DEAR MAYO CLINIC: I am a 47-year-old man, in good health and not overweight, but I was just diagnosed with sleep apnea. Since I don’t need to lose weight, what could be causing my sleep apnea? I’m using a CPAP machine, but it’s not helping much. Is there something else I can try?

ANSWER: There are two forms of sleep apnea: obstructive and central. Obstructive sleep apnea often develops as a result of being overweight, but central sleep apnea is not related to weight. Instead, it develops when the brain doesn’t send proper signals to the muscles that control breathing. Continuous positive airway pressure (CPAP) devices don’t always work for people with central sleep apnea. But other treatment options are available.

Sleep apnea is a disorder in which breathing repeatedly stops and starts during sleep. About 85% of people with this disorder have obstructive sleep apnea. It occurs when the throat muscles relax and block the airway during sleep. Being overweight is strongly associated with obstructive sleep apnea. However, while two-thirds of patients with obstructive sleep apnea are obese, up to one-third are not. The tendency of the upper airway to collapse during sleep is influenced by many things, including the skeletal configuration of the face and neck, muscle function, and even medications or alcohol.

The other 15% of people with sleep apnea have central sleep apnea, in which your brain fails to send signals to your breathing muscles. Although the condition is related to brain signals, the cause of central sleep apnea usually doesn’t originate in the brain. It’s often triggered by another underlying medical condition or by taking certain medications.

Central sleep apnea can be caused by heart disease, congestive heart failure, stroke or advanced kidney disease. The medications most often associated with central sleep apnea are opioids, such as morphine, oxycodone or codeine. In some people, no specific cause of the disorder can be identified. This is known as idiopathic, or primary, central sleep apnea.

If left untreated, sleep apnea can lead to serious health concerns. Persistent fatigue and daytime drowsiness that disrupt daily life often result from sleep apnea. In addition, the sudden drop in blood oxygen that occurs during sleep may contribute to heart problems, such as abnormal heart rhythms.

As in your case, a CPAP device usually is the first treatment used for sleep apnea. It involves wearing a mask over your nose, or your nose and mouth, while you sleep. The mask is attached to a pump that supplies pressurized air to hold open the upper airway.

For many people with central sleep apnea, however, airway closure isn’t the problem. So treatment with CPAP may not be effective. Another device, called an “adaptive servo ventilator,” may be more useful. It also delivers pressurized air. But unlike CPAP, it adjusts the amount of pressure as you inhale each breath to normalize your breathing pattern. This device also may prompt your body to breathe if you haven’t taken a breath within a certain amount of time.

The drawback to an adaptive servo ventilator is that for people who have heart problems, particularly some forms of heart failure, the device may not be safe to use.

Another treatment recently approved by the Food and Drug Administration, called “transvenous phrenic nerve stimulation,” may be a better choice for people with heart problems who have central sleep apnea. It involves a device implanted in the chest that acts like a pacemaker to help you breathe normally during sleep by stimulating the phrenic nerve — the nerve that runs from the brain to the diaphragm. This device monitors your breathing and prompts the phrenic nerve to generate a breath if you’ve gone too long without breathing during sleep.

It’s important to distinguish between obstructive sleep apnea and central sleep apnea, and the only way to tell the difference between the two is with a sleep study. Talk with your health care provider about undergoing a sleep study to definitively diagnose the type of sleep apnea that you have. From there, you and your care team can develop a treatment plan that fits your needs. — Dr. Timothy I. Morgenthaler, Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota

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Related Articles

• What is sleep apnea? published 9/26/19
• Mayo Clinic study shows sleep apnea may be tied to increased Alzheimer’s biomarker in brain published 3/4/19
• Women’s Wellness: Are women with hot flashes at risk of sleep apnea? published 12/13/18

The post Mayo Clinic Q and A: Understanding central sleep apnea appeared first on Mayo Clinic News Network.

