Obstructive Sleep Apnea (OSA) can cause the airway to collapse or become blocked during sleep. People with sleep apnea may be at higher risk for car crashes, work-related accidents and other medical problems, like hypertension, stroke or heart attack.
If you suspect or if a loved one suspects you have sleep apnea, it’s important to see a doctor.
Syed S. Ahmed, MD., a sleep specialist and a menber of the medical staff at Palmdale Regional Medical Center, is here to explain how he and his team of sleep specialists can provide evaluation and treatment for a full range of sleep disorders, including OSA.
Selected Podcast
Do You Have Obstructive Sleep Apnea (OSA)
Featured Speaker:
Learn more about Dr. Ahmed
Ahmed, Syed, MD
Dr. Syed Ahmed graduated from the Dow Medical College, Karachi, Pakistan in 1993. He works in Tehachapi, CA and other locations and specializes in Pulmonary Disease, Sleep Medicine. Dr. Ahmed is affiliated with Antelope Valley Hospital, Bakersfield Heart Hospital, Palmdale Regional Medical Center and Tehachapi Hospital. He speaks English and Spanish.Learn more about Dr. Ahmed
Transcription:
Melanie Cole (Host): Does someone in your family snore? They could have sleep apnea which is a potentially serious sleep disorder in which breathing rapidly stops and starts. My guest today is Dr. Syed Ahmed. He's a pulmonologist and a member of the medical staff at Palmdale Regional Medical Center. Welcome to the show, Dr. Ahmed. First, explain a little bit about what sleep apnea is.
Dr. Syed Ahmed (Guest): Good morning. Sleep apnea is a condition in which breathing is stopped for more than 10 seconds during sleep time. It's a major and most often unrecognized cause of excessive daytime sleepiness and snoring.
Melanie: So, how would somebody know that they have it? Are they the ones that recognize it? I'd like you to talk about symptoms or is it a loved one that recognizes some of these symptoms?
Dr. Ahmed: It can be both ways but most of the time, your partner will recognize because they notice that you have loud snoring, you have a breathing problem while you are asleep. Sometimes you choke, you gasp for air. Many times people have a body movement and a person who has sleep apnea can experience excessive daytime sleepiness and it can have intellectual changes and they can have morning headaches, too. Besides that, they have personality changes. They can feel non-restorative when they wake up in the morning.
Melanie: So, if somebody has these symptoms and their partner pushes them in to see a doctor, such as yourself, to get this checked out, how do you diagnose sleep apnea?
Dr. Ahmed: First, we evaluate that patients do have symptoms and signs of sleep apnea. Those that I mentioned: excessive daytime sleepiness, frequent awakening, intellectual changing, difficulty falling asleep, morning headache, sexual dysfunction, personality changes, snoring, breathing pauses at nighttime and choking sensation. Then, we have them come in to do a sleep study. We call it “polysomnography”.
Melanie: So, who would be at risk for this type of situation, this type of disorder?
Dr. Ahmed: Mostly obese patients--those who have a high BMI; male gender--they have a high risk; postmenopausal women--they have a high risk to have it. If you have excessive weight gain in the recent past; increasing age-after the age of 40, between the age of 40 and 60--more risk. African-American people--they are at more risk.
Melanie: So people hear the words “sleep study” and they're not sure that they're going to get a good night's sleep. How do you get somebody to sleep at a sleep study? Tell us about the sleep studies.
Dr. Ahmed: Mostly done in two different places: it can be done at home, and, mostly, and preferred to happen in what is called “sleep lab”. What you do over there is, when patients come, we let the patient to fall asleep just like sleeping at home and we monitor them. What we do is, we usually segregate the different stages of sleep by checking their eye movement, by checking their body movement, by checking their wave pattern in the brain. We check their electrocardiogram because many times, sleep apnea affects your heart rhythm. We check the airflow that how many times they stop breathing or having a shallow breathing. We check their oxygen level. Do they drop the oxygen? Also, we check if they're making their body movements. That detailed sleep study needs to be performed in the specifically called “sleep lab”.
Melanie: So then, if you've determined that they do have sleep apnea, what are some of the treatments that you recommend?
Dr. Ahmed: The preferred treatment is to use a CPAP or BiPAP machine. There are other treatment options available but, most of the time, even though we've tried to use other treatments, you will end up using THE CPAP machine but other treatment, the failure rate is very high. But CPAP or BiPAP is basically using a CPAP machine means that positive air with pressure giving through your nose and through your mouth to keep your brain viable during the sleep apnea and snoring processes at nighttime.
Melanie: What's the problem with CPAP? Is there an issue with adherence? Do people tend not to use these things?
