When It's More Than Just Snoring

If you snore, you might have a serious condition called sleep apnea

illustration by craig holland

If you’ve ever longed to be wrapped in the arms of Morpheus, you’re hardly alone among seniors who would welcome nightly communion with the mythological Greek God granting restful sleep and sweet dreams.

Sleep disorders can plague people at any life stage, but they worsen and become more perilous as we age.

“It was awful. I was snoring like crazy every night. My wife was always yelling at me and didn’t want to sleep with me. It was so bad even the cat wouldn’t sleep in the same room,” says George “Sonny” Tylus, the owner of a promotional marketing company in Salem. “I would toss and turn all night and wake up still tired every morning. I knew I wasn’t sleeping right, but I didn’t know what was wrong with me.”

Tylus was diagnosed six years ago with obstructive sleep apnea (OSA), the most common type of sleep apnea, which can be life-threatening if left untreated. It is marked by brief but repeated interruptions in breathing while sleeping.

“The [sleep disorder] condition that has the most severity and the most wide-ranging adverse health effects is obstructive sleep apnea, which is often associated with the occurrence of other medical conditions or may increase the possibility of other medical conditions that are diverse and many,” says Dr. George Neal, the medical director of the New England Sleep Center at Catholic Medical Center in Manchester. “If severe enough, it can cause or contribute to heart failure or serious cardiac rhythm problems. Statistically, people with apnea have a shorter life span. Overall, there is a higher risk of stroke, heart attack, diabetes and hypertension in individuals with apnea. It can exacerbate a number of those [existing] medical conditions.”

Although it is unknown how many Americans suffer from OSA because many cases go undiagnosed, Dr. Elizabeth Lynch says that studies estimate three to seven percent of the population is afflicted. Nevertheless, numbers can be deceiving.

“When you start breaking it down into different age groups and different sexes, you can start to say that there is a little bit of disparity. Women tend to have it a little less than men and for those over the age of 65, it’s usually a little bit more prevalent, maybe upwards of 15 percent,” says Lynch, the director of the Sleep Institute of New England, which is headquartered in Kingston with satellite offices in Portsmouth and Derry.

Although OSA is more common in men overall, as women grow older they become increasingly more at risk.

“What I say to my [female] patients is this is one more ‘fun’ thing about menopause,” says Dr. Anne Magauran, director of the Center for Sleep Disorders at Exeter Hospital. “It is absolutely true that OSA is more prevalent in men, but as women become menopausal it evens out. The hormonal changes do change the incidence. Older men still have it a little more than women but they are almost equal. It’s almost a three-to-one men-to-women ratio prior to menopause.”

Often when seniors tell their family, friends, or even in some cases their physicians, that they are experiencing problems with falling asleep, staying asleep and suffering with other symptoms, they are told that it is just a normal part of the aging process.

“The problem is more widespread than people thought but the awareness of it is increasing. More and more research is being conducted. People who suffered often took this as that’s just the way it is, but it doesn’t have to be that way anymore,” says Magauran.

One of the first ways to combat OSA is weight control as obesity is a major contributing factor.

“In the people I see, it is 80 percent weight-related, although it is not in the other twenty percent,” says Lynch. “Sleep apnea is a serious problem and it’s increasing. Not only have we recognized it more, but we’re seeing it more based on the fact there are just more overweight people.”

The most effective and most widely used non-surgical treatment for OSA is continuous positive airway pressure, which uses a machine called at CPAP to increase the air pressure in the patient’s throat to prevent the airway from collapsing when breathing in. The machine has an attached mask that covers the nose or the nose and the mouth.

“A lot of people are hesitant to have this issue further explored because they don’t like the idea of CPAP,” says Magauran. “It used to be years ago that people would have a sleep study and be handed a machine and they would go home and use it and say ‘I’m not doing this’ and it would end up in a closet. But things are very different now and we work with patients to help them through the process and with their CPAPs.”

Tylus says that his CPAP is saving his life and he uses it faithfully every night.

“I’m overweight, I have a crooked air passageway that can’t be operated on and I’m getting older, so I have three things wrong with me,” he says. “I also have Afib [atrial fibrillation] so my doctor told me I was playing with fire. The machine isn’t fun, but it’s better than the alternative of having a heart attack and never waking up again. With my machine, I was doing so much better within only a couple of weeks, and when I went in for a check-up my doctor confirmed that. The data doesn’t lie.”

Says Magauran, “One thing that’s really great about my job is that it truly makes a difference. We can really improve how people sleep, how they feel during the day and the quality of their lives. I hear all of the time from my patients how much better they feel.”