Sleep Apnea Pathfinders

In this episode, we discuss who else is podcasting about sleep apnea.  Specifically, what patients are also trying to raise the awareness of sleep apnea.Are you one of those people who really love podcasts and can't get enough information about sleep apnea (I'm one of those people)?  There are some patients who have great podcasts and we are becoming a community of patients who are working to raise awareness and hopefully helping people take action.I am someone who learns by listening to something more so than reading things.  So, podcasts are a perfect format for me.  I can slow them down and also play them again and again.  Since developing this drive to learn all that I can about sleep apnea, I turned to podcasts to find quality information.  What I found was podcasts by sleep physicians as well as dentist who are board certified in dental sleep.  Well that was not satisfying for me and I wanted more of a patient focus.I found three podcasts that have been fantastic sources of information as well as inspiration.  They are Emma Cooksey's Sleep Apnea Stories, The American Sleep Apnea Associations Awake podcast, and Dr. Steven Park's Breath Better, Sleep Better, Live Better podcast.  It may be curious that I am talking about other podcasts, but I believe the more information for people to listen to raise awareness the better.  Our focus at Sleep Apnea Pathfinders has a distinct approach that sets it apart from these other fantastic podcasts.Our first season was structured around discussing the Social, Physical, and Emotional impact of sleep apnea.  This season we are interviewing patients and discussing related medical issues they experienced in addition to their sleep apnea.   We also will dive deeper into issues around diagnosis and treatment.  After all, there are millions of people diagnosed who could not find a treatment that worked for them.  This is a staggering number on top of those who are also undiagnosed as yet.  There are lots of myths out there which cause sleep apnea to be viewed as an overweight mans issue.  We as patients should feel empowered to advocate for ourselves and ask more questions.  I hope to bring information which can help illuminate more issues which are actionable and useful to patients and their famililies.

I wanted to take a step back and thank all of the listeners of Sleep Apnea Pathfinders.  This seasons episodes have been heard in 7 different countries and 37 cities in the U.S.  It reminds me that sleep apnea is a worldwide issue and many of us are searching for information which is empowering and actionable.  In this episode, I talk about some of the important issues I covered in the first few episodes.  One issue is the usage of 2 different scoring rules by the American Academy of Sleep Medicine for oxygen desaturation when scoring hypopneas.  Those are partial closures of our throats.  When 4% is used, it is less likely hypopneas will be counted in the Apnea Hypopnea Index.  For some people, it may mean that they will technically be diagnosed with primary snoring and not sleep apnea.  This is especially problematic for women, who research is indicating that hypopneas are more prevalent in women.   I plan to do a more in-depth episode on this issue as it also generally undercounts sleep breathing events for both men and women.The other episode I'd like to highlight is the episode on Atrial Fibrillation and sleep apnea.  My guest was Melanie True Hills, who is the CEO of STOPAFIB.org.  She shared her sleep apnea and AFIB story and educated us on her mission to help people identify and manage AFIB.  She shared that those who experience a procedure called cardio ablation and cardioversion whose treatment is unsuccessful are likely to have sleep apnea.  We will delve into cardiovascular conditions more.  The host of conditions which comprise cardiovascular disease have a high rate of occurrence with sleep apnea.  While you may not have any of these conditions, it is important to discuss these issues in hopes that it reaches someone who is experiences these issues.  Ideally, the younger someone who meets the signs and symptoms is diagnosed the better for their long-term health.  I discuss my interview with John, a sleep apnea patient who has a BMI of 24 which is normal for his height and weight.  He is a thin person and despite signs and symptoms of sleep apnea, it was unlikely his doctor would refer him for a sleep study.  This interview points out that sleep apnea is not about weight for all individuals.  Many people with normal BMI have sleep apnea and they too may believe the myth that its only for overweight people.We plan to continue to interview various individuals with sleep apnea as well as their partners.

