Tina Chavez never had trouble sleeping — until, that is, about three years ago, when the 48-year-old from Los Alamos, New Mexico, began routinely waking up in the middle of the night. After two years of tossing and turning, she finally sought help. Chavez’s doctor sent her to Barry Krakow, M.D., director of the Sleep and Human Health Institute in Albuquerque. Krakow immediately suspected that Chavez’s insomnia might be a symptom of a more serious medical condition: sleep apnea, a disorder in which people struggle to breathe while sleeping. Once diagnosed with apnea, Chavez began treatment — and began sleeping through the night.
While most sleep experts consider daytime sleepiness the hallmark symptom of sleep apnea, few doctors make the link with insomnia. Krakow, author of the book Insomnia Cures, has uncovered evidence that suggests this oversight may be hiding a silent epidemic. Conventional wisdom holds that only overweight, middle-aged men develop sleep apnea, but that notion is changing. While middle age sleep apnea is more common in men than women, for some reason women begin to catch up after menopause. “The more we learn about sleep apnea, the more prevalent it seems,” says Nancy Collop, M.D., a sleep specialist at the University of Mississippi Medical Center in Jackson. The problem strikes an estimated 5 to 10 percent of people, and Collop suspects sleep apnea may be underdiagnosed in women. Making a link between insomnia and sleep apnea could help turn up cases of apnea that might otherwise go undetected, Krakow says.
People with sleep apnea can unknowingly suffer through hundreds of mini-suffocation episodes each night.” Everybody’s throat tissue gets narrower when they’re asleep, but in people with sleep apnea this narrowing makes breathing difficult,” Collop says. If the throat becomes too narrow, breathing stops entirely. The lack of air triggers the body to wake itself up and prevents sufferers from falling into a deep sleep. People with apnea may also have trouble staying asleep. Or they may unwittingly realize they are continually struggling for breath and become subconsciously afraid to fall asleep.
Krakow’s research shows that even in insomnia cases where stress or trauma would seem the obvious culprit, apnea is often the cause. In one study, Krakow examined crime victims who suffered from insomnia and discovered that 91 percent of them had some form of sleep apnea.
Most sleep-apnea sufferers also complain of more than restless nights. A common problem — one that Chavez’s husband had to endure — is snoring. “About half of habitual snorers have some sort of sleep apnea,” Collop says. Memory lapses, daily headaches, waking up to go to the bathroom, daytime sleepiness, or waking up with a headache, may also indicate apnea.
The disorder boosts the risk of strokes, high blood pressure, and possibly heart attacks, making treatment crucial. Luckily, the problem is curable. Depending on the severity — and the patient’s tolerance level — a general practitioner might recommend an over-the-counter nasal strip or a custom-fit dental device that positions the jaw for wider airways. The most common and effective treatment (and the one that worked for Chavez) is wearing a Continuous Positive Airway Pressure, or CPAP, machine while you sleep. The small device blows air through the nose to prevent the throat from collapsing. It took Chavez a week or so to get used to the device, but she says it was worth it. “I now have the energy to do big projects around the house,” she says. “I’m thinking clearer, I’m stronger, and I feel like a productive member of my community again.” Her husband is sleeping better too: She no longer snores.