Q: I am pretty rigorous about getting to bed at a decent hour and believe that I'm getting a full night's sleep, but when I wake up, I spend the majority of my day in a haze. Could I have a sleep disorder, and do I have to stay in a sleep lab to find out?
A: While you may be spending a full eight hours in bed each night, it's important to recognize that the quality of the sleep you get is more important than the actual number of hours you spend sleeping. That being said, there are several possible explanations as to why you're not waking refreshed.
One of the most common sleep disorders is Obstructive Sleep Apnea, or OSA. OSA affects approximately 18 million Americans, yet the vast majority of sufferers remain undiagnosed. OSA causes patients to stop breathing during sleep, due to their airways collapsing and preventing air from getting to the lungs. These apneic events can last anywhere from 10 seconds to one minute and may occur hundreds of times each night.
These disruptions cause a number of serious health problems that interfere with daily life, including chronic fatigue and memory impairment, as well as more serious conditions such as hypertension, diabetes, and an increased risk of stroke and heart attack. In order to better assess what is going on while you sleep, you should consult a sleep physician who can discuss your condition and will likely suggest a sleep study.
In the past, patients being tested for OSA were required to spend the night in a certified sleep lab to participate in a polysomnogram. During a polysomnogram, the patient's heart rate, respiration, blood oxygen levels, airflow, and electrical activity of the brain are monitored. However, earlier this year, the Center for Medicare and Medicaid Services approved the reimbursement of Continuous Positive Airway Pressure (CPAP) treatment for OSA patients that were diagnosed wearing portable monitoring equipment in the comfort of their own home. CPAP is a breathing device that fits over the patients' nose or nose and mouth and provides pressurized air at a constant and continuous pressure to keep the airway open. The use of this common treatment prevents the tissues in the airway from collapsing, allowing the patient to breath continuously.
The decision to allow home testing for OSA is expected to lead to a shift in how millions of OSA sufferers are diagnosed and may result in significantly increased diagnosis and treatment rates. Not only will diagnosis and treatment help to make you feel more rested when you wake up, studies have shown other health benefits include the ability to better control one's type 2 diabetes, cardiovascular issues as well as depression issues.
Dr. Atwood is a board certified pulmonologist and sleep medicine physician at the University of Pittsburgh Medical Center and the VA Pittsburgh Healthcare System. He directs the Sleep Medicine outpatient clinic at the UPMC Sleep Medicine Center and is the Director for the VA's sleep disorders program. Dr. Atwood is an investigator on research examining the role of home-based sleep apnea diagnosis and therapy. Dr. Atwood is currently the immediate past Chair of the American College of Chest Physicians' Sleep Institute.
