Sleep Apnea Elevates Risk for Health Problems - Genesis Health System

Published on February 28, 2013

Sleep apnea elevates risk for serious health problems

Treatment provides life-changing benefits

Dr. Jon Lemke would often wake up gagging and gasping for air. While he slept, his wife would occasionally shake him to get him breathing again.

Those frightening symptoms led him to have an overnight sleep study at the Genesis Sleep Disorders Center in Davenport, where he became one of 18 million Americans to be diagnosed with obstructive sleep apnea.

The night of his sleep study, his breathing paused about 70 times per hour.

Jessie Fischlein, polysomnographic technologist, shows a
continuous positive airway pressure (CPAP) mask to Dr. Jon
Lemke, who has obstructive sleep apnea. He was diagnosed
during a sleep study at the Genesis Sleep Disorders Center
more than three years ago, and never sleeps without his
CPAP machine.

The CPAP has a mask that fits over the nose and/or mouth
and gently blows air into the airway to help keep it open
during sleep.

His sleep apnea was so severe, Genesis sleep staff awakened him and put him on a continuous positive airway pressure (CPAP) machine for the rest of the night. The CPAP has a mask that fits over the nose and/or mouth and gently blows air into the airway to help keep it open during sleep. A titration study was begun to determine the optimal air pressure he would need.

Since then, he is never without his CPAP machine. It has made a night-and-day difference in the quality of his sleep.

“I always wake up refreshed. Before, I couldn’t say that,” says Dr. Lemke, who is Chief Biostatistician at Genesis. “My wife loves the CPAP. In fact, I haven’t heard of a spouse who doesn’t. Spouses no longer have to deal with the snoring or gasping and being woken up time after time throughout the night.”

More important to Dr. Lemke, however, are the benefits to his health. Lack of oxygen is hard on the heart and brain. The CPAP machine keeps his upper airway open so his lungs and blood remain oxygenated while he sleeps, which helps to prevent health consequences ranging from heart disease to diabetes.

“I never sleep without my CPAP machine,” he says. “Untreated sleep apnea is harmful to every system in your body. Studies show that even going a week without using your CPAP can be devastating...the lack of oxygen affects every organ of your body.”

Uncovering Sleep Apnea

Obstructive sleep apnea occurs when the muscles in the back of the throat relax and momentarily close off the airway. The blood oxygen lowers. The brain senses this decrease and briefly rouses the person from sleep so the airway reopens. This pattern can repeat itself 10 times or more each hour all night, making it difficult to reach the deep, restful phases of sleep.

The pauses in breathing can last 10-30 seconds or more and occur up to 400 times a night. They can lead to serious health complications -- from high blood pressure, heart disease and stroke to depression and memory problems.

As Chief Biostatistician at Genesis, Dr. Lemke spends his work days applying his knowledge of statistics, science and mathematics to important questions in health care. Not surprisingly, he is fully aware of the scientific studies that show the risks of untreated sleep apnea.

  • There’s a very strong connection between sleep apnea and cardiovascular complications like high blood pressure, coronary artery disease, congestive heart failure, stroke and abnormal heart rhythms. The drop in oxygen level from not breathing, and the increase in heart rate and blood pressure caused by waking up, causes stress to the heart.
  • People with an untreated case of sleep apnea face a four times greater risk of stroke. They are three times more likely to have heart disease.
  • Obstructive sleep apnea patients with heart disease who used CPAP for one month enjoyed a 32 percent increase in their left ventricular ejection fraction (a signal of the heart’s pumping power.) Yet, their results completely reversed after just one week without it, a study showed.
  • Untreated obstructive sleep apnea patients have a higher incidence of post-operative complications and longer lengths of stay after surgery.
  • Elective surgery patients with untreated or undiagnosed sleep apnea are approximately nine times more likely to end up in the Intensive Care Unit.
  • Each year, untreated sleep apnea costs at least $9,000 more per Medicare patient.

Improving symptoms of Metabolic Syndrome
From personal experience, Dr. Lemke also has learned how sleep apnea contributes to Metabolic Syndrome. That’s the cluster of conditions -- increased blood pressure, a high blood sugar level, excess body fat around the waist or abnormal cholesterol levels -- that occur together and increase the risk of heart disease, stroke and diabetes.

Through his participation in the Genesis wellness program, he learned he had Metabolic Syndrome.

“All the Metabolic Syndrome conditions are improved when a person with sleep apnea goes on the CPAP machine,” Dr. Lemke says. “Once I started using a CPAP, all my risk factors improved and I didn’t have Metabolic Syndrome anymore. My glucose, triglycerides and blood pressure lowered, and my waist was reduced.”

Screening Inpatients

In addition, Dr. Lemke was on a team of health care professionals who led a pilot study that screened inpatients at Genesis for obstructive sleep apnea. It was so successful, the program has been rolled out to all Genesis hospitals.

The program screens newly admitted patients (who have not been previously diagnosed) using a questionnaire to determine if they have a “high likelihood” of having obstructive sleep apnea. When results are inconclusive, nurses observe hospital patients while they sleep for signs of sleep apnea like snoring or pauses in breathing. Patients are informed if they are at high risk, and a letter is sent to their primary care physician.

At least 25-35 percent of Genesis inpatients are found to have symptoms of sleep apnea.

“It’s pay me now or pay me later,” Dr. Lemke concludes. “The sooner a person gets their sleep apnea treated, the better they can avoid damage to their body.

“If they’re excessively tired or if they snore or stop breathing while they sleep, I strongly recommend they go to the Genesis Sleep Clinic to determine if they should have a sleep study. The test is easy, and it could save them many health complications in the future.”

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