Sleep Apnea is Hazardous to Your Health and Well Being

Published May 25, 2012, Pawtucket Times

In 2003, Rehoboth resident Art Warner got strong messages from his surrounding environment about his health, both during the day and at night.

At that time Warner discovered he had great difficulty staying awake at his job, oftentimes falling asleep right at his desk.  Coupled with his sleepiness during work hours and his wife’s constant elbowing in the middle of the night to wake him up because of his loud snoring, a very tired Warner became extremely frustrated.  His worried wife would regularly watch as he stopped breathing during his sleep as he snored.  The overweight, middle aged man was finally forced to recognize the he had a health condition that could not be ignored.

After an examination from Warner’s primary care physician, he signed him up for a sleep lab study, which surprisingly revealed to the patient “sleep apnea.”  This serious sleep disorder caused hundreds of short stops of breathing each night, which kept Warner, a public relations executive, from getting a good night’s sleep..

Ultimately, it was a medical treatment prescribed after the sleep lab study that would finally allow Warner to get the sleep he needed and stop his snoring. No longer falling asleep at his desk, or getting sleepy behind the wheel while driving his car, instead   a good night’s quality sleep has resulted in Warner living “a totally different life,” because he feels rested.. With this newly-found lifestyle, he has more energy to workout at the gym, and even stay up past midnight.

Very Observable Symptoms

According to the Sleep Apnea Association, 12 million Americans [including Warner] have sleep apnea, a common medical chronic condition in which the person has one or more pauses in breathing, or shallow breathing when asleep   The Washington, D.C-based group estimates that another ten million people may remain undiagnosed.

Dr. Michael A. Pomerantz, a pulmonary specialist who reads sleep lab studies for Rhode Island-based Coastal Medical, reports that untreated sleep apnea is associated with an increased risk of high blood pressure, heart disease, stroke, obesity, diabetes, in addition to traffic accidents caused by falling asleep at the wheel. “Those are all pretty good reasons to be evaluated,” he says.

Snoring, night time awakening and day time sleepiness are three prominent symptoms of having sleep apnea, adds Pomerantz.  Frequently, a bed partner may observe heavy snoring or long pauses (lasting at least 10 seconds) in breathing during their companion’s sleep, causing the sleeper to wake up periodically throughout the night, states Pomerantz.

According to the medical literature, the typical sleep apnea male patient is over age 40, obese, and familial.  Smoking and alcohol also increase the risk of this medical condition.  Dr. Pomerantz, who has practiced his medical specialty for over two decades, adds that 50 percent of sleep apnea patients also complain of early morning headaches.

Diagnosing and Effectively Treating Sleep Apnea

        If sleep apnea is suspected, an over night visit at a sleep lab is considered to be the best diagnostic test to this serious medical condition, notes Dr. Pomerantz, who has  successfully completed his sleep board certification .  Among other things, the patient is hooked up to equipment by wires which monitor the level of sleep, in addition to the airflow to determine if the sleeper is breathing or not, the deepness of sleep, oxygen levels, chest wall movement, and pulse rate, he says.

For treating milder cases of sleep apnea, Dr. Pomerantz recommends simple ‘life style’ changes and treatments such as shedding weight, avoiding alcohol, sleeping on your side or abdomen, or keeping nasal passages open at night by using prescribed medications.  A dental device can also move a jaw forward to make breathing easier.

In moderate to severe cases, a C-PAP, or “continuous positive airway pressure” machine can deliver an increased air pressure through a mask covering the nose or mouth.  The air pressure generated by this machine is somewhat greater than that of the surrounding air, just enough to keep the person’s upper airway passages open, preventing the apnea and snoring.

“Compliance with sleep apnea is not always great,” Pomerantz, says, because patients may feel discomfort with the C-PAP machines. “For some patient it’s only a matter of getting use to it and finding a more comfortable mask,” he says, because their masks may feel overly confining or obstructive.

New Studies Link Sleep Apnea to Cancer

In addition to those  research studies associating  sleep apnea with increased risks of hypertension, cardiovascular disease, depression and early death, the New York Times recently reported that two new research studies presented at the American Thoracic Society conference this week have discovered that this chronic condition  has been linked to an increased risk of cancer in humans.

