Sleep Apnea & Seniors
Sleep Apnea: Tests and Treatments
It’s difficult to tell on your own if you have sleep apnea. You are, after all, asleep when it occurs. Most likely, if you have sleep apnea, someone else heard you gasping for air or snoring in your sleep. Or, perhaps you’ve been feeling tired and listless during the day and sought a doctor’s consultation and sleep apnea was diagnosed.
Sleep apnea frequently goes undetected, especially in the elderly, although they’re more likely to have it. Estimates of the percentage of older adults with sleep apnea are all over the map, in part because of varying definitions of the condition — but they’re always startlingly high. Sonia Ancoli-Israel, professor of psychiatry at the University of California, San Diego, has studied the disorder for 30 years and reports that almost half of older adults experience apnea to some degree, with even higher rates among those with dementia.
“It’s under-recognized in all age groups,” she told me in an interview. “But in older people, physicians are even less likely to recognize it.”
Why?
Apnea in younger people frequently coincides with obesity; in elderly patients, that’s less often true. Loud snoring, often a tip-off, may go unnoticed when seniors live alone. And, as Dr. Ancoli-Israel pointed out, “there’s a belief that old people are supposed to be sleepy during the day.”
What is it?
The name for this chronic disorder comes from the Greek word “apneas,” which means “without breath.” Sleep apnea occurs when a person stops breathing multiple times throughout the night. According to the National Institutes of Health, these lapses in breath can last from a few seconds to a few minutes. Those afflicted resume breathing after snorting loudly or making a choking sound in their sleep.
Upon waking the next morning, the person still feels tired, despite thinking they got a good night’s rest. In severe cases of sleep apnea, pauses in breathing may occur as many as 30 times an hour. Under the circumstances, this could mean the equivalent of 4 hours of sleep vs. the recommended 6-7 for the elderly. The interruptions can happen 10 or more times an hour and because they are quite common in older adults, the symptoms can exacerbate — or sometimes mimick — dementia symptoms. In fact, seniors who’ve visited their doctor fearing dementia due to memory loss have found they do not have dementia, but sleep apnea, and the memory loss was due to improper sleep.
In the vast majority of cases, the culprit for this potentially fatal disease is a malfunction in the flap of tissue near the back of the throat. This variety of the disorder is known as obstructive sleep apnea. Instead of remaining open, the flap closes when one exhales. This in turn cuts off the supply of oxygen; while a minimal amount of apnea is not dangerous and common in a lot of people; moderate to severe cases can lead to high blood pressure, headaches, weight gain and many cardiovascular diseases. The human body and all its vital organs needs fresh oxygen to survive, so it is not surprising that sleep apnea can be potentially debilitating, particularly for elderly individuals who may already be suffering from poor health.
Seniors who already suffer from problems with their heart and central nervous system have a higher risk of developing central sleep apnea, another variety of senior sleep apnea that largely affects those over age 50. People who are overweight, especially ones considered obese, are much more likely to suffer from the condition. Only 30% of sleep apnea patients are within a healthy weight range, a fact which stresses the importance of a proper diet and exercise plan.
Testing and Treating
If you have symptoms of sleep apnea, your doctor may ask you to have a sleep apnea test, called a polysomnogram. This may be done in a sleep disorder center or even at home. A polysomnogram — or sleep study — is a multiple-component test that electronically transmits and records specific physical activities while you sleep. The recordings are analyzed by a qualified sleep specialist to determine whether or not you have sleep apnea or another type of sleep disorder. If sleep apnea is determined, you may be asked to do further sleep testing in order to determine the best treatment option.
The severity of a person’s sleep apnea will determine the appropriate treatment plan, though the best thing one can do is make much-needed lifestyle changes. Losing weight, sleeping on your side, and refraining from smoking cigarettes can have amazing results on the frequency of nightly interruptions. Treatments can include the use of a C.P.A.P. machine — the acronym stands for continuous positive airway pressure, a therapy that involves wearing a mask over the nose and/or mouth during sleep.
Most of the time, cognitive problems won’t evaporate when seniors are treated for sleep apnea. But researchers find that with C.P.A.P., many older patients see marked improvement. “They’re not dozing off during the day, they’re not dragging,” said Dr. Bradley Boeve, a neurologist at the Mayo Clinic. “Quality of life improves.”
For more information about seniors and senior living, visit alternativesforseniors.com.
BLOG Date: Tuesday, July 14, 2015
Writer: Ryan Allen