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Sleep Apnea Awareness 

You will learn the following in this section:

Symptoms and Signs

Nontraditional Symptoms and Signs

Gender Differences in Sleep Apnea Symptoms and Signs

Racial Inequity In Recognizing Sleep Apnea

Screening and Diagnosis Pathways

Treatment Options

Chronic Health Conditions Seen with Sleep Apnea

Just the Basics

Symptoms

Something a Person Experiences

Signs

Something a bed partner or relative notices

  • Sleepy all the time despite getting a full night's rest

  • Poor concentration

  • Morning headache

  • Dry mouth

  • Poor memory

  • Irritable 

  • Difficulty staying asleep

  • Reflux or heartburn

  • Issues with mood such as depression or anxiety

  • Issues with comprehension

In Children

  • Same as above

  • Gasping or choking while asleep

  • Pause in breathing during sleep (Apnea)

  • Loud snoring 

  • Tossing and turning at night

  • Physically there but not mentally present

  • Drowsy Driving

In Children

  • Bedwetting

  • Hyperactive/Inattentive (can look like ADHD)

  • Poor school performance

  • Attention Issues

  • Frequent movement while asleep

  • Sleeping in an unusual position with neck extended

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Nontraditional Signs and Symptoms

  • Frequent trips to the bathroom at night

  • Teeth grinding

  • Clumsy

  • Taking a long time to process information

  • Can't remember dreams

  • Can't connect the dots between all these symptoms

Gender Differences in How Women Describe Sleep Apnea 

Why Women Are Underdiagnosed With Sleep Apnea

Women with OSA complain of symptoms such as insomnia, restless legs, depression, nightmares, palpitations, and hallucinations whereas men are more likely to report snoring and apneic episodes.

Wimms A, Woehrle H, Ketheeswaran S, Ramanan D, Armitstead J. Obstructive Sleep Apnea in Women: Specific Issues and Interventions. Biomed Res Int. 2016;2016:1764837.

  • This contributes to women being grossly underdiagnosed with sleep apnea

  • Also the myth of being an overweight man as the only type of person who could have sleep apnea impacts women being underdiagnosed

Multiple factors combine to lower the total number of events (how many times the airway closes for 10 seconds in an hour) counted by sleep studies with regard to women

  • The stages of sleep are made up of Rapid Eye Movement (REM) and Non-REM.  20% is REM and 80% is NONREM.  Women have been found to have more events during REM.  This results in less events being counted during the sleep study which lowers the total events 

REFERENCE:  Forbes Magazine-Sleep Apnea in Women: Risk Factors and More https://shorturl.at/anOS9

  • Women tend to have Hypopneas (partial Airway Closure) which may not get counted as events during a sleep study which then lowers their total events

  • The lack of recognition by primary care physicians of differing ways women report symptoms of sleep apnea translate to less women being referred to sleep physician

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Racial Inequity in Recognizing Sleep Apnea

Various factors lead to less minorities being diagnosed with sleep apnea

Recognized need by Primary Care of Signs and Symptoms

Barrier faced by all 

Signs and symptoms often go unnoticed by individuals.  This same issue is widespread among society and various medical professionals.  This leads to a lack of referral by primary care physicians to sleep medicine.  

Some medical specialties are doing better at recognizing when someone may have sleep apnea.  Cardiologists have added sleep as their 8th lifestyle habit for a healthy heart.  Some cardiologists are even board certified in sleep medicine and treat both conditions.

Minority Representation in Primary Care and Sleep Medicine Workforce

Race of Physician Impacts Mortality and Health Outcomes

Various studies have shown that when minorities have a physician who matches their race, they have better outcomes.  There are studies which show that that concordance in the race of both physician and patient leads to longer life expectancy and reduced mortality.

REFERENCES

Snyder JE, Upton RD, Hassett TC, Lee H, Nouri Z, Dill M. Black Representation in the Primary Care Physician Workforce and Its Association With Population Life Expectancy and Mortality Rates in the US. JAMA Netw Open. 2023;6(4):e236687. doi:10.1001/jamanetworkopen.2023.6687

 

Minorities More Likely to Receive Lower-Quality Health Care, Regardless of Income and Insurance Coverage

News Release | March 20, 2002; National Academy of Medicine Statement

Lack of Access to Health Care

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A large body of research has shown that compared with the White population, racial and ethnic minority groups experience disparities in access to care and healthcare quality, including effectiveness of treatment, timeliness, patient safety, and preventive screening.

Reference: Agency For Healthcare Research and Quality

accessed January 10, 2024

Minority Americans Have Lower Rates of Insurance Coverage and Less Access to Care Lack of health insurance is linked to less access to care and more negative care experiences for all Americans. Hispanics and African Americans are most at risk of being uninsured.

Reference: Minority American Lag Behind Whites on Nearly Every Measure of Healthcare Quality, Many have Communication and Financial Barriers to Care, and Lack Trust in Doctors: A Press Release by The Commonwealth Fund March 2002 accessed January 10, 2024

Diagnosis and Screening Pathways

There are different ways a person can be diagnosed with sleep apnea.  First there are screening tools used by sleep medicine to get an idea that a person may need a more extensive test.

The primary screening tool used by sleep medicine is the Epworth Sleepiness Scale.  This tool asks questions about drowsiness.

The STOP-BANG is a tool a patient can take independently and see where they score.  

Screening Tools
Sleep Studies
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Treatment Options

In this section we will give you basic information about:

  1. What options are available

  2. How effective each option is

  3. What are some barriers to adopting the treatment

  4. Average cost of treatment option

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