What is sleep apnea? Ottawa sleep expert discusses symptoms and treatment

We break down what you need to know about the common disorder with Andrew Holmes from Sleep Efficiency.

Many people are going to bed at night with undiagnosed sleep apnea, according to an Ottawa sleep expert.

CTV Your Morning Ottawa speaks with Andrew Holmes of Sleep Efficiency about sleep apnea and how to treat it.

What is sleep apnea?

“Textbook definition would be pauses in your breathing for 10 seconds or longer,” Holmes told CTV Your Morning Ottawa on Tuesday.

“It’s muscle tissues in the upper airway that cause partial or complete blocks and these interruptions throughout the course of the night cause a lot of sleep fragmentation (and) oxygen desaturation.”

Holmes says there is a “wide range of severity” for sleep apnea.

According to Health Canada, the most common type of sleep apnea is obstructive sleep apnea, which happens when the upper airway gets blocked during sleep.

What are the symptoms of sleep apnea?

“The classic symptoms would be chronic snoring, daytime fatigue, excessive daytime fatigue, poor memory and concentration, multiple awakenings throughout the course of the night,” Holmes said.

Health Canada says many people with sleep apnea don’t know if they’re snoring and gasping for breath at night. If you have any symptoms, you should see your doctor.

Other symptoms are: gasping or choking during sleep, morning headache, irritability or mood changes, low sex drive and falling asleep while driving.

How severe is sleep apnea?

Holmes says, in addition to diagnosing a patient with sleep apnea, it’s important to determine how severe it is.

“It’s broken down into mild, moderate, and severe. Mild sleep apnea would be somewhere between five to 15 respiratory events per hour,” Holmes said. “Those are these pauses or reductions in airflow. Anything between 15 to 30 events per hour would be considered moderate – this would be a moderate apneic.”

Holmes says anything over 30 respiratory events an hour would be considered severe.

Are there treatment options for sleep apnea?

Holmes says there are traditional and new treatment options available for patients with sleep apnea.

Holmes says the most common treatment is CPAP, also known as continuous positive airway pressure.

“That’s the mask that people wear,” Holmes said.

The special mask keeps the throat open, stops the snoring and pauses in breathing while the patient sleeps.

Holmes notes there is only about a 50 per cent compliance rate for patients using CPAP therapy.

When it comes to treating sleep apnea, Holmes says the more respiratory events you have on an hourly basis, the faster you respond to treatment.

“With one or two small steps, we can make a massive change to their overall health,” Holmes said.

“When that upper airway gets splinted and they go from stopping breathing 50 times per hour down to just one or two, increase in energy levels, memory and focus, it becomes this positive feedback loop. The weight starts to come down because they’re exercising more because they’ve got the energy levels to do so.”

What is the new treatment option Zepbound?

Health Canada recently approved Zepbound as the first medication in Canada for the treatment of moderate-to-severe obstructive sleep apnea in adults living with obesity.

“This is to be in conjunction with a weight-loss program, of course, reduce calorie intake, extra exercise,” Holmes said.

“Zepbound is, right now, the only clinically validated weight loss drug that’s been approved to treat those with severe sleep apnea.”

Zepbound is approved for use alongside a reduced-calorie diet and increased physical activity.

Holmes said the early data shows the medication is reducing 25 to 30 respiratory events per hour, meaning patients are “going from severe apnea down to mild, which is a massive win.”

“Another tool in the toolkit to be able to treat sleep apnea.”

Tips to improve sleep

Holmes recommends a diagnostic sleep test to determine if you have sleep apnea and how severe it is.

“A lot of people are positional apneic. About 55 per cent of people who have issues breathing only have issues when they’re on their back,” Holmes said. “So, sleeping on your side is probably a good start.”

He also recommends going to bed at the same time each night and waking up at the same time, along with exposing yourself to daylight.

“Sleep hygiene practices aren’t really going to treat sleep disorder breathing, though,” Holmes said.

“Those are just things to optimize your sleep overall. But ultimately, what you want to do is get a sleep test done first and foremost.”

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