Everybody’s busy these days. Kids, work, family drama, professional obligations, maintaining a home, and making ends meet all within 24 hours can cause some folks to minimize the hours of sleep they get each night. If you want to be at the top of your game, it’s recommended that you get between 7 to 9 hours of sleep nightly. However, the latest stats from the Center of Disease Control and Prevention found that more than 35% of adult Americans are sleeping less than that. And when age and race come into the mix, almost 46% of Black Americans just aren't sleeping enough.
While sleep deficiency can cause you to feel fatigued, it can also lead to far more concerning conditions such as an increased risk of heart disease, high blood pressure, stroke, and depression. Furthermore, it can affect your metabolic system leading to weight gain and increase your risk of diabetes.
Although some people experience insomnia from time to time, if you experience excessive daytime sleepiness or have been told that you snore or gasp while you sleep, you should speak with a healthcare professional. You could have a condition called sleep apnea. It’s a sleep disorder that occurs when you stop breathing and start again while sleeping causing loud snoring and tiredness during the day. If left untreated, however, it can lead to other serious medical issues like heart disease and high blood pressure.
To get a better understanding of sleep apnea and why more Black men have been dying at higher rates than other groups, BET.com spoke with Osezemeghonghon "Dr. Seze" Obilor MD, a sleep medicine doctor at Dignity Health St John's Medical Center, in Oxnard, CA.
BET.com: Can you please explain sleep apnea in its simplest form?
Dr. Seze: It means when you sleep, you're not breathing well. It occurs either because you have episodes where you completely stop breathing for a minimum of 10 seconds or, even if you're breathing, they're shallow breaths causing your oxygenation to drop by 3 to 4 percent for a minimum of 10 seconds. These episodes can repeatedly happen throughout the night while you're sleeping, and you never get quality sleep because your body's struggling to breathe the whole time.
BET.com: Why are men more predisposed to sleep apnea, and why are Black men the most at risk?
Dr. Seze: Testosterone affects the soft tissue in the palate in your mouth, making it looser and more relaxed. Men have higher testosterone levels than women, but you may see it more in postmenopausal women as estrogen levels decrease.
When it comes to Black men, part of it is because we're diagnosing it more now that more people are finally becoming more aware of it. Also, for those who don't get diagnosed, when they develop other medical problems, like diabetes, hypertension, strokes, and heart attacks, which, unfortunately, are already at a higher incidence in Black men, as doctors, we now think to check for sleep apnea. We now know that sleep apnea accompanies these things and can also make treatment of those other medical conditions very difficult.
BET.com: What are the symptoms and signs of sleep apnea?
Dr. Seze: Fatigue is one of the most common symptoms that lasts all day, but some people may experience headaches in the morning when they first wake up. Typically, it will disappear throughout the day. Some people will have dry mouths and sore throats when they wake up from having decreased sleep apnea.
You can also experience interrupted breathing as you sleep. Some people will experience parasomnias which are things that really shouldn't happen while you're asleep, like sleep talking, sleepwalking, kicking in your sleep, and teeth grinding. Also, for people who already have things like restless legs, it can worsen because of sleep apnea.
BET.com: Since things like sleep talking and teeth grinding can occur without being related to sleep apnea, how do you know when you should see your doctor?
Dr. Seze: There are some screening tools [like sleep studies] for sleep apnea; You can also Google the "Stop Bang" questionnaire. It's an acronym for things that you check off. In general, if you answer yes to having three or more of these issues, you may have sleep apnea.
S: Snoring. Do you snore?
T: Tired. Are you tired?'
O: Observing. Has anyone observed you stop breathing as you sleep?
P: Pressure. Do you have high blood pressure?
B: BMI (body mass index). Is it higher than 35? (calculate your BMI here)
A: Age. Are you over 50?
N: Neck. Is the circumference greater than 17 inches (43.2 centimeters) for men and greater than 16 inches (40.6 centimeters) in women?
G: Gender. Are you male?
There’s also a possibility that some people with sleep apnea may not score three or more on this test, and that's one of the reasons why it's such an under-diagnosed condition.
BET.com: Is it often underdiagnosed and misdiagnosed?
Dr. Seze: Yes, but mostly under-diagnosed, especially now because, with the way society is, a lot of people are working two to three jobs. So when people feel tired, they ignore the fatigue and the tiredness or chalk it up to something else like taking certain meds.
However, even if some people think they have it, they are very shy about being diagnosed with sleep apnea because nobody wants to use a CPAP (Continuous positive airway pressure) machine. It deters people from speaking out loud about it early enough to treat it because I'll have people who are referred to me, and the first thing they say is, 'I don't want to live with this machine.' But you may not have to use it; for some, other options exist.
BET.com: What are the other options, and how does the CPAP machine work?
Dr. Seze: If you have been diagnosed with a mild case, behavioral changes like sleeping on your side or stomach instead of your back can help. When you sleep on your back, your airway collapses more—making it harder for you to breathe while you sleep. Also, if you drink alcohol, you should make sure not to do so three or four hours before bedtime because it relaxes the airway muscles, and you will have more airway narrowing.
If you are overweight, losing weight can help, but it doesn't always eliminate it. Also, if you are really fit, especially like a bodybuilder, and have a thick neck from lifting weights and building muscles, that added weight in the neck can also contribute to sleep apnea.
The CPAP machine is the most common treatment. It takes the air you are breathing and pushes it into the airway opening it so that you don't have that collapse and you don't snore anymore. There's no medication; it's just air with a little push behind it to get it where it needs to go. After trying all other options, the last resort would be surgery. Some children with enlarged tonsils had them removed and that took care of their sleep apnea.