Are you one of those who only think sleep apnea is something that only people who are overweight can develop?  Well, sleep apnea can be found in people with all body types.  I interview John Dortch, a thin person with sleep apnea.  His body mass index  is 24, which is normal weight for his height, according the a BMI calculator from the National Heart, Blood, and Lung Institute of the National Institute of Health.John is someone whose physician would not think he fit the typical profile of someone who could have sleep apnea.  In this episode, we talk about his path he's traveled to get diagnosed and how he adapted quickly to CPAP.  John had classic symptoms of sleep apnea-snoring, gasping for breath at night, needing to nap daily, and wanting to go back to sleep after a night of 7 hours .  His wife complained of his snoring for years.  There are millions of people who snore out there, and sometimes it leads to a sleep divorce.  This is where a bed partner goes to sleep in another room.  Well, John talks about his wife doing jus that one night when his snoring got too loud.In this episode, he also discusses experiencing cluster headaches which occur suddenly and the pain is over one eye and can be debilitating.  After being evaluated by a physician in the office, he was admitted to the hospital due to the concern that it could be a brain tumor.  It would later be diagnosed as cluster headaches.  In trying to soothe his cluster headaches, John found himself taking deep breaths.  This alleviated some of the pain, and he would later conclude after being diagnosed with sleep apnea that lack of oxygen was a major contributing factor causing his cluster headaches.Another thing John had adapted to over the years was going to the bathroom up to 2 times a night.  He attributed it to aging and much to his surprise, once starting cpap he was sleeping through the night more .  John was not open to an in lab study and he felt (like many people) that it would be too uncomfortable.  When he heard about how easy a home sleep study would be, he was more open to the idea of a sleep study.  We discuss his adjustment to cpap being easy and how for some people its not that easy.  Since starting cpap, John has been cluster headache free, he doesn't need naps during the day, and his bathroom trips are all but eliminated.  His sleep doctor explained that he was never able to sleep at night and his body was not able to suppress the function of needing to go the bathroom.John shared that in thinking back to his father, he snored and had a host of medical issues.   He speculated that his father potentially had sleep apnea and it was untreated.  This interview with John about his sleep apnea showed that those stereotypes that this sleep disorder is only for someone who is overweight is false. If you or someone you know is thin, but they snore and you've witnessed them gasping for air at night, please suggest they see a sleep physician.

In this episode, David and Yvette discuss the three reasons why sleep apnea can go undiagnosed for years or even decades.  Fatigue becomes normal to the individual due to their life circumstancesUneducated about sleep disorders and sleep hygieneYou slowly become the person We are faced with managing fatigue within the context of what is happening in and around our lives.  We often (especially when younger) can just adapt to being tired all of the time.  In David and Yvette's lives, the birth of their first child and the effort that went into building their careers, prevented them from sleeping the recommended 8 hours.  We normalize being tired, and even most people in your circle may even talk about how tired they were when they first had children.  The fatigue even can become a shared type of tired when both parents are chronically sleep deprived.  Or maybe the don't have children, but they put everything into building their careers.   There were other instances where fatigue was just a part of daily life.While in our youth, many people are very social, and the thought of being tired due to a sleep disorder was not top of mind.  In fact, sleep hygiene (soft lights, no digital devices, leave enough time for winding down, etc.) was not a term that was discussed often.  Despite symptoms (headaches, pain in eyes, trouble concentrating, health palpitations, snoring, restless legs) being evident to Yvette, David still felt that they were unconnected.  There was no indication that these symptoms were connected somehow.  Even a trip to the primary care physician after heart palpitations/tightness in chest were not enough for the doctor to refer to a sleep physician. Symptoms of sleep apnea which may be described as more classical symptoms (sleepiness all the time, snoring, falling asleep in strange places) develop slowly.  The symptoms rising to the level of a disorder is often missed by the individual.  Symptoms are minimized and when combined with normalizing fatigue, a person can find themselves meeting the criteria for a sleep disorder without even realizing the seriousness of their symptoms.   Those around them can readily see the falling asleep at parties, dinner, and breakfast.   As that process slowly becomes more regular, the debilitating fatigue overtakes many areas of someone's life.  These three reasons can combine to keep sleep apnea from being a focus for the individual and physician.  While the individuals family can tell that sleep is an issue, it is often very difficult to get a loved one to work with primary care to seek further evaluation through a sleep study.There are a number of other reasons and contributing factors which keep sleep apnea invisible for millions of people around the world.

