By Ken Mallows
Most sufferers don't know it, but sleep apnea is an hereditary disorder. If you have sleep apnea, there's a one-in-four chance that some of your children will have it, according to Michael Decker, PhD, Registered Nurse, Registered Respiratory Therapist and Diplomate of the American Board of Sleep Medicine.
"This is what a lot of people don’t understand. Sleep apnea is an inherited disorder," says Decker, who is Associate Professor in the School of Nursing at The Frances Payne Bolton School of Nursing at Case Western Reserve University. He told Fleet Owner magazine: "Kids with sleep apnea have reduced academic performance. They don’t do well in school. They can become hyperactive. I often encourage a person who may have sleep apnea to get tested. Even if you may not want treatment yourself, your children may have this disorder, and they need treatment because it’s going to impact the rest of their life."
He adds that the latest research concludes that sleep apnea is a neuromuscular disease of the upper airway. Says Decker: "The part of the brain that controls the upper airway fails to work properly in people who have sleep apnea. They simply have less strength in their upper airway muscles. Many people have sleep apnea but the disease may not show itself unless there’s a trigger. That trigger, for instance, can be a change in weight or alcohol use."
Decker notes that while many doctors suspect sleep apnea based with an office visit and a questionnaire, it can only be properly diagnosed with monitors that check vital signs during sleep like blood oxygen levels, heart rate, blood pressure, etc. Until these tests are performed, however, many doctors give their at-risk patients – like truck drivers – a CPAP machine which can work immediately. "Is it worth putting that person and others around them at risk for six weeks on the road while a sleep study is scheduled, or do you go ahead and treat them right away and say you know this isn’t going to be perfect but it’s going to make you feel a lot better and keep you alert and possibly alive until we get you into the laboratory? The answer often is 'yes.'"
While CPAP usage is common, it can be uncomfortable for many patients. "It’s very difficult for people to adapt to CPAP because it's blowing air into your face; it’s like having a vacuum cleaner running in reverse connected to a mask attached to your face. It’s very difficult to breathe against that. So many people are just unable to tolerate CPAP. They make an honest effort but they’re just not able to adapt to that high pressure in their face."
Fortunately, there are other remedies including oral appliances and implanted neurostimulators that 'ping' the upper airway muscles during sleep much as a heart pacemaker works. "You turn it on when you go to sleep, perhaps by passing a little magnet over your chest and that turns it on. They’re very effective. The secret is picking the right patient, because there are certain people it won’t work in and other for whom it works exceptionally well."