Sleep apnea affects the health of 54 million Americans. Heart disease, diabetes and obesity are all linked to Obstructive Sleep Apnea (OSA). Fatigue-related productivity loss is estimated to cost companies $1,967 per year for each sleep deprived employee.
What can’t be measured can’t be quantified. We know sleep is crucial, but how can we estimate the effect of broken, shallow sleep?
The total impact must include both emotional and economic figures when you consider the facts. Almost 20 percent of all serious car crash injuries in the general population are associated with driver sleepiness, independent of alcohol effects.
Individuals with sleep apnea, a condition in which one stops breathing during sleep, are at twice the risk of traffic accidents as unaffected individuals.
In the year prior to diagnosis, the medical expenses of individuals with sleep apnea are found to be almost two times that of control individuals who have not been diagnosed with the condition.
Sleep-disordered breathing also heightens the rate of divorce and use of paid personal leave.
The number of tired Americans maybe in the tens of millions. Dr. Jordan Stern, founder and medical director of BlueSleep, estimates that sleep apnea affects a quarter of Americans, and the condition has consequences for almost everyone else, not the least of whom are bed partners who have to tolerate the loud snoring and periodic gasps associated with sleep apnea.
While not limited to overweight individuals, sleep apnea is a major issue for those with extra pounds, a demographic that now comprises about 60 percent of the American population.
All systems need oxygen to function. We spend approximately one-third of each day sleeping. Those with sleep apnea are not getting enough oxygen a third of their lives. Over time, the built-up effects of reduced oxygen contribute to a host of other conditions, making the true cost of sleep apnea a sky-high, uncountable figure.
“Sleep apnea ... contributes to the most common and expensive diseases that we treat, notably high blood pressure, diabetes, cardiovascular disease like stroke and heart attack—those are the common ones,” Dr. Stern said.
Women with sleep apnea are also known to have low birth-weight babies and higher frequency of cesarean section.
“Many doctors out there who treat these disorders—primary care doctors, cardiologists—are unaware that sleep apnea may be impacting the disease they are trying to control,” Dr. Stern said.
Dr. Stern is an ear, nose, and throat surgeon, and one of the few otolaryngologists in the country also board-certified in sleep medicine. Since 2008, he has run BlueSleep, a center dedicated to the diagnosis and treatment of sleep apnea (now offered via telemedicine).
Part of the reason many specialists may not be seeing the links between sleep and their area of medicine is that the formal study of sleep apnea started only 30 or 40 years ago.
“In the world of medicine, that is extremely, extremely young,” Dr. Stern said.
Around 80 to 90 percent of obstructive sleep apnea cases remain undiagnosed and untreated, which compounds the costs of health care, both to the individual and to the health care system, according to a report published by the NationalCenter for Biotechnology Information.
Though sleep researchers are nowhere close to understanding all of what happens when we shut our eyes at night, we do know the following.
Adults who sleep poorly have higher incidence of anxiety, depression, and headaches, particularly morning ones. In children, sleep apnea is linked with ADHD.
Because memories are built during REM sleep, disruptions to REM can lead to poor information retention, as well as poor focus in people of all ages. Inadequate or disrupted sleep is associated with higher cancer risk and a host of cardiovascular issues such as high blood pressure, heart palpitations, and stroke.Sleep is also essential to our largest organ—our skin. Poor sleep begets dark circles under the eyes, and crepey, older looking skin. The skin condition psoriasis is often exacerbated by stress and poor sleep.
Mechanics of Breathing
The good news is that sleep apnea is largely a mechanical problem—not some tricky-to-fix chemical imbalance. Stern explains that the tongue is made of muscle interspersed with fat. One third of the tongue actually resides in the throat. Add tonsils to the mix, and it can make for a very crowded airway.
When people gain weight, they gain it on their tongues as well as in their necks, and that bulk constricts airways. This is a major reason why sleep apnea is associated with weight. However, the condition can affect thin people too. Some people have slender jaws and large tongues, so when they lie down, airways can be harder to keep open.
BlueSleep provides a home testing kit to easily find out if a patient has sleep apnea. The palm-size device is connected to a strap that goes around the chest, a cannula, and a fingertip oximeter. From these three points, the device records breathing effort, airflow, and oxygen level, respectively. (BlueSleep now offers a more convenient Home Sleep Test that fits on your finger.)
The collected data is analyzed and scored by BlueSleep. The Sleep Specialists look for how frequently the patient stops breathing, for how long, and other parameters.
At-home sleep testing significantly reduces the cost and discomfort of going to a sleep lab, not to mention that a familiar sleeping environment is more likely to yield more accurate results.
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