Have you ever experienced heart palpitations and were unsure if it warranted speaking to your doctor? Has your doctor placed you on statins for rising cholesterol based on a family history of heart disease? What does sleep apnea have to do with heart palpitations?  The American Heart Association issued a statement in June 2021 that “between 40% and 80% of people in the U.S. with cardiovascular disease also have obstructive sleep apnea (OSA), yet it is under recognized and undertreated in cardiovascular practice.”1 Sleep Apnea Pathfinders set out to find out more about Atrial Fibrillation (A-fib).  AF is defined as an irregular, often rapid heart rate where the hearts upper chamber (atria) beat out of coordination with the lower chambers (ventricles) and causes poor blood flow.In this interview with CEO of STOPAFIB.org, Mellanie True Hills, we discuss a wide range of topics from what is Afib to how does it overlap with sleep apnea.  Ms. Hills is an award winning author for her book A Woman’s Guide to Saving Her Own Life: The Heart Program for Health and Longevity.   40% of individuals don’t have observable symptoms; roughly 6 million people affected by Afib.  "When you have Afib, you have a 500% increase risk of stroke.”   Heart failure is a big issue as is cognitive issues.She discusses the way to diagnose Afib: Electrocardiogram or loop recorder. The risk factors for Afib involve people with high blood pressure, underlying heart disease, diabetes, congestive heart failure, as well as sleep apnea.  For those she encounters who wake up with their heart racing, a common question is have they had a sleep study.  “The two (Afib and Sleep Apnea) go hand in hand”, according to Ms. Hills. Crossover issues of women not being referred based on language.  Women tend to be diagnosed with mild sleep apnea.  The research is also showing that women may experience hypopneas, (partial closures of the airway) more than apneas (full closure of airway)2.  David discusses the impact of the American Academy of Sleep Medicine guidelines of defining desaturation with a 3% or 4% measurement (2 & 3).Triggers are discussed.  The sympathetic nervous system is engaged (for those with sleep apnea, this is nightly).  She posits that Afib runs in families and also added that so does sleep apnea.  Paroxysmal, Persistent and Long standing. They discuss typical treatment.Intrathoracic pressure of sleep apnea can cause a stretching of the atria of the heart.  Results in remodeling of the heart and also electrical signaling. Ms. Hills shared her story of how she experienced Afib and how her surgical procedure helped her get rid of Afib.  Ms. Hills was gracious to share her sleep apnea story and how diagnosed with sleep apnea, she had to reframe how treating her condition as a means to keep her Afib managed.  She learned of the connection through research done by Drs. Susan Redline and Virend Somers in 2008 showing the connection between Afib and sleep apnea.David shared family history with heart conditions and sleep apnea.Treating Afib early is key.1.      Newsroom.heart.org Statement published online June 21, 2021 “Sleep Apnea worsens heart disease, yet often untreated”; A scientific statement by the American Heart Association in their associations journal Circulation2.      Prolonged partial upper airway obstruction during sleep-an underdiagnosed phenotype of sleep disordered breathing; Anttalainen, U; et al3.      Cardiovascular and somatic comorbidities and sleep measures using three hypopnea criteria in mild obstructive sleep-disordered breathing: sex, age and body mass index differences in a retrospective sleep clinic cohort; Johnson, K; et al

