Sleep, Interrupted

Snoozing spouse sound like Mount Vesuvius? It could signal dangerous—but treatable—sleep apnea.
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If you’re married to a “sound” sleeper— as in loud sounds—it may be time to make some noise yourself. Heavy snoring can be a tipoff to a dangerous condition called obstructive sleep apnea, and persuading your partner to be evaluated at a sleep lab could be a smart move.

The name apnea comes from the Greek meaning “without breath.” A sufferer’s breathing stops many times during the night due to temporary closings of the airway. That reduces the blood’s oxygen level; the condition can disrupt sleep and cause daytime drowsiness. Even if you devote eight hours to slumber, you can wake up sluggish and unrefreshed.

An estimated 22 million Americans have sleep apnea, and roughly 80 percent of them don’t know it yet. The condition made the news last September, when it may have been a factor in an NJ Transit accident. A train operator apparently dozed off as his train approached the Hoboken terminal; the ensuing crash claimed one life and injured more than 100. Tests found he had untreated sleep apnea.

But one needn’t doze off at the wheel to be harmed by the condition. Over time, it can cause high blood pressure, heartrate irregularities and an increased risk of heart attack and stroke. Fortunately, there is treatment that can lower those risks and improve sleep quality so that one awakens feeling rested. To mark National Sleep Awareness Week (March 5–12), Bergen checks in with two county residents whose experience proves the point:

HIS WIFE WAS RIGHT

Online reviewers rave about the Teaneck auto-repair shop run by Ridgefield Park resident Dimitris Moutafis, where at almost 67, he still puts in sometimes 14-hour days. One of them calls his business “a sleeper” because he’s “too busy working on cars to be bothered with Internet and advertising.” But it was as a literal sleeper that, a decade ago, he ran into trouble.

“I was tired all day long,” recalls Moutafis, who came to this country in 1975 and still has a touch of the sunny Aegean in his speech. “And my wife said, ‘You snore so much, like a big animal— what the hell is going on?’”

Today he pokes fun at his slow response: “She said, ‘Go to the doctor! Go to the doctor! Go to the doctor!’ And one day I said, ‘You know what? I’ve got no choice. Let me go to the doctor.’”

John Villa, D.O., medical director of the Institute for Sleep/Wake Disorders at Hackensack University Medical Center, ordered a polysomnography—a sleep test—in the hospital’s comfortable, hotellike sleep lab.

“They hooked me up to the computer with wires connected to my head and body, and people watched the computer overnight,” says Moutafis. The test showed he had severe sleep apnea. He was outfitted with a continuous positive airway pressure (CPAP) device. Through a hose connected to a face mask or nasal pillows, it gently pushes air into the nostrils to give breathing a boost. He was given different masks to try until he found one he was comfortable with.

“Now I sleep like a baby,” Moutafis reports. He rates his slumber as 90 percent better than it was. Indeed, Dr. Villa says his latest follow-up sleep study shows that while he’s using the machine, his breathing pauses just three times an hour (within a normal range not considered apnea)—versus 69 times without the CPAP. 

Says Moutafis: “To everybody now I say, ‘Go for the sleep apnea!’ I’m like a salesman.”

“The trick to CPAP is breaking down the barriers that make it difficult to wear,” explains Dr. Villa. Indeed, some people find the machine hookup clumsy at first. But once they’ve grown accustomed to it, many of those same people wouldn’t dream of spending a night without it.

SHE CAN DREAM AGAIN

“I knew I snored, but I never thought of the possibility of sleep apnea,” says Elizabeth, 65, of northern Bergen. (She’d rather omit her last name.) A selfdescribed Energizer Bunny type, she didn’t feel terribly fatigued even when her sleep apnea was untreated. But today, she says, “I know my sleeping is better.” Recently widowed, she had girlfriends sleep over, and in the morning one told her, “Elizabeth, you kept me up all night. I kept looking over to make sure you were breathing!”

She was evaluated and outfitted with a CPAP through the Center for Sleep Medicine at Holy Name Medical Center by pulmonologist Adam Glassman, M.D., whom she’d first seen for bronchitis. Her test showed her sleep was interrupted by breathing pauses 32 times an hour. “I was in shock,” she recalls. But the finding made sense to her in a way, because she didn’t recall doing much dreaming. She asked the doctor if her apnea had been depriving her of REM (rapid eye movement) sleep, the dreaming stage, and he said it probably had. “Sleep apnea tends to be worse during REM, so the body reduces such sleep as a self-protective measure,” Dr. Glassman explains. He adds that someone denied REM sleep for a period also may have a “REM rebound” afterward, pigging out on dreams “to make up for lost time.” Says the doctor: “When you have fewer interruptions in sleep, you can experience all of the stages you need to be properly refreshed, including REM, in which you dream and consolidate learning from the day.” Elizabeth reports with pleasure that “since I’ve had my sleep apnea machine I’ve been dreaming about my husband again.” And when her 3-year-old grandson visits overnight, he enjoys their bedtime ritual.

“Put your elephant mask on,” he reminds her.

Where to get your sleep study

To schedule an overnight sleep study to find out if you have obstructive sleep apnea or another treatable sleep disorder, contact one of these hospital units in Bergen. A visit will need to be prescribed by your primary care physician; check your insurance coverage.

• Englewood Hospital and Medical Center, Englewood; 201.894.3154
• Hackensack University Medical Center, Hackensack; 551.996.3732
• Holy Name Medical Center, Teaneck; 201.833.7260
• Valley Hospital, Ridgewood; 201.251.3487

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