Inside Scope
Say hello to Inside Scope — Lakeland Regional Health’s podcast, where our experts share insights on today’s popular health topics, hosted by our own Dr. Daniel Haight.
Inside Scope
Is Snoring a Warning Sign for Sleep Apnea?
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Tired of being told that your snoring is keeping the whole household awake? Your family may be worried that snoring is a symptom of a much more serious issue: sleep apnea. In this episode of Inside Scope, host Dr. Daniel Haight talks with Dr. Joseph Demidovich III, a sleep medicine specialist, about the signs of sleep apnea and the damage it can do if left untreated. A person with sleep apnea is not getting enough air to their lungs while they sleep, which can result in high blood pressure, being tired all day, and possibly lower levels of concentration. Dr. Demidovich urges people who think they may have sleep apnea to talk with their primary care provider.
Is your snoring a medical emergency? Well, that might be a little bit of an exaggeration, but let's find out. With me today is Dr. Joseph Demitovich, a board-certified lung and critical care sleep medicine physician with Lakeland Regional Health, who also sees patients at our Kathleen Center near Interstate 4. Welcome to the Inside Scope. This is a podcast from Lakeland Regional Health where we talk to experts available right here in our community. Now, today is a real snoozer, but not in a bad way. Dr. Dominovich, we want to talk about sleep apnea and we want to get your insights on this term that we're hearing so much about. And can you introduce that topic for us?
SPEAKER_01Sure. Then thank you for inviting me to uh speak with you all. Um hopefully uh your your guests will be more knowledgeable in sleep apnea and recognize concerning signs about sleep apnea. And with all that said, hopefully this doesn't turn into a podcast that cures insomnia.
SPEAKER_00No, we'll we'll keep you awake. Okay. So I want to really get into it because so many people do know about sleep apnea. They know about CPAP, and we're gonna describe what that is. I mean, what are the signs of sleep apnea and you hear that because you want to have the is this me or is this a family member?
SPEAKER_01Um The most common symptom is usually snoring, loud snoring. But a lot of times um the patient doesn't know they have sleep apnea, so they rely on the bed partner, family members. Trevor Burrus, Jr.
SPEAKER_00Because they're asleep. Okay, that was the key point. I understand. So so it is the people notice the snoring. Is all snoring bad? I mean, is snoring can be not bad. So what is what are we worried about when we hear snoring? Aaron Ross Powell, Jr.
SPEAKER_01Snoring is caused when the upper airway obstructs when you fall asleep. But what we get more concerned medically is if when you don't get enough air or oxygen to your lungs, and the oxygen desaturation is what ends up usually leading to health consequences.
SPEAKER_00Aaron Powell So the best part about sleep is you're relaxed, and your body relaxes, your muscles relax, but you're telling me it's the it's the tongue is relaxing and it's just sort of going back. And it what's but what's actually blocking air coming in and causing that? What's causing that?
SPEAKER_01Aaron Ross Powell, Jr. Well basically, like you said, the tongue is falling back, and then the muscles that are responsible for keeping the airway open are now relaxed as well because you're asleep. And so you know while you're awake, snoring is not a problem. But these muscles are no longer functional. The tongue falls back into the upper airway and obstructs it. Uh and therefore you're trying to breathe, it can gets an obstructed airway. Um, but it's very difficult to get the airflow to your lungs.
SPEAKER_00I grew up with my father, he would snore very loudly in a small house, and you could always hear him stop. The snoring stopped. And I guess not knowing it, I think he was basically not breathing for those seconds to minutes. And if you're not breathing, your oxygen level goes down. That's irritating. What kind of irritation or damage does that cause if you're having these little stopping in breathing for a minute or two?
SPEAKER_01So the oxygen desaturations are occurring during these absence of breathing. So the oxygen in my bloodstream would be going down. Correct. And this is very stressful on the heart. And the heart is basically in a stressful state, releases certain hormones that uh increase your blood pressure, uh, retain fluid, actually cause you to urinate frequently as well.
