In conjunction with rapidly growing epidemics in obesity and insulin-resistant diabetes, obstructive sleep apnea, or OSA, is also very much on the rise.
The American Sleep Apnea Association reports that OSA affects 1 in 4 men and 1 in 9 women in the United States. Eighty percent to 90 percent of moderate and severe OSA cases remain undiagnosed.
Left untreated, OSA is associated with an increased incidence of hypertension, stroke, heart failure, coronary artery disease, cardiac arrhythmia, gastroesophageal reflux disease and memory loss.
Individuals with OSA are also 10 times more likely to die from a motor vehicle accident because of impaired driving performance.
Another key cause of sleep apnea is medication. For example, pain patients who require opiate medications for pain are at higher risk because of varying degrees of respiratory depression. The combination of obesity, depression and medication for chronic pain can result in some of the most severe cases.
OSA affects not only individuals and their families, but also affects productivity and jeopardizes workplace safety. A sleep study done in Australia in 2010 estimated the indirect costs of having sleep disorders to be around $3.1 billion in lost productivity to employers. The cost of work-related motor vehicle accidents associated with sleep disorders amounted to $517 million. Employers have a real economic interest in encouraging their employees to get tested and treated.
Once a DIAGNOSIS is made, physician specialists typically provide recommendations on specific breathing equipment for nighttime use. The most common technical solution involves the use of a breathing device that provides positive airway pressure and helps maintain a regular rhythm.
A good night’s sleep is one of the greatest gifts and pleasures of life. The ability to diagnose sleep apnea and provide equipment to manage the problem is an important part of the solution. Those suffering from poor sleep, whatever the cause, will benefit even more from a whole-person, patient-centered approach.
Sleep wellness can best be achieved with a multidisciplinary team that is able to assist clients with insomnia and weight management, and provide education on lifestyle, physical activity and diet. The team should be combined with medical providers who are available to engage in management of associated conditions such as diabetes, high blood pressure and high cholesterol. Outcomes will be optimal if psychologists are able to provide education and insights on healthy sleep behaviors, relaxation techniques and dream therapy.
Ancient Polynesians sailed throughout the Pacific with twin-hulled canoes, navigating by celestial bodies, ocean currents and guidance by the ancestors. The traditional navigator does not simply travel from one place to another; rather, the journey transforms the way-finder. Sleep is not a problem to be solved, but a mystery to be lived.
———
Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
