SLEEP M EDIC IN E Get Treated for Sleep Apnea for Better Rest and a Healthier Heart More than 25-million Americans suffer from obstructive sleep apnea. This health condition does more than rob sleep; it also can damage the heart. “Sleep apnea occurs when the muscles in the back of your throat relax, closing off your airway,” explains Ravi Aysola, MD, director of the UCLA Pulmonary and Sleep Medicine Clinic in Santa Monica. “You wake up because you can’t breathe and your oxygen levels are dropping.” As Dr. Aysola explains, the body goes into fight-or-flight mode, ratcheting up blood pressure, heart rate and stress-hormone levels. The extra stress on the heart increases the chances of heart attack, stroke, high blood pressure and irregular heart rhythms, called arrhythmias. It is not always easy to self-identify sleep apnea. Symptoms include snoring, morning headaches, daytime fatigue and irritability. “I often hear from patients who say they make frequent nighttime trips to the bathroom,” says Dr. Aysola. “Really, it’s not a need to urinate that wakes them; it’s the apnea.” A quick questionnaire called the STOP-BANG, completed in a doctor’s office, often is the first step in getting a diagnosis. STOP focuses on snoring, tiredness, observed sleep disruption and blood pressure. BANG assesses risk factors such as BMI (overweight people are more prone to sleep apnea), age (the risk is greater for those older than 50), neck circumference (a number greater than 16 inches in women and 17 inches in men increases risk) and gender (apnea affects more men than women, until menopause). People at risk can do a sleep study either at a sleep-disorders lab or at home. “You wear sensors for a night or two that monitor your breathing, heart rate and blood-oxygen level,” Dr. Aysola says. The standard treatment for apnea involves wearing a mask at night that keeps the airways open through continuous positive airway pressure, or CPAP. If symptoms are mild- to-moderate, an oral appliance similar to a mouth guard may help. Some people with severe problems opt for surgery to remove obstructive tissue. Sleep apnea may seem like a mere annoyance, but Dr. Aysola stresses that the cumulative effects on the heart are serious. “In order to keep the heart strong, you need to breathe steadily all night long.” The UCLA Sleep Disorders Clinics Neurology Sleep Clinic 300 UCLA Medical Plaza Suite B200 Los Angeles, CA 90095 (310) 794-1195 Pulmonary Santa Monica Sleep Clinic 1223 16th Street Suite 3400 Santa Monica, CA 90404 (310) 449-0939 Pulmonary Sleep Clinic 200 UCLA Medical Plaza Suite 365-B Los Angeles, CA 90095 (310) 825-8061 For more information sleepcenter.ucla.edu 1-800-UCLA-MD1 (1-800-825-2631) Ravi Aysola, MD LAW Vital Signs Fall 2016 Vol. 72 3