SPEAKER_00Well, it wakes you up, too, because I always heard the snoring, then the stopping, and then all of a sudden, it was almost like he woke up. Um and and how could you possibly get a good night's sleep if you're like how often does this happen during the night? Can you get a good night's sleep if you're constantly doing this? Aaron Ross Powell, Jr. You you can't.
SPEAKER_01And um if you have severe disease, that's technically thirty times an hour. I'm 30 times an hour. So every two minutes, what you're describing is occurring. So just imagine you're asleep and every two minutes someone's poking you on the forehead to wake up, wake up. That's basically what's happening over a six, seven-hour time.
SPEAKER_00Trevor Burrus, So you can't go through all those phases of sleep. You're not getting a good night's You're not getting a good night's sleep. No, not at all. Trevor Burrus, Jr. And that's stressing the heart, it could be raising your blood pressure. That's a silent thing, right? You won't even know your blood pressure is going up unless you check it. Trevor Burrus, Jr.
SPEAKER_01That and then a lot of times too, um, the physician is trying to figure out why the patient may have high blood pressure.
SPEAKER_00Mm-hmm. Because there's other causes of high blood pressure, but if you have sleep apnea, is it is really the the spouse and and others in the family may know about the snoring? But sometimes you said the patient may not even know, but if the patient knows they have high blood pressure, this starts to factor into could sleep apnea be causing it? Correct. Okay. And then what other dangers then happen beyond a person that's having the sleep apnea? They're having these episodes. What other other things that happen out after that, during the day? What what what are they often experiencing?
SPEAKER_01So because they're not again restful sleep, they feel very tired throughout the day. Uh a lot of times they'll just wake up, they may be in the bed for the last six, seven hours, and they wake up like nothing ever happened. They're just as tired as they lay down to go to bed at night. Also, too, it affects their memory, uh, their cognition, their ability to think, and uh the constant sleep fragmentation or sleep deprivation, or I should say relative sleep deprivation, uh has the patient inability to do certain um maneuvers like drive a car or concentrating, pr doing things at work.
SPEAKER_00Driving the car, I think that's one of the things that hits me as most dangerous, is that if you're sleeping at a stoplight, but then you're dozing off and having these little mini sleeps for a few seconds while driving, they could turn into a minute of sleep and that's a crash.
SPEAKER_01Yes.
SPEAKER_00I'm thinking that if you have concerns, what in your practice, what tends to lead a patient to you to start asking these really good questions about could I have sleep apnea?
SPEAKER_01Aaron Ross Powell So a lot of times they're motivated to come in from the bed partner. And if they maybe if they don't have a particular bed partner, a lot of times when they come back from vacation with their friends, so many times I see patients in the office, they're on a whether it's a guy's trip or a girl's trip.
SPEAKER_00Trevor Burrus, So like a golfing outing, and then they're that's the joke of the next day. Wow, you really snored a lot, or you know, or somebody I think nowadays people are recognizing to say, hey, Charlie or Joe, you you may have sleep apnea, you should get that checked out. So you are you're having patients come to you because of those kinds of made aware, they were made aware. Trevor Burrus, Jr.
SPEAKER_01Correct. Yeah. A lot of times there's a post-vacation item on their to-do list, just come see me because they may have sleep apnea.
SPEAKER_00Trevor Burrus, Jr.: Yep. And now you did mention uh men and women. Uh, this is not a men's only does this affect men more than women? What what what do you see playing out there?
SPEAKER_01Trevor Burrus, Jr.: Well, overall, um there's more men who are uh affected with the disease, but after menopause, it's uh equal.
SPEAKER_00Uh so 50-50. Yeah. Interesting. You know, some folks feel that if you're if you have a thicker neck or you're somewhat overweight or have other health conditions, you're at risk for sleep apnea. But is that always the case? Can sleep apnea run in the family?
SPEAKER_01It can. And usually individuals who are not the typical person that you are mentioning could have sleep apnea. It's usually due to their airway anatomy. A lot of times they may have a jaw that's set back, or a very small uh chin, um, or very narrow posterior airway anatomy to where just lying on their back predisposes them to sleep apnea.
