Allergy Consumer Review Issue #82

March 2006

Dear Everyone,

This month's featured article is on the little talked about relationship between Allergies and Sleep Apnea, a topic which I am sure will interest many of you. Sleep apnea, for those of you that do not know about it, is a sleep disorder where people literally stop breathing for a few seconds, sometimes hundreds of times a night. When they stop breathing, they can wake up and with mini-arousals they can return back to sleep, but the restorative sleep pattern is interrupted. The sleep apnea sufferer may think they were asleep all night but wake up exhausted.

Sleep apnea is a dangerous condition because it significantly increases the chances of a heart attack and stroke. It can only really be diagnosed in a sleep lab although there are many warning signs, including "gasping snoring".

I have been recently diagnosed with sleep apnea, and figured that since I have post nasal drip and congestion from allergic rhinitis which worsened during the night, then it was no wonder that I had apnea episodes. I am still going through the treatment process under medical supervision and deciding on all the actions I must take. Taking a prescription nasal spray (Flonase) and making some environmental changes in my sleeping environment has started to help, although I am under no delusion that I am "cured" as yet. I will keep you posted on my progress.

Keep Well.

Mercia Tapping
President / CEO AllergyBuyersClub.com
Contact Information

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Allergies, Sinusitis and Sleep Apnea
By Mercia Tapping, President, AllergyBuyersClub.com

Postnasal drip and nasal congestion, which are frequent symptoms of allergies and sinusitis, are also quite often present in patients suffering from a dangerous sleep disorder called “Sleep Apnea.” Many medical experts agree that during the night congestion due to allergies and sinus problems exacerbate or increase apnea episodes or point to some causal link between them.

Sleep Apnea

The most obvious symptom of sleep apnea is “gasping snoring.” Someone who has sleep apnea will literally stop breathing anywhere from a few seconds to a couple of minutes, up to 30 times or more per hour. The sleeper usually is unaware of the sleep interruptions but feels exhausted in the morning. The sleep apnea sufferer is both exhausted on a daily basis and chronically sleep deprived. Most concerning of all is the lack of oxygen when someone stops breathing which may precipitate a heart attack or stroke.

The relationship between these three medical conditions, while known and documented in medical literature, is not as fully explored in the treatment of sleep apnea as one might expect.

Sleep apnea is a serious sleep disorder in which breathing actually pauses or temporarily stops during sleep for 10 seconds or more, due to an obstruction of the airways. This can occur up to 20 or 30 times per hour, and as much as 300 times per night. During sleep, the soft tissues of the larynx relax too much, loses muscle tone and closes the air way, causing measurable blood deoxygenation. The body’s carbon dioxide levels rises to dangerously high levels. The frustrating aspect of this sleep disorder is that the sleep interruptions may not wake the sleeper up consciously, but the sleep cycle is being continually disrupted and the sleep apnea sufferer is chronically exhausted.

Although anyone at any age can develop sleep apnea, risk factors include being overweight, not having had your tonsils or adenoids removed, having a large tongue, having allergies or sinus problems, small throat opening and a thick neck. Although anyone can develop sleep apnea at any age, it is diagnosed more often in males who are pushed into a sleep study by their bed partners complaining of their snoring. At this time, it is believed that up to 25% of middle aged men suffer from sleep apnea and 10% of middle aged women.
www.pbs.org/secondopinion/episodes/obesity/medicalglossary

There are three types of sleep apnea: obstructive, central and mixed. If you think you might have sleep apnea, consult a physician, but the exact nature of the sleep disorder can only be diagnosed by having a sleep study, called a Polysomnogram.

Obstructive Sleep Apnea (OSA) is the most common form. Obstructive apneas can result in two problems: fragmented sleep and lowered levels of oxygen in the blood. The combination of sleep disturbance and oxygen starvation can result in multiple problems, including automobile accidents, hypertension, heart disease, and mood and memory problems.