An estimated 20 million Americans have sleep apnea, and many don’t even know it. Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired after a full night's sleep, you might have sleep apnea. Sleep apnea can affect people of any age, including infants and children, but it’s most often seen in men over 40, especially those who are overweight or obese. 

Treatments for sleep apnea can include lifestyle changes, oral devices and sometimes surgery. Multiple effective treatment options are available for obstructive sleep apnea. And now there is a new treatment for the less common form of sleep apnea, central sleep apnea, or CSA. Previous treatments for central sleep apnea largely have been ineffective, as they haven't tackled the source of the problem. The new device, called Remedē, is an implanted device that stimulates the nerves and muscles that keep people with central sleep apnea breathing throughout the night. Mayo Clinic is the first in Minnesota to use the device, which is newly-approved by the Food and Drug Administration.

On this Mayo Clinic Radio podcast, Dr. Timothy Morgenthaler, a Mayo Clinic sleep medicine specialist, will discuss diagnosing and treating sleep apnea. Dr. Morgenthaler also serves as chief patient safety officer for Mayo Clinic. Also on the program, Dr. Brent Bauer, director of research for the Mayo Clinic Integrative Medicine Program, and Dr. Karen Mauck, a Mayo Clinic internal medicine specialist, will discuss how to know which CBD products are safe to use. And Dr. Kaisorn Chaichana, a Mayo Clinic neurologic surgeon, will explain new brain mapping techniques for hard-to-treat brain tumors.

Here's your Mayo Clinic Radio podcast.

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Listen: Mayo Clinic Radio 9/28/19

An estimated 20 million Americans have sleep apnea, and many don’t even know it. On the Mayo Clinic Radio podcast, Dr. Timothy Morgenthaler, a Mayo Clinic sleep medicine specialist, discusses diagnosing and treating sleep apnea. Dr. Morgenthaler also serves as chief patient safety officer for Mayo Clinic. Also on the podcast, Dr. Brent Bauer, director of research for the Mayo Clinic Integrative Medicine Program, and Dr. Karen Mauck, a Mayo Clinic internal medicine specialist, discuss how to know which CBD products are safe to use. And Dr. Kaisorn Chaichana, a Mayo Clinic neurologic surgeon, explains minimally invasive surgical techniques for treating brain tumors.

The post #MayoClinicRadio podcast: 9/28/19 appeared first on Mayo Clinic News Network.

An estimated 20 million Americans have sleep apnea, and many don’t even know it. Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired after a full night's sleep, you might have sleep apnea. Sleep apnea can affect people of any age, including infants and children, but it’s most often seen in men over 40, especially those who are overweight or obese. 

Treatments for sleep apnea can include lifestyle changes, oral devices and sometimes surgery. Multiple effective treatment options are available for obstructive sleep apnea. And now there is a new treatment for the less common form of sleep apnea, central sleep apnea, or CSA. Previous treatments for central sleep apnea largely have been ineffective, as they haven't tackled the source of the problem. The new device, called Remedē, is an implanted device that stimulates the nerves and muscles that keep people with central sleep apnea breathing throughout the night. Mayo Clinic is the first in Minnesota to use the device, which is newly-approved by the Food and Drug Administration.

On the next Mayo Clinic Radio program, Dr. Timothy Morgenthaler, a Mayo Clinic sleep medicine specialist, will discuss diagnosing and treating sleep apnea. Dr. Morgenthaler also serves as chief patient safety officer for Mayo Clinic. Also on the program, Dr. Brent Bauer, director of research for the Mayo Clinic Integrative Medicine Program, and Dr. Karen Mauck, a Mayo Clinic internal medicine specialist, will discuss how to know which CBD products are safe to use. And Dr. Kaisorn Chaichana, a Mayo Clinic neurologic surgeon, will explain minimally invasive surgical techniques used for treating brain tumors.

To hear the program, find an affiliate in your area.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post What is sleep apnea? appeared first on Mayo Clinic News Network.

