Healthy Focus

A little night music: Is it snoring—or sleep apnea?

Tony Fry, Director of Cardiopulmonary Services, likes to make one thing clear about snoring: It’s not normal.

Tony Fry, Director of Cardiopulmonary Services

In fact, snoring can be a real health concern, primarily because it is one of the major signs of sleep apnea, a condition in which breathing repeatedly stops and starts during sleep and which may be connected to cardiac health issues. Sleep apnea is fairly common, occurring in about 30 percent of post-menopausal women and affecting approximately 3 to 5 percent of the population, says Tony.

The good news is that sleep apnea is very treatable, and often surgery isn’t even required to get patients resting comfortably.

Diagnosing sleep apnea

Complaints from a bed partner that you’re snorting, gasping or seem to be pausing while you’re breathing are a good reason to schedule an appointment with your health care provider. One of the first questions he or she will likely ask is whether you find that you just can’t keep your eyes open when your day begins to slow down, perhaps while reading or watching TV, says Tony. Daytime tiredness and morning headaches are also common signs of sleep apnea.

“If you aren’t breathing like you’re supposed to, your brain will wake up,” says Tony, which means you aren’t getting what’s considered restorative sleep.

To make a diagnosis of sleep apnea, your physician will use a test called polysomnography, during which electrodes are attached to your skin in several places and monitors record your heart rate and breathing as you snooze in a sleep lab. Although polysomnography hasn’t changed much in the past 50 years, according to Tony, what has changed is the approach to sleep studies. Clinics and hospitals are working to make these studies less stressful, and most sleep labs now resemble hotel rooms, says Tony. Some patients are even able to do a sleep study at home, with sensors collecting information that can be downloaded at the lab.

Higher heart disease risks

An accurate diagnosis is important because there are different types of sleep apnea.

Central sleep apnea (CSA) is different than obstructive sleep apnea (OSA). In CSA, the part of the brain that controls breathing and the drive to breathe isn’t working properly, says Tony. You may have CSA, OSA or a mix of the two, and all have ties to other health problems.
“When you have untreated sleep apnea, it puts you at risk for diabetes and stroke,” says Tony. “Treatment is definitely proven to decrease morbidity and cardiac risk.”

These ties to cardiac health issues have made doctors much more aggressive about diagnosing and treating sleep apnea, adds Tony. In 2007, the results of a 10-year study suggested that people with moderate to severe untreated sleep apnea have a 2.5 times greater risk of stroke than the general population, according to Tony.
The potential cardiac issues are generally the same for men and women, although women are less affected by them if their sleep apnea is mild, says Tony. It all comes down to a lack of oxygen in the blood, as well as potential damage to the heart and the lining of the coronary arteries. This is also accompanied by a rise in carbon dioxide in the bloodstream which is also detrimental to organs.

Treatment options

If you’re diagnosed with sleep apnea, your physician will recommend treatment based on the severity of the condition, as well as other health issues:

  • CPAP (Continuous Positive Airway Pressure), a machine used while you sleep to increase pressure in the airway, keeping it from closing during sleep
  • Dental appliances that pull the bottom jaw forward to keep the airway open
  • Surgery on the upper airway

Most sleep apnea patients respond well to sleep appliances, but “follow-up is the key,” says Tony. “We can usually troubleshoot for them and make them more comfortable.”

Another emerging option for OSA is Inspire therapy, a small, fully implanted system that delivers mild stimulations to airway muscles to keep the airway open and which may be an option for people who can’t tolerate CPAP, says Tony.

7 symptoms of sleep apnea

  1. Loud, ongoing snoring that is usually loudest when you’re sleeping on your back.
  2. Daytime sleepiness, especially during quiet moments
  3. Morning headaches
  4. Problems with memory and concentration
  5. Irritability or mood swings
  6. Waking up frequently to urinate
  7. Dry mouth or sore throat when you wake up

Source: National Heart, Lung, and Blood Institute


Memory loss after 60: Is it really inevitable?

There’s one thing that’s crucial to remember about memory loss: It doesn’t have to happen to you.

Franklin J. Holcomb, DNP, APRN, PMHNP-BC

Experts agree that just because you hit a certain age—60, 65, even 85—doesn’t mean you are going to lose your ability to remember things, especially if you continue to maintain a healthy lifestyle.

