Obstructive sleep apnea is a condition that prevents individuals from breathing normally in their sleep. Listen to this episode if you suspect you may be suffering from the sleep-related disorder.
Shelby Stockton: (00:00)
Welcome to the South Florida ENT Audio blog. I'm your host, Shelby Stockton. Today I spoke with otolaryngologist Dr. Eamon McLaughlin about sleep or the lack thereof. Dr. McLaughlin explains why sleep is so essential to our physical and mental health. Focusing on sleep apnea as a sleep disruptor, Dr. McLaughlin talks about treatment options to ensure that you get a good night's rest. If you or your bed mate suffer from disrupted sleeping, take a listen.
Shelby Stockton (00:29):
Hi, Dr. McLaughlin. Thank you so much for spending some time with me today.
Dr. Eamon McLaughlin (00:33):
Thanks for having me, Shelby.
Shelby Stockton (00:35):
So sleep awareness week is upon us, and I have a few questions for you.
Dr. Eamon McLaughlin (00:40):
Of course.
Shelby Stockton (00:41):
So I'm a master sleeper. I'm very, very good at it. But I do know that sleep is elusive for a lot of people. Why is sleep so important?
Dr. Eamon McLaughlin (00:52):
If you think about just the time that we spend six, eight, nine hours a night, you know, you spend a decent amount of your life sleeping and it's important for waking up and feeling well rested. And so when things start to interfere with sleep, it can really start to impact your energy levels during the day, your productivity at work, motor vehicle accidents, accidents on the workplace. And then for things like sleep apnea, increased risk for hypertension, other cardiovascular injury, and if people have severe enough sleep apnea, it's an independent risk factor for mortality, for death, despite all those other things. And it's something that the incidence is definitely rising. We think it might be in part due to the obesity epidemic in the United States, but it's something that we're seeing more and more. And I also see more and more patients now that are tracking their sleep, which I think is great.
They either have the Oura Ring or a Garmin or a Fitbit or one of these apps on their phone, and then they're coming in and they're saying, I'm not sleeping well. I had a patient that just saw me and he was very type A, CEO executive type, and he compared his sleep data with all of his friends and he was very upset that his sleep data wasn't as good as all of his friends' sleep data. And that was what made him come in to see me. That was the first time that had ever happened, but I think more and more people are becoming aware of it. And a lot of those apps that people use are really great, especially maybe as a screening tool. Maybe they're over calling some things that aren't really truly sleep apnea, but they're also very helpful. We would rather catch more things that maybe are not really clinically significant than miss those things.
Shelby Stockton (03:02):
Great. Yeah, that's so funny, gamifying your sleeping, I guess I know one way to sleep better. Okay. So what are some treatment options for specifically sleep apnea?
Dr. Eamon McLaughlin (03:13):
Sure. Yeah. So sleep apnea is diagnosed with a formal sleep study. A lot of times we do those at home, it's not very obtrusive to do. And let's say the sleep study comes back and it shows that maybe you have mild sleep apnea. For patients that have mild sleep apnea, some different treatment options, it might be something as simple as maybe sleeping more on your side. And there's some devices that can help people sleep on their side compared to sleeping on their back, maybe getting the allergies under better control or something like a nasal surgery, like a septoplasty. As sleep apnea gets sort of more severe, those kind of smaller type things, especially nasal type things, the studies have shown that they really, although they might make a change, they're probably not going to make a huge impact. Another thing to consider, I mean, what we should say, first of all, that as the sleep apnea is getting worse, that the first line treatment is still CPAP.
CPAP is a mask that you wear at night, either over the nose or the nose and mouth, and it pushes air in to prevent the airway from collapsing. And it can be very effective. I mean, it can be almost 100% effective. It can be sometimes hard for patients to use. So a lot of times there's a lot of troubleshooting with different types of masks and things like that.
Another thing that I know some ENTs make, I personally team with a sleep dentist for this, but an oral appliance is another great option. That's something that you wear in your mouth that pulls the jaw, the mandible forward and with it pulls the tongue forward. And that has been shown to be very helpful for patients that have mild or moderate sleep apnea. And it's always a difficult thing to bring up, especially as an ENT, because you might be meeting a patient for the first time, you haven't really developed a good rapport with the patient. But the other thing that you always have to bring up with them is their weight. If people are overweight, you always have to mention it's not a perfect one-to-one relationship, but it definitely, any amount of weight that patients lose will 100% help their sleep and their snoring and all of those things.
Shelby Stockton (05:41):
Okay, so great. But some people I know because I have friends and family, the CPAP machine, they find it to be cumbersome or uncomfortable. So what about them?
Dr. Eamon McLaughlin (05:53):
So that's when we start to think about, okay, is it possible, does this patient have big tonsils? Does this patient have big adenoids? Would a procedure to remove them or remove the uvula, which is a procedure that's called a UPPP or a uvulopalatopharyngoplasty, is that the type of procedure that may potentially benefit them to open up their airway? It's not really new anymore. We've been doing it now for probably close to 10 years. But there is another procedure done by ENTs that's called Inspire. Inspire is a nerve stimulator or basically a pacemaker for the nerve that controls the tongue. So while you're asleep, it senses while you're breathing in and out and it's giving a signal to the tongue to move forward to prevent the collapse of the airway. And that's it. It's really a great option for some patients. It has about an 80% reduction in their sleep apnea. It has about a 90% reduction in snoring. And so that's something that we're able to offer our patients, which also is definitely part of the algorithm.
Shelby Stockton (07:06):
Wow, that's amazing. All right. So everybody, if you suspect even a little you have sleep apnea, go get tested.
Dr. Eamon McLaughlin (07:13):
Definitely. And most people, I would say come to see me with this, and it's usually their bed partner that is demanding that they're coming to see us. I say, "Well, how long have you been snoring?" They say, "Well, 15, 20 years." And I say, "Well, why are you here now? Well, now I'm sleeping on the couch, or my wife is in the other room." So the other thing that we forgot to mention in terms of importance is you can't belittle the importance that it has on your bed partner, in terms of, if your bed partner is not sleeping well, then that is not going to lead to a very happy daytime either. Definitely important.
Shelby Stockton (07:49):
Exactly, yes, yes, for interpersonal communications alone.
Dr. Eamon McLaughlin (07:54):
Perfect. Yeah.
Shelby Stockton (07:55):
Well, thank you so much for your time. This has been very, very educational. I know you're busy, but thank you.
Dr. Eamon McLaughlin (08:01):
Okay, perfect. Thanks, Shelby. Anytime.
