Anatomy of a Lullaby

Stealing breath and life

Sleep apnea


 

Vol. 7 No. 4
February/March 2005

Anatomy of a Lullaby
In Emory's growing sleep research program, scholars encounter mystery and paradox

Stealing breath and life
Sleep Apnea

We do have some very good people [in sleep research], and we’re gaining a critical mass to do this kind of work.
Donald L. Bliwise, Professor of Neurology, Program Director, Sleep, Aging and Chronobiology


I think there are valuable things we can learn about how plastic or mutable the circadian system is by looking at people who travel abroad and contend with jet lag, or people from different cultures.
Hillary Rodman, Associate Professor of Psychology


The Power of Sleep
Exploring disorder and disturbance
Kathy P. Parker, Edith F. Honeycutt Professor of Nursing

What’s A Few Drinks Between Friends?
Exploring the ancient drinking party with students
Peter Bing, Associate Professor of Classics

Transforming
and Transformative Knowledge

Practicing what we profess
Karen D. Scheib, Associate Professor of Pastoral Care and Pastoral Theology

Further reading

Endnotes

Return to Contents


They stumble through their days in a daze, attributing their fate to lack of sleep or maybe depression. But something far more insidious, even deadly, may be at work.

Sleep apnea is among the most common and dangerous sleep-related medical conditions. It is also under intense scrutiny by Emory researchers. In sleep apnea, individuals stop breathing repeatedly, sometimes for up to a minute at a time and, in serious cases, hundreds of times a night. Yet sufferers are often unaware of these repeated sleep disruptions. Over years, the collective oxygen deprivation can lead to heart attacks, strokes, and early death, explains David Schulman, assistant
professor of medicine. Sleep apnea affects an estimated ten percent of middle-age and older men, and about half as many women. “I liken apnea to diabetes because it’s underdiagnosed,” says Schulman. “It’s one of those diseases that when left unattended leads to serious, even life-threatening consequences, and it is not particularly glamorous.”

During an episode of sleep apnea, the airway narrows, either because it partially collapses or is obstructed by fatty deposits. Drinking alcohol also loosens up the muscles supporting the trachea, which can lead to episodes of sleep apnea. Eventually, the brain realizes it’s getting short-changed and jump starts breathing, Schulman explains. But the repeated breathing interruptions take their toll. “Folks with severe sleep apnea can spend thirty to forty minutes each night at dangerously low oxygen levels,” he says. The accumulated oxygen deficit can precipitate a host of serious health problems.

“A lot of people with sleep apnea wake up feeling they haven’t slept a whit,” says Schulman. “They may fall asleep at work or while driving and are often moody. Most people don’t sleep enough anyway. We work long hours and we want to spend our free time with family and friends. The one thing we’re willing to sacrifice is the amount of time we spend sleeping. So we learn to live with that feeling of general fatigue.” Many patients with sleep apnea become aware of their condition from partners, who complain about snoring—a mild manifestation of sleep apnea. But those who sleep alone may know only days of perpetual fatigue and attribute their plight to lifestyle.

There are several treatments for sleep apnea, including weight loss, surgery, and prosthetic devices designed to keep the airway open. But the most effective remedy is a relatively simple device called continuous positive airway pressure, which consists of a mask that fits over the mouth and nose and through which pressurized air is forced. “It’s considered the gold standard of treatment for sleep apnea,” says Schulman. Unfortunately, the apparatus is decidedly uncomfortable, and only about half of sleep apnea patients can stand to wear it through the night. (The sensation resembles what you’d feel if you stuck your head out of a car window at 25 miles per hour.) “Trying to convince someone to keep it on when they’re sleeping is not something most folks are happy to sign on to,” Schulman adds, “even though it will make them feel much better very quickly.”