What happens to our physical and mental health when we don’t get enough of it, and the options available for those suffering from sleep apnea – the most common sleep related breathing disorder.
Shelby Stockton (00:00):
Welcome to the Texas ENT audio blog. I'm Shelby Stockton. Today I spoke with otolaryngologist, Dr. Manish Wani and Dr. Cary Moorhead about sleep. We talked about why sleep is so important, what happens to our physical and mental health if we don't get enough of it and what procedures can help those with sleep apnea. Hi, Dr. Wani and Dr. Moorhead. Thank you so much for joining me today.
Dr. Cary Moorhead (00:23):
Nice to be with you, Shelby.
Dr. Manish Wani (00:26):
Great to be here, Shelby. Thanks.
Shelby Stockton (00:28):
Thank you. So as you know, we are going to talk about all things sleep. And I want to talk to you first, Dr. Wani. Why is sleep so important for us humans?
Dr. Manish Wani (00:39):
Yeah, that's a great question. I can give you probably four different, at least four good answers to that. A good night's sleep helps our brain function so much better. We are more alert and clearheaded and things like learning and problem solving, things we do on a daily basis we're just much better at when we don't have the fogginess and the slowness to react. The second reason, when we're fully rested, I think we're also in a better mood. We're able to control our emotions and behavior better and I think the day just goes so much smoother.
Dr. Manish Wani (01:17):
Physiologically, it does reduce risk. When we get a good night's sleep, our heart works better. With sleep deprivation, for example, and sleep apnea, it does increase risk of heart disease, kidney disease, high blood pressure, diabetes, strokes, that kind of stuff. And then a good night's sleep also can keep our weight under control. There are hormones that regulate our appetite, the way we eat, the way we interact. And so all this stuff helps us just become overall more healthy.
Shelby Stockton (01:57):
For the vein of us, that's a reason to get sleep right there. Dr. Moorhead, why do so many people have sleep issues?
Dr. Cary Moorhead (02:08):
Well, there's a lot of reasons. One of the main things that we see is sleep apnea. And one of the underlying risk factors for sleep apnea is weight gain. And as our population has increasingly gained weight, we see more and more problems with people having obstructive sleep apnea. Other things that we see involves just poor quality of sleep and insomnia and those things in our crazy lives full of stress, we often just have a lot in our minds. We have a hard time falling asleep. We have so many things to try to accomplish. We don't even get enough hours of sleep. So there's a lot of different things that really conspire to increasing numbers of sleep problems.
Shelby Stockton (03:06):
Dr. Wani, what can happen to somebody physically if they have sleep apnea, aren't getting enough sleep? How is that dangerous to their lifestyle?
Dr. Manish Wani (03:19):
I mean, essentially what happens with sleep apnea is these patients stop breathing at night, which means that oxygen is not getting to their heart, it's not getting to their brain, it's not getting to their essential organs, and short-term, I mean, people with sleep apnea, they can fall asleep at the wheel and have a bad car accident. They could be operating some machinery and fall asleep and get into trouble in that sense. We call it the daytime fatigue that they have. Long-term, of course, it can cause high blood pressure, it can cause heart attacks, it can cause strokes, it can cause kidney problems because physiologically our body needs oxygen. And if at night you stop breathing like patients with obstructive sleep apnea, you're depriving your body of oxygen.
Shelby Stockton (04:20):
Dr. Moorhead, what can people do that have sleep apnea? What are some solutions to this?
Dr. Cary Moorhead (04:28):
Well, once we've diagnosed sleep apnea, I usually present my patients with the categories of solutions that are either surgical or nonsurgical. And under the categories of nonsurgical treatment, if the patient's overweight, we always discuss losing weight as one of the approaches. The gold standard nonsurgical treatment traditionally has been CPAP, which is the mask that people wear at night that delivers air under pression and keeps their airway open. And so most commonly, if someone's diagnosed with sleep apnea, that's going to be the initial discussion is having them try CPAP.
Dr. Cary Moorhead (05:17):
Another nonsurgical option is a dental appliance. They're devices that people can wear in the mouth that bring their jaw and tongue forward. And in some patients, that can help. And then in patients where the nonsurgical options either aren't tolerated or are not working, then we have options that are surgical. Traditionally, those have been things included where we try to improve their breathing through their nose. We may remove large tonsils to open up the back of the throat.
Dr. Cary Moorhead (05:53):
Those are kind of the traditional surgeries. More recently, we've had the option of the Inspire implant, which is getting a lot of publicity these days in which we implant a stimulator device that helps the muscles of the throat open at night when people are asleep, whenever they take a breath. So that's probably a general summary of the different options patients will get once they've been diagnosed.
Shelby Stockton (06:22):
Well, I'm going to toot your horn a little bit here because, and congratulate you for getting a Physician of Excellence Award for Inspire. So you've done, I'm assuming, quite a few Inspire, would it be surgeries? I don't know, even though what to call it.
Dr. Cary Moorhead (06:38):
Yeah. Well, thank you for the compliment. That award was provided to me for several things. One is for somebody who has done a high volume of the Inspire implants, which are surgeries, they're about two hour outpatient surgery. And it's also based on outcomes measures, how well the patients are doing postoperatively and how well we do, I'm tracking their progress through that Inspire journey. But thank you for pointing that out.
Shelby Stockton (07:19):
Of course. Dr. Wani, is there anything else you'd like to add about surgical treatments for sleep apnea?
Dr. Manish Wani (07:24):
Yeah, Shelby. One thing I'd like to talk about is a procedure that's called AirLift. It is a minimally invasive procedure. And essentially what we're doing is we're suspending the hyoid bone causing what's called tongue advancement. And we're opening the airway with this procedure. It's a 30 minute procedure with low morbidity, but it is effective in some patients for snoring and sleep apnea. So that's something else that we also look at.
Shelby Stockton (07:56):
So Dr. Wani, I'm going to end on you. Someone has sleep apnea or they think they may have sleep apnea, what are some warning signs that they should probably come see you or Dr. Moorhead?
Dr. Manish Wani (08:09):
Sure. The biggest warning sign is snoring. And if their bed partner is complaining. And we're not talking about light snoring, I mean, this is with snoring that you're being heard from the other side of the room, your bed partner can't sleep with you because it's so loud. And lot of times we call it witnessed apnea. They can actually see that you're not breathing at night, that you stop breathing at night. And that is a warning sign. The other things are things like morning headaches.
Dr. Manish Wani (08:42):
If you wake up with headaches, if you wake up just not feeling refreshed, feeling tired, if you feel like you have to take either naps in the afternoon, just poor energy, fatigue. Those are all very common signs of sleep apnea. Some of the uncommon signs that we do see, I mean, there are people that come in that feel like they don't hear so well. And we do a hearing test. It's perfect, but the problem is they're just not alert enough and they're not hearing well.
Dr. Manish Wani (09:13):
So that's another thing we look at. There are patients that come in for dizziness and we find that it's nothing wrong with their inner ear, but their balance is being affected because they're not getting enough oxygen to the brain and sometimes that could be a sign of sleep apnea. So those are the things that we look for in patients to diagnose sleep apnea.
Shelby Stockton (09:36):
Wow. That's so interesting. Gentlemen, thank you so much for your time. This is educational and helpful for everyone. I really appreciate it.
Dr. Cary Moorhead (09:45):
Well, thank you. I enjoyed it.
Dr. Manish Wani (09:47):
Thank you, Shelby. It was our pleasure.
