hajal: Exactly. The difference now is that we have a treatment since the mid-80s or so early 80s. We have a treatment that can cure the sleep apnea. It's become much more relevant recently because we know it's associated with significant disease and could cause mortality of the person who snores. Now, of course, the deception of sleep and being sleepy during the day could cause mortality of other people if that person gets behind the wheel of a car. Raena Morgan: Right. Dr. Rizan Hajal: But it's important because it's a it helps sleep apnea can affect the functioning, the productivity of the person. So in case you're running a business, it's important to get that treated. But also, affects the personal health by raising the blood pressure, causing more irregular heart rhythms, heart attacks or even stroke, have all been linked to sleep apnea within the last few years. Raena Morgan: So there are some real health risks. Yes. Dr. Rizan Hajal: And we know the treatment is important. Absolutely. Raena Morgan: Explain exactly what's happening. Dr. Rizan Hajal: What happens is that there's an area behind the roof of the mouth and behind the tongue that is very weak in the way that it's protected by muscle. And what happens is that when we sleep, our muscles relax completely, and they would end up getting a little bit narrower, making the noise when the air moves, that's the snoring part, which is fine in and of itself it's not disrupting the sleep. But when the snoring starts disrupting sleep, this is what we call an apnea. It could be in apnea through one when the airway collapses completely and the person is not breathing. So, we go and then snore or it could be a loud snore where the person has to make an effort just to get the more air moving. And that is also part of the apnea problem and it's called hypopnea. So anything with the snoring that starts disrupting the oxygen, the heart functioning, or the brain functioning is called the sleep apnea. Raena Morgan: Can you be a snorer without having sleep apnea? Dr. Rizan Hajal: That's true and people can, of course. When you are a snorer and don't have sleep apnea, it could be that you're going down that path and 20 years down the road, or 20 pounds down the road, you could end up having sleep apnea. But we do find some people who just are snorers, without having sleep apnea. Raena Morgan: How about the reverse of that. Could you have sleep apnea and not be a snorer? Dr. Rizan Hajal: It's rare to have apnea without being snorer. It's quite rare. You would have to have so much disruption of your sleep that you think that you're unable to fall asleep or sometimes when people have surgery on their upper airways, they will end up having apneas and the disease without having so much snoring. Raena Morgan: Oh, I see. What are some of the symptoms of apnea? Dr. Rizan Hajal: Of course, the symptoms are three and one is would be the snoring. Raena Morgan: Right. Dr. Rizan Hajal: So, your bed partner will come in and they usually describe the apnea. Sometimes they describe it so well where we love them for it, because they give us the diagnosis. Number two is the fatigue and tiredness during the day. People say that they are in a fog, unable to be productive, unable to drive, unable to function during the daytime. And number three would be if they have any medical conditions that could be associated with that. Number one being obesity, and of course, the cardiovascular problems or diabetes and then those could be manifestations of the sleep apnea. Raena Morgan: So, obesity has an effect on sleep apnea. Dr. Rizan Hajal: Absolutely because it makes the neck a little bit heavier. Both men and women when they gain weight, they gain weight around the neck size and makes it little bit heavier, which means more reason for the airway to collapse and cause trouble with the breathing. Raena Morgan: And you stop breathing during the night. Dr. Rizan Hajal: Yes, when we do the tests, some people are amazed but we don't even count that you have sleep apnea if you quit breathing five times or less. So, we're talking about people who quit breathing 15 times, 20 times, I've seen people more than a hundred times an hour. Raena Morgan: A hundred times an hour. Dr. Rizan Hajal: Right. So, you can imagine the quality of their sleep, how that's going to be. Raena Morgan: But they don't realize it when they get up in the morning? Dr. Rizan Hajal: Well, most of the people when they come here, they say yeah, I know I've been snoring for 10 years, but I thought that I'm getting older or maybe when I lose a little bit of weight, it'll be better. And people put it off so much and there's also lack of awareness. I find that even if they discuss it with their physician, it doesn't ultimately lead them into the sleep lab most of the time. And those people end up showing up because they're fatigued and tired. They are misdiagnosed with depression or other things, thyroid disease before they get diagnosed with sleep apnea. Raena Morgan: Because fatigue during the day could be from a multitude of reasons. Dr. Rizan Hajal: That's true. Raena Morgan: And if you check your thyroid and you checked, and you take antidepressants, and you're still feeling fatigue, and you snore. Dr. Rizan Hajal: Right and I say even before you take the antidepressants, maybe it's a good idea to discuss about the sleeping pattern. It shows up in very subtle things, like men's erectile dysfunction is linked to that and in women, the muscle aches and joint pains could be linked to that as well. So, there's a whole host of diseases that I think the physicians are not frequently asking about their sleeping pattern and their snoring before they label with the other diagnosis. Raena Morgan: Well, thank you very much. Dr. Rizan Hajal: Thank you.