For years, Jennifer Greenberg was a major snorer. “I was quite notorious,” she said. “When my daughters were in middle school, they had fun recording me. No one could believe this loud sound was coming out of me.”
Now 60, Greenberg didn’t realize that her snoring was actually a warning sign of a serious medical problem — obstructive sleep apnea. Her case, in fact, was quite severe — with her breathing and her sleep disrupted 43 times an hour.
Today she’s found relief with help from the Peter C. Farrell Sleep Center of Excellence at UC San Diego Health, and wants her experience to serve as a “wake up call’ for others. “I was surprised by my diagnosis,” said Greenberg, who is petite and thin. “I thought it was usually older, obese men who got sleep apnea. Now I know that anyone can have this problem.”
Sleep problems, particularly sleep apnea, are actually fairly common in the U.S. and can be more serious than people realize. “Sleep issues affect many aspects of our lives both in terms of our overall health and our social interactions,” said
Atul Malhotra, MD, chief of the Division of Pulmonary and Critical Care Medicine at UC San Diego Health, who co-heads the state-of-the-art
Sleep Medicine Center with
Lisa Shives, MD.
In fact, the list of problems associated with too little sleep is long and growing. “Chronic sleep deprivation increases the risk of high blood pressure, heart disease, type 2 diabetes, stroke, obesity, depression, even cancer," said Malhotra.
Inadequate sleep can affect memory, learning, judgment, creativity, mood and other mental functions and
has been implicated as a significant factor in traffic accidents. Marriages can also suffer, with recent research suggesting that when wives have trouble falling asleep, their relationship with their husband may suffer.
Fortunately, most sleep problems can be improved with proper treatment. At the Sleep Medicine Center, which opened in April 2015, Malhotra and a multi-disciplinary team diagnose and treat a wide variety of sleep problems. Among them those associated with lifestyle/occupational issues, such as shift work, as well as sleep disorders, which include 84 different varieties affecting an estimated 50 to 70 million Americans.
Among them are
sleep apnea, which involves breathing difficulties that interrupt sleep;
insomnia, a hard time falling or staying asleep;
restless legs syndrome, tingling, unpleasant sensations and movement in the legs that disrupts sleep; narcolepsy, poor control of sleep-wake cycles resulting in bouts of extreme sleepiness that can strike at any time, and
parasomnias, such as sleep walking, sleep talking and other behaviors that can interrupt sleep.
Sleep apnea is the most common of the sleep disorders, affecting an estimated one in 10 Americans, said Malhotra. People with sleep apnea experience breathing pauses or shallow breathing that can result from various causes. “The tongue can block the airway or the back of the throat can collapse. Jaw structure, airway muscle problems and obesity can also be factors.”
Unfortunately, sleep apnea often goes undiagnosed, according to Malhotra, noting the condition is difficult for doctors to detect during routine office visits. Worse yet, most people who have sleep apnea don't know because it only occurs during sleep.
Sleep partners are often the first to recognize the condition. “They may hear their partner snoring heavily, which is a marker of sleep apnea, or notice pauses in their breathing.” Excessive daytime sleepiness can also lead to diagnosis. “People will come to me and say, ‘I can’t stay awake,’ or ‘I need a bunch of cups of coffee to keep me alert,’” said Malhotra.
For Greenberg, the decision to seek medical attention was prompted by a visit to her chiropractor, who asked how she was sleeping. “He said, ‘If you’re not sleeping well, then how will you heal?’ I thought isn’t that the truth?” The exchange prompted her to visit Malhotra, who recommended an overnight sleep study.
Greenberg spent the night in one of the center’s specially equipped patient evaluation rooms. The center also offers at-home diagnostic testing for individuals who prefer and can be monitored remotely.
“The staff made things really comfortable and assured me that if I needed intervention, they’d be on hand to help,” she said. To Greenberg’s surprise, the sleep specialists awakened her within two hours, with news that she had severe sleep apnea that was pausing her breathing 43 times an hour.
“This meant that 43 times an hour, my brain wasn’t getting enough oxygen. That’s really not healthy,” said Greenberg, who was immediately placed on a
Continuous Positive Airway Pressure (CPAP) machine. The machine gently blows air down a patient’s airway to help keep it open while sleeping, thus allowing a continuous flow of oxygen to the brain. This is one of the most common treatments for sleep apnea.
Since last October, Greenberg has been using the CPAP machine nightly. “It’s made a huge difference,” she said. “I was a person who had to take deep naps in the afternoon. I never knew why. Once I started the treatments, I noticed right away feeling much more alert and awake. One of the best benefits is increased concentration during the day.”
Snoring is now a thing of the past, she added, and she’s dreaming again.
Greenberg’s experience has led her to become a crusader for spreading the word about sleep disorders. “It’s a huge health issue,” she said. “I think there’s more of an awakening to this problem today by astute physicians and the public.” But more public education is needed, she said.
“To see it embraced by UC San Diego and the sleep clinic they offer is real progress in my eyes.”
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Pulmonary and Critical Care Medicine
Sleep Medicine Center