THE LOUD SILENT KILLER
How your snoring could cost you your life?
There is nothing worse than suffering unknowingly.
I am a practicing orthodontist in the New York City area, who is Ivy League trained and was living with a condition that was affecting my physical, mental and emotional health without being aware of the significance of the problem I was having. Even worse, my condition is closely related to my life’s passion, orthodontics. I quickly learned that I was not alone, and that as many as 6-10 percent of men my age could be suffering with me and not know it. I was 34 years old and diagnosed with severe Obstructive Sleep Apnea.
Obstructive Sleep Apnea (OSA) is a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep most commonly due to the throat muscles relaxing and blocking your airway. Because not much was known about OSA before 15 years ago, there is not a wealth of information about how dramatic the long term consequences of the condition are. However, it is accepted that the negative effects on overall health are widespread and have consequences on every system of the body. These problems are primarily caused by lack of oxygen to the brain when breathing stops because of the obstruction, lack of deep sleep which is the time the body uses to restore and prepare for the next day, and subsequently the body being in a near permanent state of shock trying to maintain normal function.
“The source of my problem: a deviated nasal septum and other blockages in my nose that were partly due to a broken nose as a child that had not been corrected. Depending on the source of the problem, which can be in the nose, throat, jaw shape or size, and/or the muscles that support keeping the throat open, the treatment for Obstructive Sleep Apnea can range from lifestyle changes such as diet and exercise to surgery.”
For me, I was always tired, had a difficult time focusing, and found it very difficult to lead a healthy lifestyle. The real tragedy was that I had lived with the effects of sleep apnea for so long that I didn’t even realize that there was a problem. My baseline for my mental, emotional, and physical health had been so affected for so long that I thought the way I was living was “normal.” Sadly, my story is not an exception, but an increasingly common situation. While I was in a highly susceptible demographic, I would learn that Obstructive Sleep Apnea is a common health problem that affects all ages, genders, and races. The incidence of the problem is growing to epidemic proportions and is a progressive disease, the effects getting worse and worse with time.
I attended a lecture held by an orthodontist in Southern California who had recreated his office to help patients suffering from Sleep Apnea. His story was very compelling, as he also suffered from the disease himself. I will never forget him recounting the tale of the father of a patient he was treating with braces who had died at the age of 47 due to complications of Obstructive Sleep Apnea. I was affected not only because I immediately realized that there were people who walked into my office every day at risk that I could help, but more importantly, that I was one of those people. The next day I made an appointment to see a Physician, who specialized in sleep disorders.
The evaluation by my specialist was straightforward. I filled out a questionnaire dealing with my tiredness during different daily activities. There was a short clinical examination to evaluate my nose and throat, the two inlets for air. It was clear from the exam, and what the description of what I was experiencing during the day, that I was having a problem. However, more tests to evaluate the depth of my problem were needed. The gold standard for diagnosis for OSA is overnight polysomnography. Which, historically, required spending the night in a sleep lab where monitoring was overseen by a sleep technician throughout the night. This approach is prohibitive because it is very expensive and the often difficult to get a typical evening of sleep because the sleep labs are a foreign environment that rarely have the comforts of home.
Recently, home sleep tests have been used more widely to diagnose OSA. While more limited in the amount of information that can be gathered, the home sleep tests are more cost effective and often allow for consecutive evenings of evaluation, giving more accurate diagnostic information. My test results revealed that I suffered from severe Obstructive Sleep Apnea, my breathing stopping as many as 31 times per hour.
The source of my problem: a deviated nasal septum and other blockages in my nose that were partly due to a broken nose as a child that had not been corrected. Depending on the source of the problem, which can be in the nose, throat, jaw shape or size, and/or the muscles that support keeping the throat open, the treatment for Obstructive Sleep Apnea can range from lifestyle changes such as diet and exercise to surgery. For my problem, nasal surgery was the ideal treatment to address the root cause of my sleep apnea. A common treatment protocol is to use a CPAP (Continuous Positive Air Pressure) machine at night to blow air into my lungs. This is a common solution that addresses the effects of the disease but does not treat the cause. I found the CPAP to be extremely uncomfortable, and also was not open to a treatment solution that would make me dependent upon a machine every night for the rest of my life.
The surgery to fix my nose was an outpatient procedure. I was in the hospital for the better part of a day, but able to recuperate in the comfort of my home. Having never had surgery before, I have no basis for comparison, but beyond a few days of severe congestion and moderate pain that was easily managed, the recovery was relatively easy. My surgeon informed me that the surgery went exceptionally well, but because of the swelling and blood clotting in my nose following the surgery, I had no idea if the procedure was a success. I will never forget my follow up visit to his office a week later. He used a small vacuum to remove some of the clotted masses in my nose that were a normal part of healing. My eyes widened as I took my first true breath in over 15 years. In the following weeks, as my healing progressed, I noticed a daily energy surge and ability to focus that I had never felt before. I was remembering my dreams and woke up energized, ready to manage the stresses of a professional life in New York City. I knew at once that I had to help others.
I became committed to educating myself about ways that I could help people, my patients, my family, and my friends, who suffered from Obstructive Sleep Apnea. While my solution involved surgery, an extreme treatment option, it turns out that a common and effective treatment involves the use of an oral appliance, not unlike appliances I have used in my treatment of patients to correct orthodontic malocclusions. Using these appliances, which have varied designs and levels of comfort, while sleeping at night would help keep the airway open and are relatively easy to use.
Historically, snoring and other sleep breathing issues have been fodder for movies, sitcoms, and household humor… but if this snoring is associated with Obstructive Sleep Apnea, then it is anything other then a joking matter. If you or anyone you know is excessively sleepy during the day, snore and/or stop breathing when asleep, then encourage them to be evaluated by an ENT, a Physician who specializes in sleep disorders, or an Orthodontist educated in the treatment of Obstructive Sleep Apnea. It could save a life!!