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Know the warning signs of sleep apnea and when to talk to your doctor about getting a sleep test

Written By Lauren Glendenning
Brought to you by Kaiser Permanente

If you're feeling excessively sleepy during the daytime yet you feel like you're properly sleeping, eating and exercising, you might consider talking to your doctor about sleep apnea.

This chronic daytime fatigue might come in the form of a strong desire to nap, extreme fatigue while watching TV or reading, and feeling heavily fatigued while driving. Many patients report feeling like they're hungover every morning, said Dr. Patricia Dietzgen, Family Medicine Physician at Kaiser Permanente's Frisco Medical Offices.

"We all know how we feel with even one bad night's sleep. Imagine this on a daily basis," she said.

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Sleep apnea is a common disorder in which a person has shallow breaths or one or more pauses in breathing — lasting from a few seconds to minutes — while sleeping. This can occur 30 times or more per hour.

If left untreated, sleep apnea can cause an increase in the risks of high blood pressure, heart attack, stroke, obesity, diabetes and heart failure. It also can make irregular heartbeats more likely and increase the chance of work-related or driving accidents.

"Sleep apnea is very common and often goes undiagnosed. If you feel fatigued every day, have loud snoring, wake with a headache, or have poorly controlled high blood pressure, it's best to see your doctor for further evaluation," Dietzgen said.

 Warning signs

There are two types of sleep apnea that are more common at high altitudes — obstructive sleep apnea and central sleep apnea. The most prevalent symptom of sleep apnea is a history of daytime fatigue.

"When a person is being evaluated for sleep apnea, it is important that they get evaluated at the altitude where they are actually sleeping, and therefore in the mountain region a home-based sleep study is typically preferred," said Dr. Shannon Garton, Family Medicine Physician at Kaiser Permanente's Edwards Medical Offices. "In our region with high altitude, it is more common that people who are of normal body weight may have sleep apnea and there also remains an increased risk in patients who are overweight."

Obstructive sleep apnea, the most common type of sleep apnea, obstructs the airway during sleep ranging from mild decreases in airflow to significant blockage, even pauses in breathing, during sleep, Dietzgen said.

"When trying to breathe, the air gets blocked resulting in characteristically loud snoring. This decrease in airflow results in decreased oxygen, waking you from sleep, causing disruption in your normal sleep cycle," she said. "This leads to a host of symptoms including daytime fatigue, waking as if you slept poorly and waking with a headache, amongst others."

Central sleep apnea is when the brain does not send a proper signal, and a patient just stops breathing while asleep.

Sleep apnea can't be specifically diagnosed with a doctor's office visit, but there are certain characteristics that doctors look for in patients, including large tongue, short neck, loud snoring and obesity, Dietzgen said.

These signs might prompt doctors to ask further questions such as whether a patient is tired, wakes up feeling unrested, has high blood pressure, is over 50 years old and whether anyone has seen the patient stop breathing or gasping for air while asleep.

"It is important to diagnose sleep apnea as left untreated, it can lead to high blood pressure, heart attack, stroke, lung issues, diabetes, increased work-related injuries, and increased motor vehicle accidents," she said. "And, equally as important, poor quality of life due to constant fatigue."

 Treatment

Sleep apnea is a chronic condition that requires long-term management. After a diagnosis, testing gives doctors specific information as to how to treat individual circumstances.

"It may be as simple as adding oxygen at night to using a positive airway mask to help keep your airway open at night," Dietzgen said.

A technician will help fit the mask on the patient and after using the device for a few weeks, doctors typically recommend retesting nighttime oxygen levels, she said. Doctors also recommend weight loss, exercise and sleep hygiene — in other words, changes to the nighttime routine such as decreased computer or TV time, decreased alcohol and other lifestyle modifications — in order to help improve sleep.

"Better airflow and improved oxygenation typically result in much more restful sleep and less daytime fatigue," Dietzgen said. "We often hear that our patients have not slept that well in years, and have a much better quality of life."

 

Should you get a sleep study?

  • If you snore but don’t have other symptoms of sleep apnea, you may not need a sleep study. Lifestyle changes may reduce your snoring. Examples of changes you can try are losing weight (if needed), avoiding alcohol and sedating medicines before going to bed, sleeping on your side, and going to bed at the same time every night.
    • A sleep study is the only sure way to find out if you have sleep apnea. If you have symptoms of sleep apnea, including being very tired and sleepy during the day, your doctor will probably suggest a Home Sleep study.
    • You may want to know if you have sleep apnea, because it has been linked with other health problems including high blood pressure, stroke, diabetes, heart failure, and depression. It also can lead to car accidents.
    • If you know that you have sleep apnea, you can treat it. Treatment usually helps        people who have sleep apnea and may lower your risk of problems such as high blood pressure or stroke.

* Source: Kaiser Permanente