In Part 2 of our interview with Dr. Kubacky, we discuss how fatigue is a hallmark of PCOS and how a host of other health issues are associated such as diabetes, high cholesterol, infertility, and hypothyroidism.  We discuss how women tend to be diagnosed with mild sleep apnea and how some sleep physicians will recommend weight loss in place of using other interventions such as a CPAP.  The path for women to be diagnosed is often difficult based on how they sometime report fatigue, according to information by the organization Women's Health Research.This led into how women's health concerns are overlooked because their presenting symptoms don't fit the typical medical perspective taught in medical schools.  For instance, a typical viewpoint is that obese men have sleep apnea.  We know that slim women also have sleep apnea.  The health inequities women face is discussed in this episode as well as those faced by minorities.Dr. Kubacky provides wonderful resources for people experiencing PCOS.Her mental health website is: https://drgretchenkubacky.com/Her PCOS website: https://pcoswellness.com/Martha McKittrick: https://marthamckittricknutrition.com/nutrition-solutions-pcos/Society for Women's Health Research https://swhr.org/science/networks/sleep/

This interview with Dr. Gretchen Kubacky, a health psychologist whose practice includes people with Polycystic Ovarian Syndrome.  According to Womenshealth.gov, this a serious health condition that caused by a hormonal imbalance of the reproductive hormones.  The imbalance creates problems in the ovaries.   She shared so much beneficial information about dealing with chronic health issues and advocating as well as shifting language about failure.Dr. Kubacky is an author of 2 books on PCOS and Mood as well as the owner of PcosWellness.com.  The wealth of information was separated into two interviews to unpack the information Dr. Kubacky shared.   We discuss the need to be you own best advocate when experiencing health challenges in order to seek care.  There also is this language used by the medical community to describe an unsuccessful treatment as the patient failed treatment.  This can be seen in IVF treatment and with respect to sleep apnea patients the term is that patient was noncompliant or nonadherent.  Dr. Kubacky talks about reframing that terminology in a way that does not shame the patient.  The treatment failed the patient and that is additional information which can be used to inform the next attempt.  Much like sleep apnea, PCOS has many different phenotypes or types of characteristics which make identification and treatment difficult.  Infertility is what causes most women to see a physician or endocrinologist.  The treatment for PCOS is lifestyle and self care.Dr. Kubacky shared that poor sleep can contribute to developing health issues, as well as mental health conditions such as anxiety or depression.  Getting quality sleep is the number one cure!

Welcome Back to Season 2 of Sleep Apnea PathfindersWe are so excited to be back for a second season!  There have been many things happening while we were on break.  Covid-19 rates have risen in some parts of the country and Juanita, Co-Host of Sleep Apnea Pathfinders is taking a hiatus due to her role as a healthcare worker in sleep medicine.  We started this podcast together in March 2021 and spend many hours talking about how we could raise awareness so that more people could benefit from treatment.  She wishes us well as we move into season 2.Joining me for season 2 is someone who has had a front row seat and knows the peaks and valleys of sleep apnea.  My wife, Yvette is joining me as co-host !Season 2 will be an exciting mix of interviews of other patients, as well as a deeper dive into health conditions which research has shown have a higher correlation.  Sleep apnea is complex enough and when you add another health issue, things can be overwhelming.  We will help shed light on the overlap of various health issues as well as some connections between various health conditions.While we only have a few weeks left this month, we will discuss two health conditions which have a significant correlation with sleep apnea-Polycystic Ovarian Syndrome and Atrial Fibrillation.You can always reach us at Sleepapneapathfinders@gmail.com or on our Instagram @SleepApneaPathfinders.

In this episode Juanita and David go over all of the highlights from each episode briefly.  Listen in if you missed any episodes and want to go back.  This episode also lets the listener hear how many topics we covered to show how much the social, physical, and emotional aspects of sleep apnea affect a person.  We also hoped that our episodes help listeners understand that not only is the individual impacted, but also their partners, families, and career.  We are excited about season 2 and will resume our Sleep Apnea Pathfinders in a little bit over a month.  We have launched a Facebook group to keep the information flowing about Sleep Apnea, so please join our group Sleep Apnea Pathfinders.

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Episode description not available.