SPEAKER_00Trevor Burrus, Jr. So and they again I think that that it's so important what you were saying earlier. Well, what are you looking out for and recognizing? It's the I wake up with headaches, I'm tired during the day, um, I'm having trouble concentrating. What do you see that this is often confused with? Like a patient might think they have depression, and no, it's sleep apnea or both. You know, what do are there other diseases that you you you you say, well, it's it's sleep apnea might be a part of this, but we have to be careful that it could be this condition or that condition. What a lot of times it depends on the age.
SPEAKER_01If it's a very young person, also you want to think of narcolepsy, where there's a central nervous and central nervous system disorder where sleep is intruding why they should be awake.
SPEAKER_00Trevor Burrus, Jr. So narcolepsy is a person who would just fall asleep all of a sudden during what should be a you should be alert and the person falls asleep. Trevor Burrus, Jr. Correct. And a lot of times they're labeled as just being lazy or not motivated. Aaron Powell Yeah. And I think we're looking at those warning signs and being able to help a person, when you ask your patients what matters most to you, you know, that's where and I and I always get great feedback from patients who say, I love it when a doctor asks me what's most important, because it may not be the headaches or the sleepiness. It might be something else, like you mentioned, having to get up so often to go to the bathroom, and it and that is in their minds, you know, disturbing a spouse or who's with them. What what do you often hear is most important to the person? And it might be just short-term or long-term. What what tends to be on their minds?
SPEAKER_01Aaron Powell A lot of times is they just can't do what they used to do when they were younger. And so they're in this new state, they're just not as functional as they feel like they should be, and their quality of life is impacted.
SPEAKER_00Well, you know, this whole sleep apnea issue seems to revolve around the sensation of feeling exhausted. A very common theme on the inside scope has been where a person might say, I feel this exhaustion is just a part of getting older. And no, that that is not the case. Please get it looked into because here's this exhaustion is not you uh aging process. It's something that can be addressed. I can imagine a person who has a low-functioning thyroid, which causes fatigue and tiredness and weight gain. Oh, it would be a mistake to say that's just old age. It's super treatable. Same with sleep apnea. You're you're able to be able to do that. But I I think that and we'll get to this a little later too, is like the steps that follow. Okay, so you may have sleep apnea. It may be explaining your high blood pressure. What's some of the first steps? Because I I do see some folks trying to figure this out all by themselves through the internet or wearable devices and things like that. Where where should you start? Because I think our primary care doctors, which everyone should have a primary care doctor, uh, are helping their patients recognize this and and head down the right road. What is that right road? Trevor Burrus, Jr.
SPEAKER_01So uh the right road, of course, is talk to your primary care physician about it. And then uh depending on um what kind of symptoms you have and other comorbidities, the primary care physician may send you to a sleep uh physician or a pulmonologist.
SPEAKER_00Trevor Burrus, Jr. And the pulmonologist is the lung specialist, and it goes well beyond that. It's it's the whole sleep dynamic. Correct. Everything was sleep. So you they would refer then to a pulmonary specialist as yourself. And then what's happening at that point? Aaron Ross Powell, Jr.
SPEAKER_01So um when they come to see a subspecialist, usually they'll have more time for the specialist to focus on their specific complaints. Yeah, everyone's different.
SPEAKER_00Yeah.
SPEAKER_01And it's tough to be in a primary care physician. The patients have such high expectations to cover so many different symptoms at once. And it's especially sleep, it's so complex and it's very difficult uh for a primary care physician to do uh everything that may need to be done in an initial visit. Trevor Burrus, Jr.
SPEAKER_00Well, it's a team effort because I I think we could talk a lot about on a separate program sleep hygiene and and the issues between you and primary care doctors helping patients and their families with everything like screen time. You know, looking at a telephone or or your smartphone or a computer screen or a TV screen at 10, 11 o'clock at night. That's telling your brain it's not time to sleep. A little bit of alcohol at night might make you sleepy, but you were telling me earlier that uh drinking alcohol may actually impair the sleep late at night.