According to the paper, in one study Spanish researchers followed thousands of patients at sleep clinics, finding that those patients with the most severe forms of sleep apnea had a 65 percent greater risk of developing cancer of any kind.  Meanwhile, lead researcher Dr. Javier Nieto, chair of the Department of Population Health Sciences at the University of Wisconsin School of Medicine and Public Health, says that his study of 1,500 government workers studied over 22 years showed nearly five times higher incidence of cancer deaths in patients with severe sleep apnea to those without the disorder, a result that echoes previous findings in animal studies.

A Personal Note

Clearly research studies show that not being treated for sleep apnea or using your C-PAP machine, if diagnosed with this chronic disorder, is hazardous to your health and well-being…

As one afflicted with sleep apnea, this writer has experienced it all – from “denial” about the severity of my snoring to finally being sent by my partner to the couch for my very loud snoring that shook the walls of our house. Co-workers teased me about  falling asleep at noon time meetings or towards the end of my workday. Even with these severe symptoms, I denied having this medical problem for years until the urging of a  friend who had a severe case of sleep apnea nudged me to “get it checked out” .  With my ultimate diagnosis and finally the treatment with a C-PAP machine, my snoring has virtually ceased, and I now wake up refreshed and well-rested.  One of my few regrets in life was losing years of “deep” sleep because I chose not to see my physician to address my sleep apnea.

For more information about sleep apnea, visit the American Sleep Apnea Association’s website, www.sleepapnea.org. If you have sleep apnea symptoms, visit your physician.

Herb Weiss is a Pawtucket-based freelance writer covering medical, healthcare and aging issues.  His Commentaries are published in two Rhode Island Daily’s The Pawtucket Times and Woonsocket Call.

The Best Of…Healthy Life Style Key to Losing and Maintaining Weight Loss

Published August  2008, Senior Digest

           Not only are food and gasoline prices skyrocketing nationwide, a growing number of Americans with bulging waist lines are watching their weight steadily increase, too.  Those overweight see diets as a remedy to drop the pounds.  But to most, finding the right weight loss strategy is at most confusing and difficult to follow.

           For over forty years, Donald Grebien, a supply chain manager at the Mansfield, Massachusetts-based American Insulated Wire Corp.(AIW), has always struggled with his waistline.  In high school, Grebien recalls being a ‘chubby senior’, weighing as much as 280 pounds. Even though he managed to shed 30 pounds through regular exercise, eliminating snacks and eating healthy foods, it is still a daily struggle. 

           Grebien’s weight would fluctuate throughout his middle age because of a variety of factors.   His family obligations of raising two small children, combined with the pressures of being a Pawtucket City Councilman, made it extremely difficult for the young man to successfully stick with a diet. It was not until this young City Councilman was faced with high blood pressure, that would ultimately force him to confront his weight issue.

            “Losing weight is a daily battle for me,” says Grebien, who noted that when his weight spiked, it was very uncomfortable wearing tight-fitting clothes.

            Joining Weight Watchers with his wife, Laureen has made a world of difference to Grebien.  He has maintained his weight loss of 10.3 pounds for the last 10 weeks.  “I am on track and feel a lot better,” he says, even noting that his waist line seems to be shrinking a bit.  His workplace even supports his dieting efforts, such as offering on site Weight Watcher classes, a nutrition newsletter and promoting employees walking during their lunch hours.

            While Grebien is tackling his weight problem through the support of his wife and belonging to a community weight loss program, finding the right diet plan or strategy can be difficult chore for many. 

 Tips on Losing Weight

            “Get responsible and sound advice about dieting before you begin,” recommends Randi Belhumeur, a Registered Dietitian who serves as statewide nutrition coordinator for the Rhode Island Health Department’s Initiative for Healthy Weight.  There is no  major expense for the consultation because most health plans now cover nutritional counseling as long as you have a medical diagnoses (including high cholesterol, hypertension and diabetes), she says.

             Belhumeur says that a nutritionist can provide specifics as to serving sizes, label reading, meal planning and weight loss goal setting.  When setting your weight loss goals, “always start with small goals that are realistic for you,” she says.  “Losing a pound or two a week is considered by medical experts to be a safe weight loss,” she adds.

            “Don’t forget to dovetail physical activity into your weight loss goals,” suggests Belhumeur.  “If a pedometer tells you that you that the baseline number of steps you take a day is 2,000, increase that number by 1,000 steps,” she says.

