Have you been getting enough sleep? If not, the week of March 5 is a good time to catch up. It’s National Sleep Awareness Week, which highlights the importance of adequate sleep for improved wellness and a higher quality of life. The week ends with the annual shift to Daylight Saving Time, robbing us of an hour of night-time.
Both quantity and quality are important when it comes to reaping sleep’s benefits. Not only is enough rest needed for sharp mental performance and optimal immune function, sleep deficits contribute to mood disorders and increase the risk of heart disease, hypertension and diabetes. And given how critical sleep is to well-being, it is no surprise that sleep disorders have been linked to many types of health risks and conditions. One of the most common types of sleep disorder is sleep apnea, a condition in which sleep patterns are interrupted by intermittent disruptions in breathing. Snoring, sometimes interspersed with short periods of silence, is often the most obvious sign that an individual may have sleep apnea.
Last month, researchers at the American Stroke Association’s International Stroke Conference reported findings from a study that appears to link ‘silent strokes,’ in which brain damage occurs without obvious stroke symptoms, to sleep apnea. However, like some other studies linking sleep disorders to medical problems, “they are only correlations and not cause and effect, and it is difficult to assess which came first, the sleep apnea or the (medical) disorder,” says Dr. Mark Muehlbach, clinical director of The Clinics at Clayton Sleep Institute. “There is evidence that some people may develop sleep apnea following a stroke,” he continues. “However, it’s not surprising that sleep apnea also is a factor contributing to stroke—mild or major. Sleep apnea typically results in changes in oxygen levels and heart rate during sleep. This may result in fluctuations in blood pressure that, in turn, may put increased stress on blood vessels. Those especially at risk would be persons who have high blood pressure or diabetes, which tends to weaken blood vessels.”
Researchers studying sleep disorders and their association to risk factors for other types of health problems continue to search for clear answers regarding exactly how sleep apnea affects the cardiovascular system. “The studies have shown that there’s a release of chemicals, hormones or locally active substances in the circulation that occur with breathing cessation,” notes Dr. Oscar Schwartz, medical director of the Barnes-Jewish West County Hospital Sleep Disorder/EEG Center. Schwartz adds that the recent findings are important because they show “the more severe the sleep apnea, the more likely people are to have these small strokes. That makes sense because every night for multiple years, they’ve had the release of these chemicals that have injured the peripheral blood vessels, as well as constricted them.”
Sleep apnea is treatable once diagnosed—and that’s the problem. “Sleep apnea is likely to be severely under-diagnosed,” Muehlbach says. “Overnight sleep testing in a sleep center (called polysomnography) is the gold standard for evaluating sleep disorders. However, in some cases, a home sleep study may be an adequate screening tool to determine if a patient needs further testing.”
Most physicians agree that the most effective type of treatment is nasal continuous positive airway pressure (CPAP), which involves wearing a small mask over the nose that delivers a constant supply of oxygen during sleep. Some individuals cannot tolerate the mask, however, and other treatments include dental appliances that hold the lower jaw forward during sleep to help maintain an open airway, devices that prevent sleeping on one’s back (the position in which many people experience apnea), weight loss and surgery.
“I believe there is truth in the old adage, Get your beauty sleep,” Muehlbach says. “If you don’t sleep well, you don’t look well. This is true not only for how you look outside, but also how you look inside.”
If you or a loved one snores or feels especially sleepy during the day, you may be a candidate for a sleep study and subsequent treatment. Rest up and look your best inside and out!