Dr. Ahmed: True. Compliance is the main issue, very true. People are not used to having anything on their face and body when they are asleep and nobody prefers to use it, but with having frequent consultation and need and being urged to use the CPAP machine, patient compliance gets better. Many times, we use some sleeping aides during the initial phase to get used to having it, increase compliance, and get used to CPAP or BiPAP machine. That's the only in the initial stage. But, the urge and the compliance is more important factor and they need to follow with the sleep physician and the patient understands the urgency and the need to use BiPAP or CPAP and the consequences not to use it.
Melanie: And, what about oral appliances? Are there some things that can even be recommended by a dentist to help with sleep apnea?
Dr. Ahmed: True. Oral appliances can be use, but it's mostly recommended in a patient who has mild to moderate sleep apnea and those who have no other comorbid condition. That's like if they don't have any hypertension, if they don't have any instance of heart disease, if they don't have any incident of stroke and like that. If they are a mild to moderate, healthy patient, oral appliances can be applied, can be used, but there are some side effects for the oral appliances, too.
Melanie: So then, what about some things people can do, behavior modifications, changes, that you would like them to make to help them along with this type of therapy?
Dr. Ahmed: Behavior modification works. What are they? Excessive weight loss, avoiding alcoholic content, try and sleep on side, don't sleep on your back or on your tummy. You should try to sleep on your right or left side, and schedule sleep time. But, these are the kind of co-measures. It will not overcome your sleep apnea. You need to have some definitive treatment. Alone, behavioral modification or what we call conservative treatment will not completely resolve your sleep apnea.
Melanie: In just the last few minutes, Dr. Ahmed, what should people with excessive snoring or sleep apnea think about when seeking care?
Dr. Ahmed: Sleep apnea is a serious disease. It affects different functions, different parts of the body, different system. It puts you on risk to have heart attacks. It puts you on risk to have a stroke. It puts you at risk of uncontrolled blood pressure. Excessive daytime sleeping increases your mortality. It puts you on risk to have automobile accident because sometimes you can fall asleep behind steering and while you're driving. Those who have a symptom of sleep apnea, they need to take it seriously. They need to do the behavioral modification. They need to see the physician to make sure they have a diagnosis in a lab, a polysomnography study and should pursue and follow the sleep physician and continue to use the sleep machine. Treatment of sleep apnea has prevented mortality increased. It can help with heart function, better control for the blood pressure, better control for the diabetes. There is enough evidence that sleep apnea treatment is extremely beneficial for the patient who has excessive daytime sleepiness or known cases of sleep apnea. Besides the behavioral modification of excessive weight loss, avoid drugs and alcohol intake, it will be helpful.
Melanie: And why should they come to Palmdale Regional Medical Center for their care?
Dr. Ahmed: We have a certified sleep physician here, those who are having extensive training in the sleep disability and they are board certified. They have training. They can do the sleep lab because they have certified sleep lab certificates, too. So, it has to be done in the facility and run by the physician, those who are certified and also the test, and then you should have a follow-up after that. It's not just only having the test, you should have a follow-up treatment to be sure the patient is getting right and appropriate treatment.
Melanie: Thank you so much. It's such good information, Dr. Ahmed. You're listening to Palmdale Regional Radio and for more information, you can go to palmdaleregional.com. That's palmdaleregional.com. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): Does someone in your family snore? They could have sleep apnea which is a potentially serious sleep disorder in which breathing rapidly stops and starts. My guest today is Dr. Syed Ahmed. He's a pulmonologist and a member of the medical staff at Palmdale Regional Medical Center. Welcome to the show, Dr. Ahmed. First, explain a little bit about what sleep apnea is.
Dr. Syed Ahmed (Guest): Good morning. Sleep apnea is a condition in which breathing is stopped for more than 10 seconds during sleep time. It's a major and most often unrecognized cause of excessive daytime sleepiness and snoring.
Melanie: So, how would somebody know that they have it? Are they the ones that recognize it? I'd like you to talk about symptoms or is it a loved one that recognizes some of these symptoms?
Dr. Ahmed: It can be both ways but most of the time, your partner will recognize because they notice that you have loud snoring, you have a breathing problem while you are asleep. Sometimes you choke, you gasp for air. Many times people have a body movement and a person who has sleep apnea can experience excessive daytime sleepiness and it can have intellectual changes and they can have morning headaches, too. Besides that, they have personality changes. They can feel non-restorative when they wake up in the morning.
Melanie: So, if somebody has these symptoms and their partner pushes them in to see a doctor, such as yourself, to get this checked out, how do you diagnose sleep apnea?
Dr. Ahmed: First, we evaluate that patients do have symptoms and signs of sleep apnea. Those that I mentioned: excessive daytime sleepiness, frequent awakening, intellectual changing, difficulty falling asleep, morning headache, sexual dysfunction, personality changes, snoring, breathing pauses at nighttime and choking sensation. Then, we have them come in to do a sleep study. We call it “polysomnography”.
Melanie: So, who would be at risk for this type of situation, this type of disorder?