In this episode, hosts of Sleep Apnea Pathfinders Podcast David and Juanita discuss 8 reasons someone may be afraid or overwhelmed with the idea of being diagnosed with sleep apnea.  The reasons may vary and there may be many more reasons which cause someone to be stuck or put the process of being tested for sleep apnea.    Those reasons are: 1. it doesn't feel like the right time to add anything new to our routines to our lives and to our schedules. And sleep apnea is no exception. Not knowing who to turn to get clarity on what you may suspect, as an emerging health issue adds to the hesitancy. A lot of people don't know if they need a referral. Or if they can go to their regular doctor or if they need a sleep specialist.   2. A second reason why this may be overwhelming is that other stressors may not allow us to really deal with additional health issues. Oftentimes, we're dealing with multiple things simultaneously, such as challenges at work, being in a caregiver role for other family members, and their health issues. And also just being a parent can be downright challenging. Our stress levels may be off the charts, and the thought of dealing with an emerging health issue is just too much. And we put that in the backseat.   3. How can we fit another health routine, when other health issues make us feel maxed out, you have a health issue. And that's, that's all your brain can handle. Sometimes you may be getting support, that helps out but adding another issue maybe too much. It's hard to get past our own mental barriers of dealing with multiple health issues simultaneously.   4. Our current medical issues may be a major health issue which takes your singular focus.  These major health issues may have more prominence and the impact of not following all available treatment options would have a significant impact on your quality of life.  While the sleep community are making inroads to help society understand the far reaching impact of untreated sleep disorders on our quality of life, a majority of people out there will do what you mentioned at the start of this episode, put sleep and most likely a potential sleep disorder on the back burner.   5. Another reason may be the prospects of the resulting medical bills. Sometimes that's a major concern for for folks in deciding whether or not they want to really go for this.  So some may put the sleep study and treatment  process on hold until they can find a way to comfortably deal with the financial cost.   6. Listening to horror stories from other people about what went wrong during testing, or the process of being treated.  Some are afraid that their experience will be similar to someone else, who didn't have an optimal experience.  And this fear can stop their process.   7. There are some people who are really fearful about wearing a CPAP mask.   This is a common concern.  Do I have to wear a mask? Do I have to wear it every night? And how long do I have to wear it? I don't like anything on my face. This is this can be a challenge for some people.  Juanita talks about a process that can help desensitize them to wearing the mask and help them adjust.  8.   Someone may feel overwhelmed once its suggested that they get a sleep study is that they can fall into analysis paralysis.  We start to an over analyze every detail we can think of.   But this runs the risk of stalling the process.  These issues are not barriers which should keep someone from starting on their path to address sleep apnea.  Juanita & David are sleep coaches who collaborate with clients to help them adjust, cope and get unstuck.

This is part B of our Episode 8 on Sleep Studies.  If you haven't listen to Part A please go back and listen for some really great gems on sleep studies.  Part B has juicy stuff too such as:What the heck are all those wires attached to us during an in lab sleep studyBrainwaves which help determine stages of sleepAttachment by the eyes to determine onset of Rapid Eye Movement (REM)Another attachment on the jaw to detect jaw movement and  or bruxism (grinding of the jaw)Legs-to determine periodic leg movementsMonitor breathing with a thermal airflow sensor in the noseEKG patches to monitor heart rate and rhythmPulse oximeter to determine level of oxygen in the blood systemHow a patient can get assistance to relax during an in lab sleep studyWhy is the sleep technician watching and listening to patients during an in lab sleep study?What are some tips to make a home sleep study effective?What is the optimal number of hours necessary for an in lab studyIn lab sleep studies can sometimes look like a hotel roomThe GOOP in our hair is yuck! Why is it necessary and best way to get it out.What's with a home sleep study and then the need to get an in lab sleep studyCPAP, BiPAP, Auto PAP, ASV explained- The various types of machines explainedPatient tip on getting your CPAP machine quicker from Durable Medical Equipment companies (Is it insurance that is holding things up or a slow DME company)Having problems paying for your CPAP or sleep study-Investigate this early using this tip we discussWhy getting your sleep study report is crucial (Even if you are told you don't have sleep apnea) to following up with key questions for your doctorWhat are the circumstances when I would get another sleep study the following yearThis episode has tons of great information for those wondering about sleep studies!In our next episode (Episode 9) we are moving back around to discuss sleep apnea from a social perspective and we are going to explore:Why are we afraid to be diagnosed with sleep apnea?  Is the solution worse than not knowing?

