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Attention on sleep apnea

Sleep apnea, and chronic sleep deprivation and all their consequences, are America's largest invisible medical problem. The current effort is to make the invisible visible.

Is it possible to sleep eight hours and still wake up feeling exhausted? Yes--if you have a disorder called sleep apnea. Apnea means "absence of breath," and, according to the American Lung Association, a person who has sleep apnea stops breathing for at least ten seconds at a time repeatedly (sometimes hundreds of times) during the night.

In children, sleep apnea can contribute to Sudden Infant Death Syndrome (SIDS). In adults, it can lead to a variety of problems including strokes and hypertension. And, because sufferers can have bouts of intense sleepiness during the day, sleep apnea may be at the root of many of the traffic accident deaths caused each year when people fall asleep at the wheels of their vehicles. Yet, medical experts acknowledge that the problem of sleep apnea has been largely ignored.

Sleep apnea needs to be diagnosed before it can be monitored or treated. Infants are classified as at risk for sleep apnea soon after birth; in fact, most infant apnea monitors are prescribed while the newborn is still in the neonatal intensive care unit (NICU). The doctor prescribes a "sleep monitor" to be used at home for several months. This device has an alarm that lets the caregiver know if the infant's cardiorespiratory rate has fallen outside the parameters set for that baby.

The procedure for adults is different. According to the U.S. Food and Drug Administration, a physician can diagnose sleep apnea and suggest treatment based on the patient's complaints of daytime sleepiness, insomnia, awareness of obstructed breathing during sleep, snoring, and headache or dry mouth on waking.

But, definitive diagnosis of sleep apnea can only be made after a test called polysomnography, which monitors multiple physiological parameters, has been performed. In most cases, the doctor sends the client directly to a sleep disorders center, also known as a sleep lab. Here the patient spends the night in a bedroom laboratory where his or her breathing pattern during sleep is evaluated.

Using a sleep diagnostic system, various skin sensors are attached to monitor physiological variables such as nose/mouth airflow, breathing pattern, heart rhythms, oxygen level, and muscle activity.

A trained technician, called a registered polysomnographic technologist (RPSGT), monitors these measurements and the patient's sleep habits continuously. The results are then evaluated by a physician specially trained in sleep disorders.

Next: Choosing the best treatment for apnea