By Gerald W. Deas
I’m sure that you are familiar with the fairy tale “Snow White and the Seven Dwarfs.” As I recall, one of the dwarfs was named Sleepy. It seems that this little guy was always falling asleep, holding up the “hi ho” march. He should have scheduled an appointment to see his dwarf-mate Doc. If he visited my office, I probably would have diagnosed him with sleep apnea.
This medical condition is due to poor oxygenation of the brain, resulting from a narrowing and obstruction in the nose and throat area that reduces airflow and oxygen. To arrive at this conclusion I would have asked Sleepy the following questions:
• Do you fall asleep when you want to be awake?
• Does falling asleep affect your work and play with the other dwarfs?
• Do you feel tired after 10 hours of sleep?
• Do the other dwarfs say you snore, keeping them awake?
• Do the dwarfs tell you that you sometimes stop breathing when you are sleeping?
• Have you ever had an accident due to falling asleep?
•Do you have a problem remembering, like Dopey has?
If Sleepy answered yes to these questions, I would be even more certain that my diagnosis of sleep apnea was correct. Further questioning might also reveal that he experiences restless sleep, headaches, irritability, hypertension, and depression. I would also make him aware that this condition could cause him to have a stroke or even a heart attack.
How could Snow White get along without him? Sleep apnea can also be caused by an obstruction in the throat or nasal passages due to a deviated septum in the nose, allergic nasal polyps, enlarged tongue, or an enlargement of the tonsils and adenoids.
The diagnosis of sleep apnea is usually made in a sleep laboratory with instruments that monitor the heart, lungs, brain, and blood gases. After the diagnosis is made, the condition can be readily corrected with the use of a nasal instrument that can deliver a continuous, positive air stream to the throat. This procedure, known as C-PAP, eliminates snoring and improves oxygen going to the brain. If this treatment is not successful, excess tissue can be removed from the back of the throat with laser surgery.
I am sure that Sleepy would have been as happy as his dwarf-mate Happy, if this diagnosis had been made and treated. He could have enjoyed the company of Snow White along with the other six dwarfs, who could have enjoyed sleep without his snoring.
— Gerald W. Deas, M.D., is director of health education communications at SUNY Downstate Medical Center.