Have you ever wanted to ask a sleep technician why they need to watch you sleep during a sleep study?  Well, David gets to ask Juanita that and more!This is part A of our discussion about in lab and home sleep studies.  In this episode Juanita and David discuss a wide range of topic that most patients don't have an opportunity to ask their sleep health professionals.This episode discusses:What is an in-lab sleep study and what does it recordWhat does a home sleep study capture (Heart rate rhythm, oxygen level, and breathing)Who decides what type of sleep study a patient can getWhose a good candidate for an in-lab study (People who possibly have complex sleep apnea which is both obstructive and central sleep apnea)Central Sleep Apnea explainedWhat sleep disorders can an in-lab sleep study help diagnose (Narcolepsy, REM Behavior Disorder)Why can't a sleep tech just give patients the sleep study resultsWhy is a home sleep study just as good as an in lab studyTune in to part B of episode 8 where we answer the question why sleep technicians need to watch us during the sleep study and more!

How many people are aware that symptoms of Sleep Apnea (SA)  & depression overlap? There is a bidirectional nature between anxiety, depression, and SA.   Most would be surprised to learn that there is a large percentage of people with SA who also have depression or anxiety.   Our mental health is on a continuum and life’s challenges can tax our coping skills.  When unrefreshing sleep or sleepless nights are added to a busy life, there may be things that happen which harm our mood.  A study found that after a sleepless night, study  participants had a difficult time shifting away from intrusive and repetitive thoughts which are also seen as symptoms of depression & anxiety.   Sleep fragmentation also contributes to disrupting our emotions.  A study was able to show that after an evening of sleep fragmentation, participants had a difficult time telling the difference between neutral events and emotional events.  It showed that the portion of the brain (Amygdala) partly responsible for processing emotions is affected by lack of sleep.  This demonstrates yet another bidirectional feature of sa and mh.   Various neurotransmitters are involved in both sleep modulation as well as anxiety & depression.  Sa also causes some neurotransmitters to be activated in the brain which can add to depression and anxiety.  We touched on these neurotransmitters in Ep 3.  The neurotransmitter GABA is the brains excitatory neurotransmitter & Glutamate is the brains inhibitory neurotransmitter.   We are advocating that all listening, continue all prescribed treatment & that they don’t change any treatment based on information contained in this ep.  There is some promising evidence that use of a Continuous Positive Airway Pressure (CPAP) machine to treat sleep apnea can also help with depressive symptoms.  The participants of a study  who were also met the criteria for depression upon entering the study, reported less depressive symptoms after three months of continuous use of CPAP. Another study found that those who previously met the criteria for depression and experienced sa, & cardiovascular disease showed improvement after use of a CPAP.  This notion of fight or flight playing a role in our emotions is important when considering all of the relationships between sa and neurotransmitters.  MH professionals would benefit from knowing these links are closer than they realized.  As patients, we benefit when our medical providers collaborate.  Patients in therapy for depression or anxiety may help play an important role in their own care.  They may be in a position to raise the awareness level of their mh care team by utilizing the Epworth Sleepiness Scale and the STOP-BANG.   Find help in the US:Texting HOME to 741741 for 24/7 support fort the crisis text lineCalling NAMI 800 950-6264Suicide Prevention 800 273-8255Text TalkWithUS @ 66745