Central Sleep Apnea is rare and people suffer from this type of apnea may be aware of their nightly awakenings. Central sleep apnea is a neurological condition which causes cessation of all respiratory effort during sleep. It is usually accompanied by a decrease in blood oxygen saturation. In this form of apnea, the airway may stay open, but the diaphragm and chest muscles stop working causing wanting of breathing. Falling levels of oxygen signal the brain causing the sleeper to awaken and resume breathing. Central apnea becomes more common as people grow older, and perhaps one in four people age 60 or older experience disturbed breathing during sleep. For most the problem is mild. It becomes more frequent and severe in people who have congestive heart failure or neurological disorders.

Mixed Sleep Apnea is a combination of OSA and central apnea. Mixed apnea usually starts with a central apnea component and then becomes obstructive in terms of symptoms.

Symptoms and Signs of Sleep Apnea:

• Falling asleep during the day at work, watching TV, in the car, etc.
• Loss of energy.
• Awakenings during the night.
• Waking up in the morning feeling exhausted even though you have been asleep all night.
• Not feeling well rested throughout the day.
• Trouble concentrating.
• Irritability, short temper.
• Forgetfulness
• Choking, gasping and/or pauses in breathing during sleep
• Mood or behavior changes.
• Anxiety or depressed.
• Decreased interest in sex.
• Also, no signs may be apparent, least of all to the sleeper. If they sleep alone, they might not be aware of any symptoms.
• And, the most important sign of all: Very loud and heavy snoring often interrupted by silence and then gasps.

Allergies, Sinusitis and Sleep Apnea

Allergic Rhinitis and Sinus symptoms are magnified at night because laying down only worsens symptoms such as congestion, postnasal drip and runny nose. Allergic and non-allergic rhinitis, and sinusitis are both thought to be contributing factors to the number of sleep apnea episodes during the night.

Allergic and non-allergic rhinitis are inflammation of the nasal passages or membranes and exhibit most of the same symptoms. However, allergic rhinitis is caused by an allergen such as dust mites, pet dander or pollen while non-allergic rhinitis can be caused by a number of different environmental factors such as tobacco smoke, hormones in the body or nasal polyps.

However, we do wish to emphasize that treating one’s sinus and allergy problems is not a “silver bullet” cure for sleep apnea sufferers, and self treatment is not recommended. Always consult a physician and request a sleep study to confirm the diagnosis.

Remedies to help Allergies and Sinusitis which could also lessen Sleep Apnea Episodes

For the allergy and sinus sufferers who have also ended up with sleep apnea, they may find that in addition to prescription nasal sprays taken at night like Flonase, some environmental changes may also be helpful. The degree of help must not be left to the self report of the sleeper, but should be measured accurately in a sleep study environment.

• Pulsatile Nasal Irrigation is the most effective way to clean your nasal passages of allergens which can cause congestion. This method is well documented in the medical literature as to its effectiveness in relieving sinus pain. Grossan’s Hydro-Pulse sinus and nasal irrigator cleans the cilia in your nose, which helps reduce sinus infections and other allergy symptoms.
• Humidifiers are also a great way to help out your nose and sinus problems. Humidifiers regulate the humidity to your personal comfort level, moistening the sinus and nasal passages making it easier to breathe, lessen snoring, and improve sleep quality.
• Hepa Air Purifiers which cleanse the air from allergens. Keeping the air clear of allergy causing particulates reduces the load on the sinuses and hence, congestion will be reduced.
• Dust Mite Covers for mattresses, bed boxes and pillows as well as hypoallergenic bedding can help protect you against allergic reactions due to dust mites.

Sleep Apnea is a very serious sleep disorder and can be treated by a variety of surgical, dental interventions and controlled by using a CPAP mask at night. Treatment should always be conducted by a sleep disorder medical specialist. However, if you also suffer from sinus and allergy conditions, we suggest that taking steps to generally improve your breathing at night might well lessen apnea episodes, since you will be better able to breathe through your nose. Only a sleep study can give you a definitive answer.

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