SPEAKER_01Aaron Ross Powell Correct. So in our society, probably alcohol is probably the most used substance to help with sleep, but in fact, it's probably one of the worst things you can do. Trevor Burrus, Jr.
SPEAKER_00Because it doesn't give you normal sleep. It's inducing sleepiness, but it's not normal sleep. It's it's uh it actually interferes with normal sleep. Trevor Burrus, Jr. Correct, correct. So actually, like deep sleep and run sleep, it impairs you uh to get into deep. Which is what you really need. Correct. You need to get into that deep sleep, and alcohol just puts you to sleep. And I think that that's sort of the first step is you're helping understand a patient. I really like how and and when I teach medical students, they really are starting to learn about going beyond what's your problem today, but getting to know the whole person. And that is things they like to do, things that they want to do, but habits they might have, like, you know, having a little bit of caffeine late at night. It might be, well, there's a you know, the folks really that caffeine is interfering with my sleep? You know, so you get into that too, right? Yeah.
SPEAKER_01Yeah, and caffeine has such a long half-life. So even afternoon coffee. So it lasts a long time than you think. Correct, yeah. So even uh afternoon coffee uh can be uh um have effects 10, 12 hours later that you would you would never think of. Trevor Burrus, Jr.
SPEAKER_00So when you're you're getting into the five cups a day, you're you're really having caffeine on board while you're trying to sleep. Correct. And and that's a difficult balance. And then you've got folks that they may have been self-treating. They're taking medicines for headaches, they're taking stimulants like you know, certain energy drinks to wake them up during the day. And then if sleep apnea is causing high blood pressure and stressing the heart, and then you're adding stimulant drinks on top of that, isn't that gonna really overstress the heart even further when you you're self-treating?
SPEAKER_01Yes, yeah.
SPEAKER_00Oh, see that as a I see that as a yeah, even as younger folks, you know, they they they they see themselves sleepy-ish, and well, I just take some stimulant, like a like an energy drink, and and how that can add up. So you're trying to gather all that information, get to know the patient with the patient's permission, you get information from the family and the spouse and the little bit of the timing. Um when you feel that you've sort of got the understanding of the possible things going on, and you're making sure they don't have a low thyroid or depression or other issues, and you're focusing on sleep apnea might be it. What actually is the trigger that says, I think you have sleep apnea? Is what more has to be done to to really be sure that that is what's causing the person's symptoms? Aaron Ross Powell, Jr.
SPEAKER_01So a lot of times in addition to snoring, their their body size, their age, other comorbidities like hypertension.
SPEAKER_00Trevor Burrus Because the high blood pressure is more of a result or is worsened by sleep apnea, not the other way around. Correct. High blood pressure doesn't cause sleep apnea. Correct. It's the okay, very good, very good.
SPEAKER_01And then um and then, like we said, their body habits, if they're obese, and then where what's happening to them too during the day? What's their consequences besides having the medical addition of hypertension? Are they able to remain awake when they need to? And if they're not, if they're extremely tired throughout the day, I think a combination of all those signs and symptoms make you start think to make you start wondering if this is obstructive sleep apnea at play. Trevor Burrus, Jr.
SPEAKER_00Yeah. And to be able to have a you know a caring conversation, to ask about things that they're used to, ask about sexual dysfunction, would that play have a role where sleep apnea might be interfering with that? Often do you find that, you know, after getting to know a patient, they have various concerns like I want to be more active in sports, this might be impacting you know, sexual dysfunction. Is it things like that are happening? You get those kinds of conversations?
SPEAKER_01Aaron Powell Yes, yeah. And uh um they have things that may be personal to them, but are affecting the quality of their life. If you know you can intervene and uh help them and reverse that process, then they're even more motivated to uh get diagnosed and treated with for instance CPAP, which we'll talk about, I'm sure we'll talk about it. Okay.
SPEAKER_00Well now, so going now to testing, what are the tell me about these kinds of tests that gather information while they're sleeping. Uh there's uh, I guess the option to do at home. And then tell me more about where do where do you like to go when you first meet somebody and you think, you know, sleep apnea is possible for this person.
