April 18 has been designated Sleep Apnea Awareness Day, the American Sleep Apnea Association announced today. The association called upon all who are concerned about sleep apnea—health professionals, patients, and their advocates—to make special efforts on April 18 to alert the public to this serious, chronic, life-shortening disease. An estimated 18 million Americans or more are believed to have this disease, and three-quarters of them don’t know it.
Over time, untreated sleep apnea can lead to hypertension, chronic heart failure, stroke, diabetes, depression, excessive daytime sleepiness that causes automobile accidents, and other serious and often fatal consequences. “Every day is sleep apnea awareness day at the ASAA,” said executive director Edward Grandi. “We created Sleep Apnea Awareness Day because we believe that educating people about sleep apnea’s dangers is everybody’s job, not ours alone.”
Why April 18? “April 18, 1981, is the day Dr. Colin Sullivan’s historic article describing his invention of the continuous positive airway pressure machine was published in The Lancet, the British medical journal,” Grandi said. “CPAP therapy revolutionized the treatment of sleep apnea.” Sullivan, an Australian, is a respiratory physician and a professor of medicine at the University of Sydney.
Prior to Sullivan’s discovery, the only effective treatments for severe sleep apnea were, in some cases, radical weight loss or major surgery—a tracheotomy. The surgical procedure creates an opening through the throat to the windpipe that the patient corks closed during the day to permit speaking and leaves open at night so that breathing isn’t interrupted during sleep.
In obstructive sleep apnea, sleep apnea’s most frequent form, the sleeper’s tongue and soft palate fall back against the back of the throat closing off the airway so firmly that the sleeper doesn’t inhale or inhales only partially in repeated episodes that last 10 seconds or longer. In patients with severe sleep apnea, the episodes can recur hundreds of time during the night, giving rise to fragmented sleep, excessive daytime sleepiness, and damage to the cardiovascular and metabolic systems from repeated oxygen deficiency.
Sullivan’s machine, which he cobbled together from a makeshift face mask, a hose, and vacuum cleaner motor, blew a steady stream of air through the sleeper’s nose into the airway, preventing it from collapsing, Grandi said. Sullivan originally intended the machine to be used as a stopgap while the patient was prepared for surgery, but it became clear almost immediately that for patients who could learn to use the device properly and routinely, the device itself offered a permanent cure. Within months of the publication of Sullivan’s article, physicians all over the world were crafting their own versions of the CPAP machine. Full-scale manufacturing followed soon after.
Since those early days of positive airway pressure therapy three decades ago, many refinements of the PAP machine have been introduced and practitioners have developed a variety of other therapies that are effective for some sleep apnea patients. None of the therapies, however, is of any benefit to the 13 million-plus people who have sleep apnea and don’t know it. If you regularly awaken exhausted after a full night’s sleep, if you snore, if you are seriously overweight, you may be one of them. If you have none of these characteristics, you may still be one of them. Only through a sleep study conducted in your home bedroom on in a sleep laboratory can you and your health care provider know for sure.For more information, visit the ASAA web site www.sleepapnea.org