            “Always keep an ‘activity and food journal’ also,” adds Belhumeur, who stresses that the documentation will be critical to your losing and maintaining your weight loss.  “You really need to be honest with yourself when you are writing the details down.  Journaling will help you make better food choices and make you aware of what you are eating,” she says.

            Belhumeur also recommends to plan exercising each week by scheduling the time in your Black Berry, Palm Pilot or in your schedule book.  “With exercise, find something you enjoy doing.  If you don’t like going to the gym, you just won’t go.”

            Social support  from family and friends is also very crucial in your efforts to successfully lose weight, notes Belhumeur.  “Weight Watchers is one of the few responsible diet programs that offers group support and sound dieting advice,” she says.

            Finally, Belhumeur says, “Don’t forget the behavioral component of weight loss.”  Psychotherapy or nutritional counseling can be helpful to changing a behavior, like night time eating or eating unhealthy foods at the workplace.      .

 Weight Loss and Lifestyle Changes

            Ray Rickman, senior consultant, for Rhode Island’s Shape Up RI Program, a state-wide exercise and weight challenge program, is not a fan of dieting.  His nonprofit group helps participants  improve their health and lifestyle by increasing their physical activity levels and developing smart eating habits. 

            Supported by Blue Cross and Blue Shield and Life Span, over 12,000 Rhode Islanders, in 13,000 teams participate to see who can lose the greatest percentage of collective team weight, log the most hours of physical activity, and walk the highest number of pedometer steps over a twelve week period.

             The fifty-five year old Eastsider and State Legislator has lost over 20 pounds by following his nonprofit group’s philosophy of reducing daily calorie intake and daily exercise.

            According to Rickman, people become overweight or obese because of their lifestyle and not from medical or chemical imbalance.

             “Most diets you just starve yourself or you eat foods you don’t like,” Rickman says.  “While many people can lose weight by dieting, they usually regain all the weight back within 12 months.” 

            “We consume more food than the body can rid itself of, where portion sizes are increasing”, say Rickman, noting that an ‘unhealthy life style and poor eating’ causes weight gain.  Almost 50 years ago, a typical orange juice serving was 250 calories; today a larger glass increases the calories to 800, he adds. 

            “In every area of our lives we try to find ways to not exercise,” Rickman notes.  “Go into a four story building and you will see people waiting for an elevator to go to the second floor, rather than just walking up two flights of stairs.  Or watch shoppers wait for a parking space close to the grocery store’s entrance rather than parking farther away.”

            To successfully lose weight, find out how many calories you need a day, based on your height and weight, Rickman recommends. “ He estimates that eating 200 fewer calories along with exercise will help you lose a 1/16 of a pound a day.  In just one month , a person can lose 2 pounds. In one year, you can expect to lose at least 25 pounds.

            Exercise does not have to be grueling.  Rickman says, “Go to the grocery store and park in the last spot on the lot where the employees park. By doing this you can lose 1/36 of a pound by choosing not to park near the entrance.  Walking up three flights of stairs will also help you lose 1/36 of a pound. 

            Brown Medical Student, Rajiv Kumar, Founder of Shape Up RI program, sees long-term sustained weight loss for those participating in his program.  The average weight loss per person is 10 pounds with preliminary research indicating that 70 percent of the participants have kept their weight off for six months. 

           For chronic dieters like Grebien (or this writer) who work daily to shed pounds, the secret to successfully losing and maintaining weight loss may well be tied to healthy eating habits, exercise and an active social network to create accountability and motivation, It’s as simple as that.

            Herb Weiss is a Pawtucket-based health care writer who covers aging, health care, and medical issues.  He can be reached at hweissri@aol.com.  This article appeared in August 2008 issue of Senior Digest.

The Best Of…Ten Simple Tips for Staying Fit

Published September 26, 2008, All Pawtucket All The Times

         In their younger years aging baby boomers never went onto the basket ball court without wearing their Converse, Reebok, Nike, New Balance or Nautilus tennis shoes.  This generation with their strong interest in health and fitness will not spend their retirement years as a couch potato watching television or sitting in an oak rocker on their porch.  With winter approaching, aging baby boomers can work to stay slim, trim and fit by remaining physically active.

            According to the International Council on Active Aging, aging baby boomers can become physically fit by simply following these tips:

1,  See your physician.   A medical checkup will determine whether you need to consider any medical clarifications before starting an exercise program.  Talk with your physician about any of your concerns or limitations.  After a day or two of exercise, if you experience major discomfort from working out including shortness of breath, headaches, chest pains, sore muscles and dizziness, see your physician.