SPEAKER_01Aaron Powell So even though we may have high clinical suspicion for sleep apnea, in order to make the diagnosis we do need diagnostic uh sleep testing. And classically, um to diagnose a patient with sleep apnea, they would have to come to a sleep lab, get hooked up to um uh various uh monitors looking at brainwave activity, uh. Uh uh flow channels to see if they're snoring or not.
SPEAKER_00Trevor Burrus, Jr. No, all that's very easy to monitor. It's pretty much just sticking a little thing and then placing something, you know, just it's there's nothing in what I would call invasive. It's very easy-going kind of Yes, yeah.
SPEAKER_01There there's no shots. No one's gonna have to do that.
SPEAKER_00Yeah, no, no needles, no. Okay. So the sleep study uh help. Because it you really need the facts for two reasons. You need to have facts to to prove that that's what's going on, but you really want to know how is it doing now so you can compare to it later, track them out.
SPEAKER_01Yeah, it's it's always great to get a baseline assessment of sleep apnea. Um because I mean there is a there is cures to sleep apnea in addition to supporting them on CPAP, but weight loss is a huge cure to it. And uh and that gets patients very motivated to start their weight loss journey. If they know I got this disease, and if I lose weight, uh besides looking good and feeling feeling well, um sleep apnea may cure this diagnosis.
SPEAKER_00Trevor Burrus, Jr.: Because you'll be telling them how many times a night and what's the impact on their oxygen, and if if it's borderline, you they might be really excited to see it get better if they're able to make those changes.
SPEAKER_01Aaron Powell Yes. Yeah, and and if and if they can see um the improvement and um especially if they no longer have to wear CPAP, hopefully that gives them more more motivation to keep the weight off after they've gone through whether it's bariatric surgery or extensive weight loss efforts, um I think it's more mo may be a more motivated factor for them to realize, hey, I had severe sleep apnea, I lost the weight, this is my reward, I don't have to deal with CPAP anymore.
SPEAKER_00The the sleep center, um, you know, I've had friends that have gone through that, and it's it's pretty straightforward. You arrive at the sleep center. Well, it's set up, you know, ahead of time with instructions on how to prepare, but pretty much a person arrives around a particular time, around eight. Yeah, in the in the evening. Mm-hmm. And they'll tell you the exact time. They get you sort of set up, bring your own pillow, I imagine, that you're you like, and then um the comfortable bedroom. They almost looks like a regular bedroom, right? Except, you know, cameras and and wires. But but it's all made as made it as comfortable as possible to try to get some sleep. Yes. What happens during the sleep study? You just okay, you just go to sleep and wake up the next morning or is other things happen during the study?
SPEAKER_01So so the uh the patients are being monitored by a technician that throughout the night, yeah. Correct. One to make sure nothing emergent is uh is uh happening. So no, there's not a severe uh issue with uh because they're monitoring the heart, making sure it's beating in the normal way it should, yeah. Trevor Burrus Or if the oxygen is going too low. And if and in fact, if the sleep apnea is extremely severe, uh depending on how severe it may be, the technician may uh uh um uh interact later on in the sleep study and actually start treatment with CPAP if it's that severe.
SPEAKER_00Trevor Burrus Because that really helps decide what are the settings you would use on CPAP. And so since we have now said CPAP probably nine times, what does CPAP CPAP what does CPAP stand for?
SPEAKER_01So it stands for continuous positive airway pressure.
SPEAKER_00Okay. Now I you'd like breaking that down. So this goes throughout, as long as you're wearing it, it's continuously applying air pressure. Correct. Gentle enough that it doesn't feel like it's forcing it, but it's enough pressure so that it will go past any blockage that your relaxed tongue might cause.
SPEAKER_01Aaron Ross Powell Yes. Uh basically it works as a pneumatic splint. And you just want enough uh positive pressure to keep the air away from uh collapsing.
SPEAKER_00Trevor Burrus, Jr. Most people I've talked to, they don't snore anymore. Is that is that pretty com I mean I mean literally I've never had anybody tell me they snore after starting SNEP, CPAP, but I've not talked to thousands of people. Yeah. Is that the case? Is that it pretty much eliminates snoring?
