Sleep apnea is one of the factors we use for a Heart Health Risk Score and address to decrease the risks from such a condition.
Briefly, this is a condition in which the body doesn’t get enough oxygen which can lead to brain and tissue injury.
Sleep Apnea Testing
Traditionally, patients have quite a journey when trying to have their sleep-disordered breathing diagnosed. In fact, quite a few primary care physicians can’t get easy insurance approval for sleep studies.
The idea of in-lab sleep testing, where you spend 1-2 nights in a sleep laboratory, is daunting. While an alternative to this is in-home testing, it’s not that much easier.
Is a sleep test necessary?
Current Clinical Guidelines
Clinical guidelines are useful concepts in Western Medicine that allow clinicians to follow similar algorithms for patients.
However, no two patients are alike, and guidelines, when they must be followed or when they become the standard of care, leave many patients and clinicians on the sidelines.
The AASM linked above recommends that, ideally, an in-lab polysomnography be done in a sleep laboratory for a proper sleep apnea diagnosis. Alternatively, an in-home sleep test can be done but with many limitations.
The AASM recommends against the use of clinical questionnaires for the diagnosis of sleep apnea.
STOP-BANG Questionnaire
The STOP-BANG questionnaire screens for the potential of obstructive sleep apnea (OSA), a subtype of sleep apnea. In fact, OSA is the most common type of sleep apnea by a landslide.
This validated questionnaire is more than enough to establish a very high suspicion of an OSA diagnosis.
Of course, whenever possible, we like to make sure. As in, clients are advised to obtain formal in-lab polysomnography (PSG) or, at the very least, an in-home sleep test.
As health coaches, we cannot advise individuals what to do or not do. But our philosophy is that guidelines should be followed unless immediate harm is possible from having untreated sleep apnea.
For our clients, we recommend that they speak to their physicians to decide if an auto-titrating positive airway pressure (APAP) is appropriate for them even before any testing can be performed.
Once treatment has begun, it’s still possible to undergo testing.
Highest Risk Patients
In our experience, individuals at the highest risk for sleep apnea or complications from sleep apnea are those with:
- heart failure
- hypertension
- obesity
- dementia
- older age
- kidney disease
- COPD
- heavy snorers
- daytime fatigue
- insomnia
If you’re looking for a hassle-free way to get treatment for OSA and want to take a home sleep test, there are companies like Empower Sleep that make the process easier.
For less than $200 you can purchase your own home testing device to diagnose OSA.
Sleep Apnea & Heart Health
There are plenty of articles linking sleep apnea and heart health; no need to dive too deep into that topic again here.
We approach the topic of sleep apnea and cardiovascular health by educating and empowering our clients. These two conditions have a bidirectional relationship; sleep apnea increases inflammation in the body and elevates blood sugars, and cardiovascular disease can make it harder to oxygenate the body.
Is OSA permanent? Not necessarily; certain underlying conditions can be treated to help reverse sleep apnea.
Can OSA treatment improve heart health? It seems that those who have their sleep apnea managed properly with a CPAP machine drastically improve their cardiovascular health.
The Magic of Masks
A properly fitted mask makes all the difference. Too often, people give up on their machines because they have difficulty tolerating their masks.
Finding a mask with the proper fit makes all the difference. Not only are they more comfortable, but they are also more effective.
We recommend working with a good sleep apnea technician or a great salesperson to help you find the full-face or nasal mask that fits you best.
Making the Habit Stick
Our clients fall into 2 categories:
- those who stick it out with their machines
- those who give up after 2 weeks
Any new habit takes time to cultivate. There will be setbacks before the habit becomes part of your routine. With tiny, whisper-quiet devices these days, you can travel with them with ease and help the habit stick.
Commuting to work, exercising, brushing before bedtime – none of these were intuitive habits until you did them enough for them to stick.
The goal is to work with the setbacks and ask:
- What went wrong?
- What can I do differently next time to improve?
Sleep Apnea Health Coaching
Our role as health coaches is to support clients in achieving their ideal health goals by helping them overcome doubts, fears, and hurdles related to changing habits. We leave clinical decision-making to the clinicians.
The goal as always is to prevent major health consequences from cardiovascular disease. We achieve this by focusing on:
- managing sleep apnea successfully and consistently
- measuring potential outcomes changes based on treatment
- adjusting other relevant risk factors to decrease cardiovascular morbidity risk
- empowering individuals with knowledge and self-confidence