Treatments for sleep apnea can include lifestyle changes, oral devices and sometimes surgery. Multiple effective treatment options are available for obstructive sleep apnea. And now there is a new treatment for the less common form of sleep apnea, central sleep apnea, or CSA. Previous treatments for central sleep apnea largely have been ineffective, as they haven't tackled the source of the problem. The new device, called Remedē, is an implanted device that stimulates the nerves and muscles that keep people with central sleep apnea breathing throughout the night. Mayo Clinic is the first in Minnesota to use the device, which is newly-approved by the Food and Drug Administration.

On the next Mayo Clinic Radio program, Dr. Timothy Morgenthaler, a Mayo Clinic sleep medicine specialist, will discuss diagnosing and treating sleep apnea. Dr. Morgenthaler also serves as chief patient safety officer for Mayo Clinic. Also on the program, Dr. Brent Bauer, director of research for the Mayo Clinic Integrative Medicine Program, and Dr. Karen Mauck, a Mayo Clinic internal medicine specialist, will discuss how to know which CBD products are safe to use. And Dr. Kaisorn Chaichana, a Mayo Clinic neurologic surgeon, will explain minimally invasive surgical techniques for hard-to-treat brain tumors.

To hear the program, find an affiliate in your area.

Miss the show? Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Sleep apnea / CBD products / brain mapping techniques appeared first on Mayo Clinic News Network.

The first Mayo Clinic Sleep and Stroke Conference included a unique element: an art exhibit designed to encourage new ways of thinking.

Margaret Grill's dreams have a recurring theme. "I regularly have dreams where I need to complete a task, but my body will refuse to move," says Grill, an artist. She tells us she tried to capture the feeling of that dream in her painting, "Nebuchadnezzar," "by portraying a series of legs in a static state." The work — a mix of drawing, collage and water-soluble oils — is finished with a layer of copper leaf, which Grill says reminds her "of the story of Nebuchadnezzar and his dream of legs made of bronze, iron and clay."

Grill's "Nebuchadnezzar" was among 21 works that recently found themselves in an unexpected venue. They were featured in a unique art show that closed out the first Mayo Clinic Sleep and Stroke Conference. "Art is a powerful way to share what one person 'sees' with another," says Timothy Morgenthaler, M.D.

Dr. Morgenthaler, a Mayo sleep medicine specialist who co-chaired the conference, conceived the art show as a way to help inspire new connections and conversations among those attending.

The resulting conversations were "fascinating," says Dr. Morgenthaler. "Many of the artists explained how they tried to capture either a recurring dream of theirs or just to capture how they experienced dreams in general," he says. "The attendees then tried to compare the artist's experience with what they know about what science says is going on during sleep.""Taking time to communicate with one another about sleep in a visual way with creative people I thought might bring a new perspective for the clinical scientists," he tells us. He also hoped "the opposite would be true — that the artists would get more in touch with sleep science as it might apply to their lives." So after a full day of scientific presentations, conference participants adjourned to the Plummer Building, where Grill and 10 other Minnesota artists displayed their work. The art captured "dreaming and brain function in a way words cannot express," says Melissa Lipford, M.D., a neurologist and conference co-chair.

Grill says it was special to have scientists "give their impressions of my work." For the scientists, the conversations were "invigorating," Dr. Lipford tells us. After the exhibit "there were multiple additional discussions about future projects and plans well into the evening." The art also served as a way to "connect to the humanistic side of medicine," she says. "The works connected me to the patient experience and served as a reminder of why each of us dedicates ourselves to this line of work."

Jesse Welsh, an education program manager in Provider Relations who recruited the artists for the exhibit, says the event earned rave reviews. Attendees appreciated "being able to use a different part of their brain," she says, and artists felt "honored" to be invited to "share their work in such a different context. This opened up Mayo to the community in a way it hadn't been before."

Participating artists included: Lexi Ames, Michaela Chorn, Margaret Grill, Bianca Jarvis, Susan Kassin, Bethany Kelley, Mary Klein, Steph Kunze, Laura Anne White, Maura Williams and Jane Wunrow.
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The post In the Loop: Illustrating the art and science of sleep and dreams appeared first on Mayo Clinic News Network.