2.   Look at options.  Do you join a local gym, aerobics in your house, enroll in a yoga class, make time for a daily walk in your neighborhood.  The key to your fitness success is doing your activities regularly.

3.  Know your style.  Some may like to take classes, others may prefer to go solo.  Exercising indoors may be more acceptable to some then outdoor physical activities.  Your schedule may also dictate when you can block out time, either in the morning, lunch time or evening, for your daily fitness program. 

4.  Start off slowly.  Learn to listen to your body. Be realistic when you begin to exercise and don’t overdo it at the beginning.   To reduce soreness and injury always ease your way into your fitness program.

5.  Get a buddy.  An exercise partner can be a great motivator in getting you started and to maintain a daily exercise regimen.  Whether it’s making a date with a friend to take a walk, play racket ball or golf or regularly seeing a personal trainer at your local gym, the personal interaction can motivate you to continue to exercise.

6.  Be realistic.  Don’t try to workout like you did in your younger years.  Always be realistic, setting age-related goals you expect to gain from participating in a physical exercise program.  If enormous benefits do not occur, like losing 30 pounds in one month, you might feel disappointed and quit exercising. 

7.  Make choices.  What are you willing to give up to make room for exercise?  What bad habits, (like smoking, drinking, sedentary and nonproductive activities, are you willing to give up?  It is up to you to choose wisely.

8.  Keep in motion.  Keeping moving all day long. Stretch, walk, march in place, stand and sit daily as often as you can when you are talking on the phone or watching television.  Every step counts.  A step counter will give you an idea as to how many steps you take a day.  Less active people may take about 4,000 steps or fewer per day.  Aim to do 250 to 1,000 additional steps of brisk walking, until you reach 8,000 to 10,000 steps in a day. 

9.   Create a support network.  Get your friends, colleagues and family members to support your new physical activity goals and ask them for their support and encouragement.  Consider getting others to help you keep your physical exercise commitments.  Telephone reminders from your vast network can keep you motivated and on track.

10.  Always Reward yourself.  Once you’ve reached your goals, recognize that milestone.  Treat yourself to something that reminds you what has been accomplished and encourages you to continue. 

One Final Note…Gold’s Gym Opens New Pawtucket Facility

            Finding the right gym can be as easy as getting referrals from your family and friends or shopping around for the right price or specific services that you need, says Mike Kasun, a personal trainer at Gold’s Gym, located at 550 Pawtucket Avenue in Pawtucket. “There are many gyms out there that may be cheaper than others but they just don’t offer a wide range of services.  Price, services provided, classes, and the gym’s location (being close to home or work) are key factors that people should consider when shopping around for a gym membership, he says.    

            Last Saturday,Pawtucket’s Gold’s Gym, officially opened its newly refurbished 25,000 square foot building with state-of-the art exercise equipment, notes Kasun. The new gym facility has 60 pieces of cardio equipment each with their own 14-inch plasma television; 105 pieces of resistance-training equipment, a “Cardio Cinema” where you exercise while watching a full length feature movie, a private woman’s workout room, along with a country club-like locker room. Two hundred free parking spaces surround the new gym.

            When joining Gold’s Gym, a new member receives two free personal training sessions, Kasun tells Your Later Years. “At your first session we assess what the person needs and wants to get out of their membership. Some may want to tone or lose weight while others are more interested in building up muscle strength, he notes. 

            “With information and health data gathered during this initial assessment a workout program can be especially designed for the individual.  During the second session the member is taken through a one hour work out specifically designed for them,” adds Kasun.

            Group exercise programs are also included in the Gold’s Gym’s membership price.   Kasun notes, “We have Les Mills Body Pump Class, offering a full body workout for participants using light weights.  Yoga, Step and other toning classes are also available, too,” he says, noting that all of the personal training staff is nationally certified in the classes they teach.

            Pawtucket’s Gold’s Gym, one of 650 locations nationwide offer AARP members the ability to enroll for only $49 and a savings of up to a 20 percent on their monthly membership as well as a seven day free trial membership period.  For more information, call Gold’s Gym at (401)722-6600.

            Herb Weiss is a Pawtucket-based freelance writer who covers aging, medical and health care issues.  This article appeared in the September 26, 2008 issue of My Back Yard.   He can be reached at hweissri@aol.com.