Recently one of my patients had a sleep study performed in Stockbridge at Dr. Rastogi’s office. I asked if I could watch the process to see exactly what they do since we are starting to treat mild to moderate sleep apnea patients who are incompliant with their CPAP machines. What does all of this mean? Read on, I will explain.
During normal sleep, your body and brain goes into 4 stages of sleep. Stage 4 is the deepest. This is when REM (rapid eye movement) sleep occurs, your body repairs itself, dreaming and release of Growth Hormone occurs. Also what happens during this phase of sleep is paralysis of the body except for the eyes and lungs/heart. Since the body goes flaccid, muscles that usually keep your airway open relax and can collapse leading to a lack of oxygen while sleep.
The problem is a lack of oxygen for longer periods of time is detrimental to health. The body cannot live without oxygen for long periods of time. During sleep your body is fighting for oxygen and wakes itself out of REM sleep into a lighter sleep. It may not actually awaken where you remember it but the REM stops until the next time. This playing between stage 3 and 4 sleep is what may cause some people to “sleep” for 8-10 hours but not actually appear rested.
Sleep studies are to evaluated how many times the body loses oxygen and for how long. This leads a physician to diagnose sleep apnea. Sleep apnea can lead to extreme tiredness during the day as well as high blood pressure and strokes.
So, what else does the sleep study do? What is entailed? I observed my lovely patient endure about an hour set up where she was hooked to leads to measure the following: brain activity (EEG), heart activity (EKG), eye movement, leg movement, snoring as well as how deep the breathing was during sleep. They were also video taped while a sleep technician (polysomnographer) monitored and rated how many times the oxygen was being lost, movements and snoring.
Yes, snoring is annoying if you are the spouse or roommate of one who does it. But, when they stop snoring is when you ought to be concerned. This is when they are not breathing. They are losing oxygen.
So, what is a CPAP machine? It is a device used with a mask either just over the nose or over the mouth and nose using positive air pressure in order to keep the airway opened while sleeping. It is an air splint to keep the muscles from totally collapsing the airway. The sleep technician will use the same leads and monitor how well the patient’s oxygen levels are being maintained for the night.
CPAP is the gold standard for keeping the airway open while sleeping. It is large, cumbersome and doesn’t travel very well. People who can get used to the CPAP machine LOVE it. They feel well rested and alert during the day.
So, what else can be done? Oral appliances titrated in the sleep lab can be a good alternative for mild to moderate sleep apnea and for patients who are non-compliant with their CPAP machines. We use a muscle splint in order to keep the airway open. This advances the lower jaw during the sleep. It travels well, easily maintained and doesn’t make any noise unlike the CPAP machine.
As always, we strive to provide our patients and community with the most up to date information available.
Hope you have a happy holiday.
Linda King (or DK as the team refers to me)