HEALTH MATTERS: Diagnosing sleep apnea, even partial, is essential
Q. I’ve been excessively sleepy during the day, and my wife reports that I snore at night. My doctor recently found that I have obstructive sleep apnea syndrome and prescribed a breathing mask to use at night. What benefit might I expect?
A. Obstructive sleep apnea is a common condition, especially in middle-aged and older obese men.
It is caused by relaxation of the muscles in the throat during sleep, leading to blockage of the flow of air into the lungs. This leads to a period of no breathing (apnea) followed by partial opening of the airway, which in turn leads to labored breathing that typically is marked by snoring. And because these episodes of disordered breathing are repetitive throughout the night, affected patients never get really restful sleep, so they feel tired during the day. Severe obstructive sleep apnea is associated with a variety of complications, including high blood pressure, stroke, heart attacks and even death.
So properly diagnosing and treating the condition is important. Treatment includes weight loss and often a breathing device to force air into the lungs (using a continuous positive airway pressure or CPAP mask). Other interventions may be needed, including surgery. And treatment may not only resolve the sleep disturbance but also reduce the complications; CPAP has been shown to significantly reduce the elevated blood pressure associated with this condition, even in patients already on blood pressure-reducing pills. We’ve recently learned that supplemental oxygen alone at night doesn’t have this benefit; the CPAP mask must be used to lower the blood pressure further. So please continue to use your mask as directed, and good luck.
Q. I know that it is recommended to have screening for colon cancer periodically, but I’m embarrassed to say that I’ve avoided doing so until now. I’m 80 years old and have no symptoms. Should I get a colonoscopy?
A. While I congratulate you on your good luck, I’d rather my patients not rely on luck. Screening for colon cancer is recommended starting at age 50 and continuing up until age 75. We generally stop screening at age 75 if prior examinations have been negative, as the benefit in the above-75 age group is small. But it’s a different story for someone like you who is older than 75 years of age but has never been screened. In that situation, we would indeed recommend a single screening test — usually colonoscopy — for all otherwise healthy patients who have never been screened. In fact, a recent study using a computer model to calculate the odds of benefit showed that some form of screening test for colon cancer probably is beneficial for folks up until their mid-80s if they have never before had any screening test. So please get in touch with your health care provider and get that colonoscopy scheduled. It should not be an unpleasant experience to have the procedure, and the benefits of finding a lesion early rather than late are substantial.
Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training. Submit a question to Health Matters at healthmatters @med.und.edu or Health Matters, 501 North Columbia Road, Stop 9037, Grand Forks, ND 58202-9037. Remember, no personal details, please. The content of this column is for informational purposes only and does not substitute for professional medical advice or care. The information provided herein should not be used for diagnosing or treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read in this column.