I mentioned that Sleep Disordered Breathing (SDB) , which Includes Obstructive Sleep Apnea (OSA) is a common sleep complaint too. Insomnia and OSA have a strong association and it is wise to arrange a “sleep test” if you’re undergoing care for insomnia to rule out SDM. Anything that fragments sleep will make you feel dragged out and often lacking energy, sometimes with Excessive Daytime Sleepiness (EDS) too.
SDB is a disorder where there is limitation of airflow at night while you’re asleep and unable to protect your airway yourself. Snoring is a type of SDB and can cause the sufferer fragmented sleep. Often times it is their bedpartner who suffers insomnia! However, many studies have shown that heavy snoring can be the cause of cardio-vascular disease, especially heart attack and stroke. Alas, as medical awareness is poor, many snorers are not treated and their disorder goes on to cause a catastrophic even which is then blamed on to something else.
SDB comprises snoring, OSA and a disorder called Upper Airway Resistance Syndrome (UARS). OSA is a disorder where there can be complete blockage of the airway (called an apnea) as well as a partial blockage which as it allows some passage of air, cases snoring. Snoring and OSA often appear together but can exist separately, hence the value of a sleep test. A sleep test can often be performed at home (home test) although admittedly they tend not to promote sleep themselves – still diagnostically, they can be worth their weight in gold!
UARS is an interesting disorder because it occurs (not infrequently) in people you wouldn’t expect to have OSA. Therein lies the problem. One tends to assume that someone suffering from OSA will be male, middle aged and overweight. Because of this most of the screening tools used are for that stereotype, so UARS may get missed on the radar!
Only a decade or so ago, Upper Airway Resistance Syndrome was not on the radar and only a few years ago, I’ve heard physicians arguing against its existence! Still, I’ve also heard a physician claim that she “didn’t believe in OSA” although exactly what she meant by that I’m still not sure. There is still much misunderstanding out there and so it pays for you to find out what issues may be affecting you, if you want a better sleep.
UARS can be seen in the young, the slim, the fit and the healthy. Young women may also be affected yet everyone assumes that they can’t have OSA because they’re not middle-aged men, yet they do have it. Their breathing problem is more due to airway collapsibility than the blockage (usually the tongue and pharyngeal tissues) found in OSA.
UARS is also not so easily diagnosed as standard garden variety OSA which can also pose a problem. Sometimes a little common-sense may be required.
So, are there other problems we should know about before we look at insomnia?