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Odler Robert Jeanlouie, MD

You sleep at night five, six, eight hours. You wake up in the morning you are still tired.  You think maybe you should stay in bed, for a while more. You go to work, feeling anergic. After lunch, you really feel sleepy. You nod during conferences, experiencing serious difficulties keeping your eyelids apart.

You think you are not sleeping enough, but you are not quite sure about it. You discuss the problem with your bed partner, your housemate. They confirm that you do sleep at night, but, my God, you do snore to the tune of waking up the dead.

You think you should exercise, that should give you an energy boost mostly in light of the fact that you are 20 lb (or more) overweight, like 70% of all Americans. Exercise should be good for you, because you have started experiencing headaches, and your blood pressure readings are higher than they used to be; it is clear you have developed hypertension.


You wonder if you have some kind of disease.

Yes, it seems that you do. The disease is called sleep apnea. The people who have it are over 40, they are overweight, they are tired all the time, they fall asleep in the middle of the day (hypersomnolence), they snore at night, they may develop high blood pressure, depression, irritability,  memory loss, deceased libido. They are at high risk for heart diseases, heart attack, heart failure, stroke, car accident while driving.

Sleep apnea is twice as common in men as in women. It is rarely diagnosed, since no one is thinking about it. Therefore, if you have it, you may spend the rest of your life miserably, drinking coffee, to no avail.

What causes the disease?  Some brain malfunction is at times associated with it, but the whole picture is too often complicated with excess weight. It is also associated with alcohol consumption and the use of sleeping pills. In some people, it is caused, or complicated, by enlarged structures of the upper airway, blocking the passageway.

You may confirm the problem, by asking your doctor to send you for a sleep study. They will keep you in a room all night, connected to monitors. The result will show that during sleep you stop breathing several times in an hour. Your blood oxygen level therefore drops frequently below normal. No wonder that you are so tired when you wake up.

How do you treat the condition?  Losing weight to a BMI of less than 30 and staying away from alcohol are the starting point that would prevent worsening. But the most effective treatment is the use of an oxygen mask, the CPAP mask that you wear at night when you go to sleep. The mask forced the oxygen down your lungs, all night, so that the oxygen level stays up even you stop breathing. This process produces great relief.

Other therapy consists in a surgery performed to the back of your throat, in order to enlarge your airways and allows you to breathe better. This is operation is called uvulopalatopharyngoplasty. It is quite a mouthful, no pun intended.

With lifestyle modifications (weight loss, exercise, etc.) and the use of the CPAP mask, most patients feel rested, refreshed, happy, and no longer fall asleep during the day. Moreover, their blood pressure, measured at the clinic, comes down nicely; they no longer need medications.

(OdlerRobert Jeanlouie, Wednesday, September 4, 2013)

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