South Florida ENT Associate Eamon McLaughlin discusses sleep and why it’s so important not only for our well-being, but also for the health of our relationships. He tells us what happens when we don’t get enough rest, and what those at risk of sleep disorders like sleep apnea can do to improve airflow.
Shelby Stockton (00:01):
Welcome to the South Florida ENT audio blog. I'm Shelby Stockton. Today I talked to General ENT Dr. Eamon McLaughlin. Due to his interest in surgery and treatment of obstructive sleep apnea, we discussed all things that have to do with getting a good night's sleep. If you wake up in the morning and don't feel rested, or if your partner complains about your snoring, you're definitely going to want to listen to our conversation.
Shelby Stockton (00:23):
Dr. McLaughlin, thanks so much for spending time with me today.
Dr. Eamon McLaughlin (00:26):
My pleasure, Shelby. Thanks for having me.
Shelby Stockton (00:29):
So today we're going to talk about something that I'm extremely interested in because it's one of my favorite things to do in the whole entire world and it's sleep. Can you tell me a little bit about why is sleep so important for humans? I guess, any species. And what happens when we don't get it?
Dr. Eamon McLaughlin (00:48):
Sleep is so important because one, we spend so much time, overall of our lives, sleeping. And if people have... I think it's one of those things where you don't know what you're missing unless... you take it for granted unless you're having trouble with your sleep. People that have problems with their sleep, specifically problems with sleep apnea, one of the main reasons why people come into the office to see me is that either they or their bed partner is now sleeping in another room. And a lot of times people will tell you, you say, "well, how long have you been storing? Or how long have you been having problems with sleep apnea?" And they'll tell you, "Five, ten years." And I'll say, "well, why are you here now?" And then they'll tell you, "Well, now I'm sleeping on the couch, and I want to do something."
Dr. Eamon McLaughlin (01:33):
So it also doesn't... You have to think that problems, especially with obstructive sleep apnea, can impact other people other than you. But if you're not getting night's sleep, decreased mental focus during the day, feeling tired, patients that can fall asleep at a red light, increased risk of motor vehicle accidents, decreased productivity at work. And in addition to all of those things in terms of how we feel from not getting good sleep, if patients have obstructive sleep apnea, then they also have an increased risk of problems with blood pressure, problems with blood pressure in their lungs, increased risk of strokes, and other problems. And if people have very severe sleep apnea, it's an independent risk factor for an increased risk of death, too. So, it's something that if people feel like they aren't sleeping right, it should definitely be evaluated.
Shelby Stockton (02:27):
That was going to be my next question. Let's say you live alone and you don't know that you're snoring. What are the symptoms while you're awake that might be like, "Hey, you need to go see someone"?
Dr. Eamon McLaughlin (02:41):
Feeling very tired during the day, even if you're getting a good six, seven, eight hours of what you could consider to be quality sleep. Waking up in the middle of the night feeling like you're choking or you can't breathe. Waking up in the mornings with very bad headaches, which can sometimes be a sign of sleep apnea. Sometimes people, they'll come in and they say, "Well, I've never had any problems with sleep, but I had a colonoscopy and they told me that I was snoring very loudly," or, "I had somebody sleep over my house, and they told me that I was snoring very loudly." And there's some small screening test that also can be done by either ENTs or by primary care doctors that if people have certain risk factors, then they're at a high risk for sleep apnea and then we should start asking more directed questions for those patients.
Shelby Stockton (03:31):
Okay. All right. So I've come to you. We've figured out I have sleep apnea. What are my options?
Dr. Eamon McLaughlin (03:37):
Well, the one thing we should say too is that in order to diagnose sleep apnea, sleep apnea is diagnosed with a sleep study. So that's something that can be ordered by a primary care doctor can be ordered by an ENT, can be ordered by a pulmonologist or a sleep specialist. And then so that is a test that you can either do at home, or sometimes we have people do it in a sleep lab where you fall asleep with some equipment on, and that's going to measure your oxygen levels, your respiratory rate, your heart rate. And that will show us then if people have sleep apnea. So that's how we... So if patients come to me and they tell me that they're snoring, they don't feel, they feel tired during the day, their bed partner says that they're having pauses when they're breathing, then the first step in terms of what we would do would be to get a sleep study.