“Our culture now has become so incredibly sensitized to the issue of memory loss so as people get older, they think they’re cognitively doomed, which is not the case at all,” says Dr. Franklin J. Holcomb, DNP, APRN, PMHNP-BC, Lake Haven Behavioral Center. While memory recall does peak in your 20s, he says, and the speed with which you can perform certain mental operations will gradually decline, many mental abilities like vocabulary and social judgment will stay the same or even improve with age.

Keeping it all together

There’s no magic formula for maintaining your memory in peak form, says Dr. Holcomb. But eating a healthy diet, not smoking, keeping your brain active, socializing and exercising all work together to aid memory recall as you age.

Dr. Holcomb agrees that “there is increasing evidence that we can preserve memory longer by keeping the body healthy and the mind engaged and active.”

He cites a recently published study from Finland that compared two groups of people over 60. The group that became very regimented about diet—limiting sugar, salt and fat consumption and increasing intake of fruits, vegetables and fish—and participated in an exercise program and computer-based cognitive training programs performed better in overall brain function than the group that led a relatively healthy lifestyle but was not as regimented.

Exercise in particular can be an important component in retaining memory function, say many experts. “I preach exercise to help memory,” says Dr. Holcomb. “I tell my patients day in and day out to do 45 minutes of moderate exercise at least three times a week, and I try to get them to walk 30 to 35 minutes a day if they can.”

Mind games

To keep your mind engaged too, Dr. Holcomb recommends “puzzles or card games or even online memory games like Luminosity. It’s also really, really important to stay social, to get out with friends and family or to senior centers, and not to worry,” he adds.

Being highly stressed, Dr. Holcomb says, “taxes you physically and mentally. If you can reduce that stress, it will help with memory and overall physical well-being.”

Dr. Holcomb notes that sleep quality is also important. Sleep is necessary in consolidating memories, so interrupted sleep can be bad for the brain. Treating issues like obstructive sleep apnea, for example, can help improve memory, he says.

Learning new tricks

Although learning new information may take longer as you age, “once something is learned, it is retained equally well in all age groups,” says Dr. Holcomb.

In fact, the learning process itself can be valuable.

“Longer formal education is linked with mental sharpness in the elderly population,” says Dr. Holcomb, “possibly because it helps create a habit of continued learning. Memory is like muscle strength in that if you keep exercising it, it gets stronger. If you don’t use it, you lose it.”

Boost your memory by:

  • Eating a healthy diet
  • Not smoking
  • Keeping your brain active
  • Socializing regularly
  • Exercising moderately
  • Getting a good night’s sleep

Making memories

Try these no-stress tactics for giving your brain a helping hand:

  • Hang a household calendar on your kitchen wall, mark down everyone’s schedules, and make it your first stop in the morning.
  • Place a box or basket in a convenient place to hold the household objects that you tend to misplace most often—keys, cellphones, glasses.
  • Take advantage of smartphone apps and set alarms to remind yourself when tasks need to be done.
  • Use timed medication containers to organize your daily medications.
  • Write a to-do list for the next day each night before you go to bed.

Slow cooker pork tenderloin in barbecue sauce

After a long simmer in a slow cooker, lean pork tenderloin shreds when sliced. Scoop up the pork with its hot-sweet sauce and serve plain, over baked potatoes or in a bun with coleslaw.

¾ cup sweet and smoky barbecue sauce*
¾ cup unsweetened apple juice
1-1/2 tablespoons apple cider vinegar
1 tablespoon brown sugar
¼ teaspoon smoked hot paprika
1 small onion, finely chopped
1 (1-½-pound) pork tenderloin, trimmed of visible fat
1 garlic clove, smashed

In a bowl, stir together barbecue sauce, apple juice, vinegar, sugar and paprika. Stir in onion. Rub pork tenderloin with garlic clove; discard leftover garlic.

Pour half the sauce into a 5-quart slow cooker. Top with pork tenderloin. Pour remaining sauce over pork.

Cover. Cook at low setting for 5 to 6 hours. (Meat thermometer inserted into pork should read at least 145 degrees.) Remove pork from slow cooker, but don’t turn off slow cooker. Let pork rest for 3 minutes. Slice pork into ¼-inch thick slices. Meat will break into thick chunks. Return to slow cooker and let soak in the sauce for 3 to 5 minutes.

Serve pork with sauce.

Makes 6 servings

Per serving (with sauce): 230 calories / 4 grams total fat / 26 grams
protein / 19 grams carbohydrates / 72 milligrams cholesterol / 270 milligrams sodium