Sleep Q and A
J.Woodrow Weiss, MD, Medical Director of The New Sleep Center at Beth Israel Deaconess Hospital-Needham answers your questions about sleep problems. To make an appointment for your sleep study call 1-800-432-8808.
1. What exactly is sleep apnea?
Sleep apnea refers to a condition in which patients partially or completely stop breathing intermittently during sleep. The most common consequence of sleep apnea is disrupted sleep which causes daytime sleepiness. Other consequences include high blood pressure, diabetes, cardiac arrhythmias and difficulty with memory or attention.
2. Is there any way to test for the condition beside an overnight sleep study?
Although a careful history and physical examination by your physician can increase suspicion for sleep apnea, an overnight sleep test is required for definite diagnosis. Sometimes that sleep test can be performed in the home but most often it is done in the sleep laboratory.
3. What is the difference between acute snoring and sleep apnea?
Snoring is a noise made by vibration of tissue in the throat. Snoring occurs most often when the air passages are narrowed. This can happen in many people during an acute condition such as a head cold, but most individuals who snore loudly and persistently have sleep apnea.
4. When is it okay to take generic or off-brand sleep stimulants?
Hypnotic drugs to promote sleep can be of benefit primarily to patients who are having difficulty initiating sleep when under acute stress or when traveling. Sleeping drugs should never be taken for more than 2-3 days, however, without a discussion with your physician. Long-term use of sleeping meds can actually contribute to insomnia.
5. Does the fit testing and accuracy of the CPAP machines require an overnight stay?
Generally, nasal CPAP testing is best done in the sleep laboratory. The recent development of new "auto-titrating" CPAP machines has allowed some patients to have their CPAP prescription made based on a home study. You should discuss the advantages and disadvantages of home studies with your physician.
6. Have there been any advances in sleep masks?
Mask technology has changes substantially in recent years but this remains a difficult problem for many patients using nasal CPAP. To help patients get the best prescription, we have started a Mask Fitting Clinic at BIDN. If you wish to be seen in the Clinic your physician should refer you through the Sleep Laboratory.
7. Is it dangerous to remove your mask after only 5 hours, in order to get uninterrupted sleep for the remainder of the night?
Many patients remove their CPAP mask during the night. Some patients do this unconsciously and others do it deliberately. In general, response to treatment is proportional to the duration the mask is used at night so we encourage you to discuss your CPAP prescription with your sleep physician if you are having trouble keeping your mask in place. That said, wearing CPAP for 5 hours is much better than not wearing the mask at all if you have sleep apnea.
8. If you do not use a mask, is there a recommended position for sleep to avoid snoring or apnea events?
Most, but not all, patients will have more frequent sleep apneas while sleeping on their back compared to when they sleep on their sides. This seems to be because the airway narrows when you are on your back since the tongue moves back in your throat. It is, however, difficult or impossible for many patients to stay off their backs once they fall asleep.
9. Do you recommend any particular pillows?
No pillow has ever been shown to be an effective treatment for sleep apnea. For that reason most patients do well focusing on what pillow is most comfortable.