Dr. Eamon McLaughlin (04:25):
But let's say you come to me and we do the sleep study and it does show that you have sleep apnea. A lot of it depends on the patient and it depends on how severe the sleep apnea is. If it's mild sleep apnea, and the patients are even a little bit overweight, there is definitely a very strong relationship, not perfect, but there's a strong relationship between weight and sleep apnea. So sometimes losing five, ten pounds can make a huge difference for sleep apnea. So when I see patients for sleep apnea, I'm always looking at their nose, if they have a deviated septum, if they have very bad allergy changes, if they have any tonsils or adenoids. I'm looking at their neck anatomy. I'm looking at how big their tongue is for their... compared to the mouth, if they have a very large uvula. And the still sort of the standard treatment for sleep apnea is CPAP, and CPAP is a mask that people wear at night that pushes air in.
Dr. Eamon McLaughlin (05:28):
And it prevents the collapse of airway in the tissue, and it can be great, and it has 100% success rate if people can use it. And that's sort of when we run into problems is because it can be very difficult to adjust to sleeping with something like that on.
Shelby Stockton (05:44):
Yeah.
Dr. Eamon McLaughlin (05:46):
It's really patient dependent, but there are a lot of different surgical options, nasal surgeries, oral surgeries. But it really depends on the patient's anatomy. I think the most important thing for sleep apnea is there's not one surgery that fits all.
Shelby Stockton (06:01):
Right. I see. I was going to say, I've seen CPAP machines and people who've had to sleep in them, and they seem cumbersome for a lot of people, especially if you travel. So what are other options besides that?
Dr. Eamon McLaughlin (06:18):
Well, one of the newer options for sleep apnea is a procedure that's called Inspire. Inspire is a surgery that I do and a couple other doctors within our group do. And it is a basically a nerve stimulator, or a pacemaker, for the nerve that controls the motion of the tongue. So it's an outpatient procedure to put in the device. And how it works is that the patients have a remote control, and when they're ready to go to sleep, they turn on the device, and it gives them a customizable amount of time to fall asleep. And then once they fall asleep, it senses when they're breathing in and out. And when we breathe in, we suck air into our lungs, and that negative pressure causes collapse of the airway. So it senses when you're breathing in and it tells the tongue to move forward. And the tongue is attached to the palate with a few small muscles.
Dr. Eamon McLaughlin (07:15):
So it also pulls the palate forward, so it's one of the few surgical options that addresses collapse throughout the whole airway. And it's benefit over other surgeries, although it is an implant and you have, then you have it for the rest of your life, but it's benefit is that it only opens up your airway when you need it because all the other surgeries we can do remove a little bit of the back of the tongue, remove the tonsils, remove the uvula. You have to remember, you do more than just sleep with your airway. So you can only be so aggressive with those surgeries before you start to impact how people talk and how they swallow and how they eat and everything else like that. So it's a very good option for patients.
Shelby Stockton (07:53):
Wow. That's amazing. Science is so cool. [inaudible 00:07:58]. Okay. So let's... Okay. Tell the people out there, before we leave, if they think they may have sleep apnea, how important it is to get that diagnosed and move forward.
Dr. Eamon McLaughlin (08:12):
It is very important. Left untreated, sleep apnea can cause problems with your heart, with your lungs, with the blood pressure in your heart and your lungs. It can also cause, like I said, if it's very severe, it can increase your risk of mortality. And then on the immediate effects, it can make you feel tired during the day, decrease work productivity, increase risk of motor vehicle accidents, and unhappy significant other or spouse. So all of those things are, and maybe the last one is the most important, but all of those things are good reasons to at least start the conversation if there's any concern, if there's snoring, if there's any witness pauses in the breathing, or if people are just waking up a lot at night and feeling like they're not getting good sleep.
Shelby Stockton (08:59):
Okay. That's great advice. Thank you so much for your time, Dr. McLaughlin. I really appreciate-
Dr. Eamon McLaughlin (09:04):
Of course. My pleasure. I love talking about sleep.
Shelby Stockton (09:05):
So do I.
Dr. Eamon McLaughlin (09:08):
Thank you.