SPEAKER_01Yeah, if it's the proper amount of CPAP, it eliminates the snoring.
SPEAKER_00Aaron Ross Powell And some CPAPs are just on the no in the nose, others are the nose in the mouth. Correct. And I think it takes a little getting used to. I mean, uh it's almost like having something touch your skin. Trevor Burrus, Jr. It does take time. It's a little bit of a Goldilocks effect.
SPEAKER_01And um everyone's different, and you just have to find what's right for them. Aaron Powell Is the CPAP something that's uh uh makes a noise while you're sleeping? Well it shouldn't. Sometimes if there it makes a noise and there may be an issue with the machines and I think I've heard these in the hospital, so they they are quiet.
SPEAKER_00They are quiet. To me, they're actually yes, it does make us it makes a sound, but it's almost a reassuring I mean it's it's to me, I'm I was always surprised how quiet it was. But you can hear it, but it's not it's nothing uh like uh that would distract you.
SPEAKER_01Trevor Burrus No, no.
SPEAKER_00And I think the benefit of uh eliminating the snoring and the absence of that sound by far and away uh I'd rather have the uh I'd rather have the sl the humming, the the very quiet humming than the snoring that's randomized. Yeah. And it could be like white noise. Think of it as well. Oh, that's what it is. That's what I thought it was, too. And okay, so I'm always very upset when I see this television commercial that shows people wearing CPAPs and they're sitting around a table having coffee and they're all wearing their CPAP masks, which nobody would ever do that, and they complain about them. And I always thought that was uh highly exaggerated. But um, do you find that sometimes the mask comes off while they're sleeping, or is that you know, w what do patients ask you for bad commercials they've seen on TV?
SPEAKER_01Well, hopefully they have friends and and then uh that have had CPAP and have benefit from CPAP. I think a lot of times that's a motivating factor. Because I think right off the bat when they hear I gotta wear a mask at night while I sleep, that's impossible. But I the the the one of the most important thing you can do for the patient is explain to them what obstructive sleep apnea is.
SPEAKER_00So kind of when you hear how important it is, i it it is something to say, well you may have a little a little uh getting used to but the benefit and I think the average person starts to weigh, yeah it's a little bit of this and I got to clean the machine and take good care of it. But then I get this benefit. I get all these benefits from it. How many people do get off of CPAP? Is there a w do you have a sort of a description of how many? Good question.
SPEAKER_01Majority of them will stay on it, especially if it's uh but if it's due to obesity or morbid obesity, if you lose around 20 percent of your body weight from baseline, that can make a noticeable difference into where you may not need CPAP anymore.
SPEAKER_00Trevor Burrus Now I am a little concerned about the folks that know they have sleep apnea. They were tested, they got the CPAP machine but it was a long time ago and they think one and done does it truly not change over five years, ten years?
SPEAKER_01I mean or should there be a checking in on Yeah yeah I mean the body changes your your sleep apnea is going to change that prescription of the amount of CPAP you may need uh will likely change depending if things have changed in your life. For instance, have you gained weight, lost weight? The settings might be different. Trevor Burrus And a lot of times too the technology is better.
SPEAKER_00It's more comfortable for the patient. Yeah there's different machines I guess over time. Some machines they've stopped making uh some for good reasons that there's just better options. What about clean the cleaning also I think is the big deal. I my infectious disease specialist so I know important you you you run distilled water through it so that's one of the things you put in it. But it's gotta you gotta keep it clean. And I think you went back to the if you've been on it a long time, wouldn't you just go back to this if you had the same symptoms you had back when you developed CPAP need or C sleep apnea in the past that's a signal to to get things checked out. Yeah.
SPEAKER_01If you're starting to realize that maybe the blood pressure is more difficult to control, you're feeling tired, even though you're compliant with the CPAP, it's a good idea to get back into um to see a specialist so they can evaluate to to see if that pressure is adequate for you.
