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Stroke and Sleep Apnea by D. Thompson Bond, Psy.D. Published: August 2006  Jane is sleeping peacefully, dreaming about beaches and other exotic places, when she’s awakened by grunting, moaning noises. She soon realizes the noises are coming from her husband, Walter, sleeping next to her. She is used to hearing his loud snoring and snorting, but these noises are different. Turning on the bedside lamp, she looks at the clock: 5:20 a.m. She looks at her husband; he’s drooling. His mouth appears contorted to one side. She tries to wake him but can’t. Not even forceful shaking disturbs him. She dials 911 and an ambulance arrives to take him to the hospital. His diagnosis? Stroke. A stroke occurs when a blood clot prevents the flow of oxygen-rich blood to a particular region of the brain. In some cases, a ruptured blood vessel can be the cause. In the United States, as many as 750,000 people suffer a stroke each year, while about 160,000 die from one. Stroke is also the third leading cause of death among American men and women. Stroke can cause severe disability – paralysis, loss of speech, swallowing disorders and emotional disturbances. Walter’s stroke may have been partially related to the normal snoring and snorting that his wife was so used to hearing. While snoring is common among adults, approximately 40 percent of chronic snorers have a more serious underlying condition called obstructive sleep apnea – a condition in which the airways that allow oxygen to enter and exit the body collapse during sleep. Almost three-fourths of stroke victims whose strokes are caused by a blood clot have apnea, while those who have moderate-to-severe apnea are three to four times more likely to have a stroke. Apnea increases a person’s risk of stroke two times more than the presence of high blood pressure or diabetes. Apnea places extra stress on the heart, lungs and other vital organs, including the brain, further increasing the risk of stroke. During sleep, a person with apnea may experience a significant drop in blood oxygen levels, falling from a normal 98 percent to almost zero in some cases. The word apnea comes from a Greek word and means “without breath” or “want of breath.” Apnea can occur when the tissues in the upper airway either totally or partially collapse while a person is asleep. Because apnea severely disrupts sleep, patients report they often feel sleepy throughout the day. They may even fall asleep while sitting in a chair or may require large amounts of caffeine to stay alert. Furthermore, those with apnea are often overweight or obese, though some are thin. Others may have high blood pressure. Some feel a need to urinate frequently during the night. A person’s sleep partner may hear loud snoring, then a 10-second (or longer) period of near-silence, indicating that the tissues in the upper airway have closed. If air cannot move through the nose and mouth because of a closed airway, then snoring is not possible. That brief silence is then punctuated by snorting and gasping when air rushes into the person’s previously blocked airway. In order to breathe, a person suffering from apnea needs to almost awaken so the blocked airway can open. Some patients experience apnea hundreds of times per night, and one apneic episode may last as long as a minute or more. Diagnosing apnea is a relatively straightforward process. A patient’s primary care physician makes a referral to a sleep disorders center. The patient consults a sleep disorders specialist and then the patient is monitored overnight via a sleep study. After the sleep study, the patient and specialist then discuss possible treatments. For more information on the diagnosis and treatment of sleep apnea, please visit www.williamsburghealth.com. Download the November 2005 issue including “For Want of Breath” (page 14), which explores sleep apnea in further detail. |
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Williamsburg Health Journal
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