In episode 6, Juanita and David share a couple of areas people may benefit in taking earlier action around undiagnosed sleep apnea and developing heart conditions.  Often times, when a person is experiencing a heart condition they are dealing with a variety of issues emotionally and physically.  The fact that ischemic heart attacks have been the leading cause of death, according to the World Health Organization for the last 20 years is staggering the consider.  The intersection of sleep apnea, strokes or heart attacks share a relationship which often is not the focus of primary and cardiac physicians.  There's generally a lack of focus when blood pressure is not responding to medication.  Nor is the possibility raised when an individual is experiencing atrial fibrillation also known as arrhythmia which is an irregular heart rhythm.In this episode, we discuss how the fluctuation of oxygen seen in some who have sleep apnea can cause issues with blood pressure the next day.  If untreated for months or years, it can lead to more chronic issues without this factor being taken into consideration.  Harvard Medical School indicated,  that over time sleep apnea exposes the heart and circulation to harmful stimuli that may cause or contribute to the progression of most cardiovascular diseases. Signs of a stroke. Studies have show that not sleeping for long periods of time impact our blood pressure.   So, untreated sleep apnea can lead to ongoing problems for individuals.  According to the American Heart Associations journal Stroke, " despite estimates of greater than 50% prevalence of sleep disorders after stroke, only about 6% of stroke survivors are offered formal sleep testing and an estimated 2% complete such testing in the 3-month poststroke period.  The reasons for the low rate of screening are at least partly related to the lack of awareness about sleep disorders among stroke providers".Another concern are those with atrial fibrillation.  According to the Cleveland Clinic Journal of Medicine, "the prevalence of sleep apnea is exceedingly high in patients with atrial fibrillation — 50% to 80%". Those with hypertension should also be aware that sleep apnea has a high rate of prevalence.  According to Medscape.com, systemic hypertension is observed in 50-70% of patients with OSA.This episode also discusses medication resistant hypertension and studies which show the prevalence of sleep apnea being between 70 to 85% of people.This information hopefully will lead to more action earlier & help empower patients to look at the relationship between undiagnosed sleep apnea and emerging heart conditions.  When issues around blood pressure come up, consider filling out the Epworth Sleepiness Scale and talking to your physician about the possibility of having sleep apnea.

What many people may not realize is sleep apnea may fly under the radar for years or even decades.  There are two consequences which have a lasting effect on our quality of life.  One consequence of undiagnosed sleep apnea, is relationships between bed partners can become strained due to repeated observations being ignored.  The other consequence is medical debt can accrue as someone experiences medical issues as a result of emerging health issues (diabetes, hypertension, cardiovascular disease), etc.) which share a close relationship with sleep apnea.   We discussed in a previous episode, how common signs (snoring, gasping, choking, etc.) are those which cannot be observed by the individual.  They rely on a bed partner or an individual recording these signs to understand the frequency and intensity.   You may ask yourself how this seemingly minor issue has grown to be a major point of contention and strained the relationship.  There may even be a need to move into a separate bedroom!  We discuss on this episode, how those concerns turn into fears and lead to a disconnect.  We also discuss from the patient’s perspective, how this dynamic may be invisible and difficult to take stock of what was lost. Another area which many people face is the hidden financial cost in the form of unintended use of sick days as a way to deal with unrelenting fatigue caused by untreated sleep apnea.   These sick days can be frequent and may result in lost wages and opportunities.  For industries where employees don’t have many sick days, or their company’s policy is strict, they may experience issues with continued employment.  For many other people who have undiagnosed sleep apnea and go on to use sick days, they may miss opportunities for advancement.  There are times where employees are given new projects which may lead to more visibility with executive management.   Those new projects could also lead to consideration for advancement in their careers.  Those who need to over utilize sick days may be passed over for consideration for new assignments.  Join Juanita and David as they bring awareness to these issues and also connect with them on Instagram @SleepApneaPathfinders.