ANSWER: A sleep test may be beneficial. However, before you seek medical attention, consider several things about sleepiness. The most common cause of sleepiness is not sleeping long enough. Getting enough restful sleep is crucial for maintaining good health. Research over the past decade has shown that healthy sleep is just as important as exercising regularly and eating a healthy diet. Most adults need between seven and nine hours of quality sleep to reap the health benefits.

When you don’t get enough sleep, over time it can have serious health consequences. For example, a consistent lack of healthy sleep can raise your risk for high blood pressure and heart disease. People who don’t get enough sleep have more difficulty staying at a healthy weight than those who do sleep well. Not getting adequate sleep also may increase a person's risk of depression, anxiety and substance abuse.

An interesting website put together by the Centers for Disease Control and Prevention website shows by city the proportion of adults who do not get at least seven hours of sleep. To learn more and to see if your city is listed, go to cdc.gov/500cities, and choose the category “unhealthy behaviors” and the measure “sleep.”

While getting enough sleep is important, a regular sleep and wake pattern also is key. Recent studies show that an irregular schedule, such as when you go to bed and wake up later on weekends than weekdays, is associated with poorer health, worse mood, and increased sleepiness and fatigue. Some studies show that this pattern of sleep, sometimes called “social jet lag,” is associated with increased likelihood for heart disease. Keeping a regular sleep and wake schedule, along with sleeping at least seven hours per night, helps improve sleep quality and effectiveness.

In a situation like yours, where you feel like you’re getting plenty of sleep but don’t feel well-rested in the morning, it’s possible that your morning grogginess could be a symptom of a treatable sleep disorder. Make an appointment to see a health care provider who specializes in sleep medicine. He or she can provide you with a comprehensive assessment of your situation that includes a discussion of your symptoms, a review of your medical history and a thorough physical exam.

Based on that evaluation, specific tests might be helpful. Those tests may or may not include a sleep study. If a sleep study is recommended, it may be conducted in a lab where you are monitored throughout the study. This type of sleep test is called a polysomnogram. It involves monitoring brain waves, muscle tone, airflow, blood oxygen level, heart rate and breathing during sleep. At other times, a home sleep apnea test can provide the needed information.

Seek care from a sleep center accredited by the American Academy of Sleep Medicine. Your health care provider will be able to help decide the best test for you and, then, based on the test results, establish your diagnosis. If you do need treatment for a sleep disorder, your health care provider can help you choose a treatment plan that will work best to accomplish your goals. Health care providers who are board-certified in sleep medicine are specially prepared to help you get the treatment you need and help you start feeling better. — Dr. Timothy Morgenthaler, Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota

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In this Mayo Clinic Minute, Dr. Morgenthaler explains what melatonin actually does for the body, and when it's appropriate to use to improve sleep. Ian Roth reports.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (0:59) is in the downloads. Read the script.

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On the next Mayo Clinic Radio program, orthopedic surgeon Dr. Norman Turner III will discuss treatment for common foot problems and ways to prevent them. Also on the program, parasitologist Dr. Bobbi Pritt will have an update on the Lyme disease predictions for 2017. And critical care physician and sleep medicine expert Dr. Timothy Morgenthaler will try to help answer this common question: Why can't I sleep?

Here's your Mayo Clinic Radio podcast.

The post Common foot problems / Lyme disease update / sleep issues: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, orthopedic surgeon Dr. Norman Turner III will discuss treatment for common foot problems and ways to prevent them. Also on the program, parasitologist Dr. Bobbi Pritt will have an update on the Lyme disease predictions for 2017. And critical care physician and sleep medicine expert Dr. Timothy Morgenthaler will try to help answer this common question: Why can't I sleep?

Listen to the program on Saturday, April 22, at 9:05 a.m. CDT, and follow #MayoClinicRadio.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

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