Broken Dreams

Cheryl Powell enjoyed an active lifestyle. She played and coached softball, and ran a craft business in her spare time. But over the years she did less and less exercise, her fitness declined and the inevitable kilos crept on. Then about two years ago her energy levels dropped drastically and she began to feel exhausted.

“I felt really unwell,” says Cheryl. “I was very tired, but I put it down to age and the onset of menopause. Then my concentration and short-term memory deteriorated. It got to the stage where I wanted to sleep all the time. I even nodded off while I was talking to customers.”

Cheryl eventually decided it was time to visit her doctor, who immediately guessed – due to a similar personal experience – that she may be suffering from sleep apnoea. He referred Cheryl to a respiratory specialist who organised for her to spend a night in the sleep lab at the local hospital. The results confirmed the doctor’s guess.
 

Dangerous fatigue

Sleep apnoea occurs when the walls of the throat come together during sleep. This blocks off the upper airway at the level of the tongue. Breathing stops for a period of time (generally between a few seconds and up to one minute) until the brain registers a drop in oxygen levels and sends a small wake-up call.

The sleeper rouses slightly, which opens the airway, snorts and gasps, then drifts back to sleep. This pattern can repeat itself hundreds of times a night, causing fragmented sleep. This leaves the person with excessive daytime fatigue, which can have severe consequences.

“I gained a lot of weight and felt terrible,” says Cheryl. “I fell out of a chair and broke my nose because I’d gone to sleep. I nearly had two car accidents because I was nodding off at the wheel. It was scary.”

People with significant sleep apnoea may also have an increased risk of heart attack and stroke. According to Professor Ron Grunstein of the Woolcock Institute of Medical Research, plenty of evidence suggests a vicious cycle exists between sleep apnoea and metabolic syndrome (a predictor of future diabetes and heart disease in people with obesity).

“It appears sleep apnoea worsens aspects of metabolic syndrome, and metabolic syndrome may worsen sleep apnoea,” he says. The condition is generally classified into two types: obstructive sleep apnoea (OSA) and the less common central sleep apnoea (CSA). Diagnosis is confirmed by having an overnight sleep study, referred to as a polysomnograph, and obesity is a common cause.

At present there is no cure and treatment relies largely on changes to lifestyle. Weight loss of around 5-10kg may be enough to dramatically reduce the severity of the disorder. In the hope of easing her symptoms, Cheryl joined Fernwood, Sydenham, Vic. “I had the help of a personal trainer and Slimplicity, as well as a program that understood my capabilities and injuries,” she says. “I now love going to the gym, and try to go at least three times a week.”
 

Breathing assistance

While Cheryl works towards long-term improvements in her health, she’s enjoying immediate relief from her debilitating symptoms by sleeping in a special mask. Called Continuous Positive Airway Pressure, it keeps the back of her throat open by forcing air through her nose.

“I refer to my apparatus as a ‘snorkel’. The experience is like a gale of wind through my nose,” says Cheryl. “But after just one night on the machine, I arose at 7am, went straight to my Saturday craft market and worked until 1pm. I felt wonderful for the first time in a long time. I was surprised to feel such a marked difference so quickly, but it shows what a lack of sleep can do.”

Professor Grunstein believes identifying a drug to treat obstructive sleep apnoea would transform the way the condition is treated in Australia.

“Currently, we find many sufferers are reticent to go to sleep attached to a machine. Not only does it restrict their movement during the night, but it can also be a source of frustration for partners who share their bed,” he says. “I think the identification of a drug to treat the condition would see a lot more people wanting treatment, and an improvement in their health.”

Meanwhile, Cheryl will continue to use her ‘snorkel’. “It isn’t very romantic,” she concedes. “But after 34 years of marriage we can cope with that. My husband is a darling and, although the machine isn’t noisy, he puts up with the gale blowing in his direction from time to time. He finds it nice and cool in the summer though – it’s his own personal fan.”

Are you a sufferer?

People with sleep apnoea will typically display one or more of the following;

• Snoring
• Excessive movement and restlessness during sleep
• Breathing through the mouth
• Thirst overnight and/or on waking
• Waking unrefreshed, often feeling more tired than before going to bed
• Daytime fatigue
• Irritability
• Reduced sex drive