SPEAKER_00Aaron Ross Powell Yeah so you start to notice I I'm getting headaches again or I'm sleeping during the day and you know some my blood pressure is not as well controlled. Yes. What other things come up regarding uh CPAP we we did I we didn't touch on it too much but there is some testing that could be done at home. What's your thoughts on that? Aaron Ross Powell So um with the diagnosis classically you would be diagnosed in a sleep lab with sleep apnea but now and actually a majority of the um patients these days who are diagnosed with sleep apnea is actually at home with uh portable monitoring now how does how do they get the portable monitor what's the what's the process they get the monitoring so they can test for sleep apnea at home well i i it it all depends on the um the referring physicians some of these can be mailed to the patient's home uh for instance with Lakeland Regional our sleep um uh uh home sleep study equipment is picked up at the sleep lab and we we do this to just to educate the patient on how to use the equipment and to place it properly because it's good to have that one-on-one the the the your the team that you have at the sleep center is wonderful I mean they they really are able to predict patients' questions answer patients' questions but get them set for that sleep test you know that night and it's one less anxiety provoking uh issue for the patient uh just imagine being a patient in a box is delivered to your house now sleep now open it up figure out how you're going to sleep with this stuff now I've I've always heard a few myths and I we think we've answered most of these so hopefully I we've covered it so if I snore I automatically have sleep apnea not automatically not automatic so snoring doesn't always equal but it's a clue and that that will bring bring that only overweight people have sleep apnea. Myth and you say that's a myth too and uh especially can run in the family because some folks are born with a certain shape of the jaw I'd know if I'd stopped breathing I I think that's uh that I think if it's if it's talk to if you talk to a patient and you're telling them about sleep apnea the patient might say I would know if I'm not breathing. Well but not if you're sleeping right and it's waking you up for just that little bit to just barely wake you up to start breathing and then you fall back asleep again. Exactly yeah so you may so that that that's a myth to say that I'd always know that I'd stopped breathing you may not know that you have sleep apnea. Correct sleep apnea is just annoying it's not dangerous. Is that a myth huge myth. Huge myth yeah I think the dangers and I and I had recently uh looked into a case of somebody who had at a young age is a stroke. Well they had a stroke because they had high blood pressure they had some heart failure and they had some heart arrhythmia where the heart wasn't beating nice and regular so it was called atrial fibrillation and little blood clots formed. And to unify it all, sleep apnea to play. They had untreated sleep apnea for some time, stressed the heart out, high blood pressure stressed the heart out, and they got to the point where they were having irregular heartbeats and the little clots that formed from that went up to the brain caused a stroke. So how how often do you see a patient with sleep apnea who didn't know they had it but something bad is happening. Very common we see that a lot of time in the hospital. Yeah we see it uh yeah because whatever bad thing happened that put them in the hospital they're also trying to address the sleep apnea which you know it's it's it's a little harder to to to get it all together but you would love to have had this discovered earlier. Trevor Burrus Correct yeah children can't get sleep apnea myth yeah so that that can happen depending upon the the the same factors. Trevor Burrus I think up to 4% of children can have sleep apnea and it's you're right it's the symptoms aren't as obvious but if they have difficulty um with attention and maybe if they're happen to be overweight for their age and the parents will say oh and the our little little kid snores and and stops snoring and then suddenly snores and gets up a lot during the night boy that that really does start to say well should we address the possibility of sleep apnea? Yeah. So that's great. And the last one was if I'm tired I just need more coffee. No I wish it was that simple that is that is not the uh not the way to go well I appreciate what all you and your team does at the sleep center. They they're excellent. So you have your clinic at the Kathleen Clinic. Where is that exactly located? So it's basically on uh Kathleen Road in I-4.
SPEAKER_01Oh yeah you can see it from the interstate just on the north side of the interstate. Yeah I'm very fortunate to have a great uh staff at Lakeland Regional to um help with the patient experience and um direct the patients and so so I'm able to see more patients, care for more patients and so we can help everyone out in the community.
SPEAKER_00It's just a very helpful very common topic and I think everyone can sort of help family and friends along with this. Well thank you very much. You're welcome thank you.