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Sleep Disorders, Sleep Apnea, and Depression

Left, Judy Sperry of ArtvoiceTV interviews Dr. Wendy Weinstein.

Q&A with Wendy L. Weinstein, M.D. P.C.

AV:What is your Specialty?

WW: I’m a Physician Board Certified in Psychiatry.

AV: We don’t hear about sleep apnea as much as we hear about other health issues like heart disease, obesity, diabetes, arthritis, and so forth. What is Sleep Apnea and who suffers from it?

WW: Sleep apnea is the cause of excessive daytime sleepiness experienced by almost 20 million Americans. The most common form of sleep apnea is called obstructive sleep apnea. Muscles in the back of the throat relax which causes blockage of your airway. This airway blockage causes the oxygen level in the blood to fall. This causes stress on the heart, which could cause a rise in your blood pressure. Other consequences include heart disease, heart attacks, stroke, and injury due to accidents. Many people suffer from low energy, poor motivation, and an impaired ability to concentrate, which are often symptoms relating sleep apnea. Depression is also another medical illness they can suffer from.

AV: What are the obvious symptoms of Sleep Apnea that can lead someone to see a Sleep Apnea Specialist?

WW: Symptoms of obstructive sleep apnea include loud snoring, pauses and gasps for air when you are sleeping, and feeling tired most of the time when you are awake, as well as difficulty thinking, concentrating, or make decisions. Some people also experience sweating when sleeping, headaches in the morning, and insomnia. Physical signs of sleep apnea include obesity, a large neck, and nasal blockage.

Obstructive breathing is very noticeable to your bed partner. Sudden stoppage of a partner’s breathing can be quite alarming. Once aroused from a deep sleep, people with sleep apnea may snore, gasp, or even choke. These symptoms often wake either the sleeper or the bed partner.

AV: Do you have to be referred to a sleep specialist by your Physician?

WW: There are special sleep study centers that Physicians can refer patients to for daytime and overnight scientific sleep studies. For example, the “Sleep & Wellness Centers” which are all over Western New York perform these studies. These studies can help determine whether a patient suffers from Sleep Apnea or other ailments that affect the quality of their sleep.

AV: What is the treatment of obstructive sleep apnea?

WW: The gold standard of treatment is continuous air pressure through a mask during sleep. This is commonly called CPAP (Continuous Positive Airway Pressure). This additional air pressure keeps the airway from collapsing. This permits normal breathing to continue during sleep, which then leads to you feeling better. Other treatments include oral appliances [oral appliances are dental mouth pieces that fit much like a sports mouth guard or removable orthodontic retainers. The device prevents the airway from collapsing by either holding the tongue or supporting the jaw in a forward position. Oral appliances are non-invasive and easy to use.], weight loss, and surgery.

AV: You mentioned that Sleep Apnea can be linked to depression and suicidal thoughts. Can you elaborate on this?

WW: Depression is a serious illness that affects over 17% of people over their lifetime. Symptoms have to be present for at least 2 weeks and are a change from your normal self. It is not just about having a bad day. It affects social relationships, your ability to work, and other important areas of functioning. Family members often notice social withdrawal or neglecting pleasurable activities. Other symptoms include difficulty sleeping, feeling guilty, low energy, poor concentration, appetite changes, feeling physically tired, and suicidal thoughts. Suicidal thoughts can be frightening and can include thoughts that “people would be better off without me”, to actually planning suicide. Untreated depression can worsen sleep apnea by causing more weight gain. Weight gain triggers sleep apnea, which could make treatment more difficult.

The most common sleep disturbance seen with depression is insomnia. Some people wake up in the middle of the night and cannot fall back to sleep. Other people either cannot fall asleep or wake up early in the morning before the alarm clock goes off. These sleep disturbances also effect 65-90% of patients that have obstructive sleep apnea.

AV: What is the proper treatment for sleep apnea when it is combined with depression?

WW: commonly, your doctor or psychiatrist can prescribe medication. Talk therapy can also be useful. The two together have the best results. Because long term sleep apnea and depression often occur together, this is very important. Symptoms of obstructive sleep apnea can also worsen depression and depression can worsen symptoms of obstructive sleep apnea. The first step is to see your doctor and explain what symptoms you are experiencing. Your doctor may decide to send you to a sleep specialist to determine whether or not you have obstructive sleep apnea. Your doctor may also send you to see a psychiatrist as well to diagnose whether or not you are depressed. If diagnosed with either depression or obstructive sleep apnea, treatment is available and you can look forward to experiencing, and improving your quality of life.

To view a live interview with Dr. Wendy Weinstein on Sleep Apnea & Depression, visit the Health Channel on Artvoice TV.

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