Have you ever thought that signs and symptoms of sleep apnea are the same?  Well, we discuss the difference between signs and symptoms in this episode.  Signs are generally not observable, (with the exception of a few signs such as neck circumference) and the biggies are snoring, gasping and chocking.  These unobservable signs, are often subject to conflicts between bed partners.  We also discuss how some signs are different for men and women especially around neck circumference and types of things reported to primary care physicians.  This may lead to women being diagnosed less often then men.  We also talk about a big MYTH around BMI.  While BMI is a factor, there are individuals who have a low BMI and are considered thin who can have severe sleep apnea.There is a disconnect sometimes between how we think we are sleeping versus how we are really sleeping.  We can rationalize that disconnected perception or even bolster how we feel with caffeine.  We discuss the effect of caffeine, and how it stimulates the body and then becomes  a contributing factor to unrefreshing sleep when used in large amounts.  Some publicly available screening tools to fill out can give anyone a more subjective measure of how their unrefreshing sleep may be an indication of sleep apnea.  They are the Epworth Sleepiness Scale and the STOP-BANG.  The Epworth gives eight situations which you rate your tendency to become sleepy. The STOP-BANG stands for:Snoring HistoryTired during the dayObserved stop breathing while asleepBlood PRESSUREBody Mass Index greater than 35Age greater than 50Neck Circumference greater than 16' for women and 17 'for menGender-men have a higher prevalenceIn regard to symptoms, Juanita and David discuss how men tend to bring common or classic symptoms of sleep apnea to their doctors attention.  Symptoms such as snoring, gasping and snorting.  Women tend to report symptoms such as mental and physical fatigue, headache, anxiety, and difficulty with insomnia.  This may cause some primary care physicians to not refer or even fill out some of the scales we mentioned.  It is important for women to advocate and use these scales so they can educate their doctors about their fatigue and hopefully get a full assessment of their sleep with a sleep physician.We also want to introduce our Instagram account @SleepApneaPathfinders!Interesting Studies:Obstructive Sleep Apnea in Women: Specific Issues and Interventions"Making a differential diagnosis of OSA in women might be more difficult given that they tend to present with more generalized daytime symptoms than men [4]. Women with OSA complain of symptoms such as insomnia, restless legs, depression, nightmares, palpitations, and hallucinations whereas men are more likely to report snoring and apneic episodes [7]."https://doi.org/10.1155/2016/1764837

Are you wondering if sleep apnea has any connection to our emotions, mood and mental health?The connection sleep apnea has with our emotions and mental health are not widely talked about.  Juanita Crawford, a sleep health professional, and David Bishop, a patient talk about undiagnosed sleep apnea and how a number of hormones and neurotransmitters altered during the process of apneas (full closures) and hypopneas (partial closures).Join them as they discuss the primary stress hormone, cortisol and its role in engaging the body's fight or flight system.  They also raise the issue of the contribution sleep apnea has on anxiety and depression.  The United States Center for Disease Control has linked insufficient sleep to several chronic diseases including depression.  A study in the journal, Innovations in Clinical Neuroscience posits that sleep apnea could possibly be a contributing factor which causes or worsens depression.They also bring up a relevant study concerning the brain's natural break pedal, GABA or Gamma aminobutyric acid.  GABA is the chief inhibiting or the calming calming neurotransmitter in the brain.  It balances out the GLUTAMATE in the brain which is our natural accelerator.  High levels of GLUTAMATE in the brain have been found to be toxic to neurons.  A study by UCLA School of Nursing of people with moderate sleep apnea, found very low levels of GABA (the break of the brain) and high levels of GLUTAMATE (the accelerator).  The contributions to agitation and aggression is discussed.This episode looks at sleep apnea from an emotional perspective.  The fourth episode will look at sleep apnea from a wider perspective as Juanita and David discuss common and uncommon signs and symptoms.

This episode discusses the issue of sleep apnea and various serious health conditions.  There has been many discussions and studies about whether sleep apnea contributed to the onset of specific serious health conditions.  The research studies have identified a number of medical conditions which have a higher rate of occurrence for people with sleep apnea.  Some are well known such as: high blood pressuretype 2 diabetesand metabolic syndrome which include high blood pressure, abnormal cholesterol, high blood sugar, and increased waist circumferenceThere are some other less known medical conditions which also have a higher rate of occurrence than that of the general population.  These are glaucoma, polycystic ovarian syndrome (PCOS), and floppy eyelid syndrome.We discuss these medical conditions in this episode as we are highlighting the issues related to sleep apnea through a physical lens.  In listening to this episode, we want to point out that other diagnoses can oftentimes become the focal point.  This leaves little room for sleep apnea which is underdiagnosed for some and possibly for many years.We will continue to talk about related medical conditions that have a higher occurrence with sleep apnea than in the general population as the episodes progress.