Dr. Ahmed: Mostly obese patients--those who have a high BMI; male gender--they have a high risk; postmenopausal women--they have a high risk to have it. If you have excessive weight gain in the recent past; increasing age-after the age of 40, between the age of 40 and 60--more risk. African-American people--they are at more risk.
Melanie: So people hear the words “sleep study” and they're not sure that they're going to get a good night's sleep. How do you get somebody to sleep at a sleep study? Tell us about the sleep studies.
Dr. Ahmed: Mostly done in two different places: it can be done at home, and, mostly, and preferred to happen in what is called “sleep lab”. What you do over there is, when patients come, we let the patient to fall asleep just like sleeping at home and we monitor them. What we do is, we usually segregate the different stages of sleep by checking their eye movement, by checking their body movement, by checking their wave pattern in the brain. We check their electrocardiogram because many times, sleep apnea affects your heart rhythm. We check the airflow that how many times they stop breathing or having a shallow breathing. We check their oxygen level. Do they drop the oxygen? Also, we check if they're making their body movements. That detailed sleep study needs to be performed in the specifically called “sleep lab”.
Melanie: So then, if you've determined that they do have sleep apnea, what are some of the treatments that you recommend?
Dr. Ahmed: The preferred treatment is to use a CPAP or BiPAP machine. There are other treatment options available but, most of the time, even though we've tried to use other treatments, you will end up using THE CPAP machine but other treatment, the failure rate is very high. But CPAP or BiPAP is basically using a CPAP machine means that positive air with pressure giving through your nose and through your mouth to keep your brain viable during the sleep apnea and snoring processes at nighttime.
Melanie: What's the problem with CPAP? Is there an issue with adherence? Do people tend not to use these things?
Dr. Ahmed: True. Compliance is the main issue, very true. People are not used to having anything on their face and body when they are asleep and nobody prefers to use it, but with having frequent consultation and need and being urged to use the CPAP machine, patient compliance gets better. Many times, we use some sleeping aides during the initial phase to get used to having it, increase compliance, and get used to CPAP or BiPAP machine. That's the only in the initial stage. But, the urge and the compliance is more important factor and they need to follow with the sleep physician and the patient understands the urgency and the need to use BiPAP or CPAP and the consequences not to use it.
Melanie: And, what about oral appliances? Are there some things that can even be recommended by a dentist to help with sleep apnea?
Dr. Ahmed: True. Oral appliances can be use, but it's mostly recommended in a patient who has mild to moderate sleep apnea and those who have no other comorbid condition. That's like if they don't have any hypertension, if they don't have any instance of heart disease, if they don't have any incident of stroke and like that. If they are a mild to moderate, healthy patient, oral appliances can be applied, can be used, but there are some side effects for the oral appliances, too.
Melanie: So then, what about some things people can do, behavior modifications, changes, that you would like them to make to help them along with this type of therapy?
Dr. Ahmed: Behavior modification works. What are they? Excessive weight loss, avoiding alcoholic content, try and sleep on side, don't sleep on your back or on your tummy. You should try to sleep on your right or left side, and schedule sleep time. But, these are the kind of co-measures. It will not overcome your sleep apnea. You need to have some definitive treatment. Alone, behavioral modification or what we call conservative treatment will not completely resolve your sleep apnea.
Melanie: In just the last few minutes, Dr. Ahmed, what should people with excessive snoring or sleep apnea think about when seeking care?
Dr. Ahmed: Sleep apnea is a serious disease. It affects different functions, different parts of the body, different system. It puts you on risk to have heart attacks. It puts you on risk to have a stroke. It puts you at risk of uncontrolled blood pressure. Excessive daytime sleeping increases your mortality. It puts you on risk to have automobile accident because sometimes you can fall asleep behind steering and while you're driving. Those who have a symptom of sleep apnea, they need to take it seriously. They need to do the behavioral modification. They need to see the physician to make sure they have a diagnosis in a lab, a polysomnography study and should pursue and follow the sleep physician and continue to use the sleep machine. Treatment of sleep apnea has prevented mortality increased. It can help with heart function, better control for the blood pressure, better control for the diabetes. There is enough evidence that sleep apnea treatment is extremely beneficial for the patient who has excessive daytime sleepiness or known cases of sleep apnea. Besides the behavioral modification of excessive weight loss, avoid drugs and alcohol intake, it will be helpful.
Melanie: And why should they come to Palmdale Regional Medical Center for their care?
Dr. Ahmed: We have a certified sleep physician here, those who are having extensive training in the sleep disability and they are board certified. They have training. They can do the sleep lab because they have certified sleep lab certificates, too. So, it has to be done in the facility and run by the physician, those who are certified and also the test, and then you should have a follow-up after that. It's not just only having the test, you should have a follow-up treatment to be sure the patient is getting right and appropriate treatment.
Melanie: Thank you so much. It's such good information, Dr. Ahmed. You're listening to Palmdale Regional Radio and for more information, you can go to palmdaleregional.com. That's palmdaleregional.com. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.