Columns

ON MENTAL ILLNESS: the dangers of sleep apnea

Jack Bragen
Thursday June 29, 2017 - 06:42:00 PM

I was diagnosed with severe sleep apnea more than ten years ago. I did not comply with doctor's orders to wear a CPAP machine, and I returned the machine. I thought at the time that it was nonsense. The sleep doctor at Doctor's Hospital in the Richmond area were quite upset with me for wasting their efforts.

Then, more recently, I would wake up every morning feeling as though a truck ran over me. This was about seven years ago.

I had a second sleep study done in Concord, and the physician, who I knew and trusted, essentially said that if I didn't use the machine, I was going to die.

Apparently, actor Carrie Fisher died in part due to sleep apnea at age 60. Had I not gone on the machine several years back, it is likely that, by now, I would be deceased.  

This advance in medical science, along with the discovery of psychiatric medications, have allowed me to remain alive so far. Sleep apnea can be caused by weight, by an obstruction in the airway, and can be caused by certain medications. In sleep apnea, the body is deprived of oxygen while you are asleep. This can lead to heart failure and to numerous other ailments. 

When the body detects a deficiency of oxygen, it sends signals to the heart to work harder. The heart can thus sustain damage; it has to work harder and at the same time, it is deprived of enough oxygen. At the same time, the brain is deprived of oxygen, making it harder for a person to wake up. This scenario, in extreme cases, could lead to death. 

Of course, sleep apnea is bad for the brain. 

When I had untreated sleep apnea, I would wake up feeling utterly exhausted, I would feel physically awful, and I would wonder what the hell was wrong with me. I would often fall asleep during the day. 

Sleep apnea is common among older adults, among people on psychiatric medication, and among people who are obese. You get tested for it with a sleep study. Both my father and my maternal uncle slept with a CPAP, and swore by it. A CPAP increases the air pressure going into the airway, making it easier to inflate the lungs. It can help open a constricted airway, and it can help offset the effects of gravity in an obese person.  

The term "CPAP" is an abbreviation for Continuous Positive Airway Pressure. There is also a "BiPAP" which switches to a lower level of air pressure upon exhalation. 

People at risk for sleep apnea also include those with COPD due to smoking. Getting tested and treated (as necessary) for sleep apnea can not only save you from an early death, it can also increase quality of life, since people who treat their apnea feel much better during the day. The brain will work better, and this contributes to mental health, and to being able to perform at an activity, whether this a job, volunteer work, or school. 

The testing entails an overnight stay in a sleep lab, in which electrodes and other test items are put on you, and in which your sleep will be studied to see how well you are breathing, as well as to find out if you are waking up repeatedly due to lack of enough air.  

Sleep apnea can deprive you of REM sleep, and this means you are not getting much benefit from your sleep. 

I find that I am usually able to nap if I am sitting up in a chair. However, when I sleep horizontally, I have to be hooked up to my machine. I don't use the humidifier section of the machine, and I don't use heated tubing. This is a personal preference, and everyone will be different.  

It is important that the individual who is conducting the sleep study is reputable, since a sleep study puts you in a vulnerable position. If something doesn't seem right at the start of your sleep study, you can leave.