Sleep Apnea


General Psychology
Steven O\'Brien, Psy.D

Sleep, why do people sleep at all? Why can\'t we just stay awake? Some
biologist suggest that sleep provides the opportunity to conduct self-repair and
purge the body of it\'s waste that has built up during the day\'s activity.
Nevertheless, the body is capable of repairing itself and disposing of wastes
during waking hours, so sleep in a way really isn\'t necessary for routine
maintenance (e.g., urinating, etc.). Dr. Quentin Regestein, lead sleep and sleep
disorders researcher at Harvard Medical School also believed that sleep kept our
distant ancestors out of harms way during the night when they could not see as
well as their night roaming predators.
Sleep is regulated by a connected series of structures in the deep midline
areas, and along other way stations that extend through the central axis of the
brain, these structures relay information about things that affect sleep. In Dr.
Regestein notes, he spoke of experiments that were performed by researchers.
The researchers he spoke of would destroy specific brain structures of a lab
animal and then note how the animal slept. For instances, in one lab animal
the researcher cut through the axis of the brain at one level, which would
prevented the animal from awakening; showing that brain structures below the
level of the cut were responsible for awakening the lab animal.
The American Sleep Disorders Association (ASDA), Association for the
Psychophysiological Study of Sleep (APSS), Association of Sleep Disorder Centers
(ASDC), and the American Psychiatric Association (APA) has studied sleep and
sleep disorders since the early 1970\'s. Out of all the sleep disorders
currently being studied, sleep apnea has gain world wide attention, affecting
over 15 million people. Apnea, derived from the Greek word "want to breath."
Sleep Apnea (cessation of air flow at the mouth for greater than 10 seconds) can
reflect 1) loss of central nervous system drive to maintain ventilation, 2)
mechanical upper airway obstruction, or combinations of both. The second
edition of Anesthesia and Co-Existing Disease states "Conversely, obstructive
forms of sleep apnea are due to an abnormal relaxation of the posterior
pharyngeal muscles" - there is persistence of respiratory movements, but airflow
is absent due to upper airway obstruction. Study shows awakening occurs when the
arterial partial pressure of carbon dioxide rise or oxygen falls. Severe apnea,
which affects about 1 percent of the general adult population, often results in
400-500 awakenings a night. Moreover, depending on the severity and the number
of episodes of sleep apnea, the patient\'s daily life and survival can be greatly
endangered. According to the Wisconsin Sleep Cohort Study, over an eight-year
period, a 37 percent death rate has been reported among persons with apnea (20
episodes or more per hour). The Wisconsin Sleep Cohort Study also reported sleep
apnea is more likely to occur in men then women, for the male hormone,
testosterone is believed to be related to sleep apnea. Admittedly, researchers
believe a female hormone, progesterone stimulates respiration and therefore may
help prevent breathing problems. In the Wisconsin Sleep Cohort Study, the
researchers noted a strong link between smoking and sleep apnea. Smokers that
smoked 40 or more cigarettes a day had the greatest risk of developing sleep
apnea then patients who had never smoked. The medical community has yet to fully
understand the intra play of factors producing the sleep apnea syndrome.
Sleep affects psychological well-being. Because sleep apnea deprives
patients of sleep, numerous of studies have consistently shown that sleep loss
affects daytime performance, sleepiness and mood. One of the first capacities
that Dr. Arthur J. Speilman of the Department of Psychology in New York spoke of,
is the ability to produce creative solutions to problems., and how being deprive
of sleep can impair a patients functional capacity. Dr. Paul Glovinsky, Dr.
Spielman\'s research colleague noted "the focus of psychology is behavior, which
at first glance might be thought to cease during sleep". Dr. Glovinsky also
noted "neither the mind nor the body truly cease activity during sleep. Far
from turning off, the brain in sleep generates a variety of states , accompanied
by predictable physiological changes and typical forms of mentation." By
studying Drs. Speilman and Glovinsky works one can conclude, the sleeplessness
of sleep apnea or the prolonged wakefulness of creative output, the timing of
physiological rhythms can be affected by psychological states.
In 1988 a congressional commission determined that sleep related
problems cost American Society 50 billion dollars a year and that 95% of
individuals with sleep disorders were going undiagnosed. According to the
American Academy of Family Physician (AAFP), The standard method for diagnosing
sleep apnea is