Athens Pulmonary & Sleep Medicine Blog

Labor Day: A Holiday Named, Somewhat Alarmingly, After Breathing Hard

Mon, 07 Sep 2026 11:00:24 GMT

Labor Day is the one federal holiday where America agrees, as a nation, to grill meat until it achieves the structural integrity of a hockey puck, wear white pants for the last socially sanctioned time until Memorial Day, and pretend that mattress sales are a legitimate reason for a three-day weekend. Nobody actually knows why we celebrate Labor Day. Ask ten people and eight of them will say "workers," one will say "the end of summer," and one — I am not making this up, this happened to me at an actual cookout in Athens, Georgia — will say "I think it's a Chevy thing."

It is not a Chevy thing. Labor Day was created in the 1880s to honor the American worker, back when a "long weekend" meant you only lost two fingers in the machinery instead of three. Since then, we've mostly repurposed it into a holiday for doing yard work so aggressive it requires its own recovery period, which brings me, by a route that would make a chiropractor weep, to the actual point of this article: labored breathing.

Yes. Labor Day. Labored breathing. I did not choose this pun. The English language handed it to me, unsolicited, the way your uncle hands you a sparkler and walks away.

The Great American Weekend of Overexertion

Here is what a typical Labor Day looks like for a large percentage of the population: you spend three months doing essentially no physical activity beyond walking to the mailbox and occasionally lifting a remote control. Then, on the first Monday in September, you decide this is the day you will move furniture, pressure-wash the driveway, coach a pickup football game against people half your age, and finish it off by carrying a cooler the size of a Kia up a flight of stairs.

Somewhere around the second flight, you notice you're breathing like a man being chased by a bear. You chalk it up to "being out of shape," pour a beverage, and move on with your life. This is a completely normal response. It is also, occasionally, exactly the wrong one.

A Reality-Based Labored Breathing Q&A

Q: I got winded carrying the cooler. Does that mean something is wrong with my lungs?

A: Probably not. It might mean you carried a cooler that weighed as much as a golden retriever up a flight of stairs while wearing flip-flops. Bodies are allowed to protest that.

Q: Okay, but I've gotten winded doing that same activity for three Labor Days in a row, and each year it gets a little worse.

A: Now we're having a different conversation. A pattern is not a coincidence; a pattern is data, and your body has been sending it to you for three years running.

Q: What if I just wait until after the holiday weekend to think about it?

A: You absolutely may do that. Many people do. They usually come see us in October, describing symptoms they first noticed at a Labor Day cookout, delivered with the tone of someone reporting a minor annoyance rather than something they've been quietly managing since Labor Day weekend.

Q: What if it's not exertion — what if I'm winded doing basically nothing?

A: That question you should not be waiting to ask a blog post. Call us.

The Part Where the Jokes Take a Breath

Here's the sincere version, because this matters more than the cooler joke: shortness of breath that shows up only with real exertion and resolves with rest is common and often unremarkable. Shortness of breath that's new, that's getting worse over weeks or months, that happens with less activity than it used to, or that shows up at rest or wakes you from sleep — that's your body flagging something that deserves an actual evaluation, not a wait-and-see approach that lasts until next Labor Day.

Conditions we see constantly at this practice — asthma, COPD, sleep apnea, heart-lung interactions — often announce themselves first as "I got more winded than I expected doing something I've always done." People explain it away for months, sometimes years, because the alternative is admitting it might be something. It's rarely nothing, and it's never something you should self-diagnose over a paper plate of ribs.

What To Actually Do About It

Notice the pattern, not just the incident. One rough Labor Day means little. Three rough Labor Days in a row, or breathlessness that's crept into everyday tasks, means it's time to get it checked.
Pay attention to nighttime, not just yard work. Snoring, gasping awake, or waking up as tired as you were when you went to bed is its own red flag — one that has nothing to do with cooler-lifting and everything to do with how you're breathing while you sleep.
Write down what actually happened. "Winded after two flights of stairs carrying 40 pounds" is useful information for a physician. "I felt weird" is not.
Don't wait for the holiday to be a diagnosis. If something felt off this weekend, that's the appointment-scheduling equivalent of your body raising its hand.

The Warm Landing

Labor Day is supposed to be a celebration of rest earned through work — a nice idea that we've mostly converted into an excuse to find out exactly how much yard our yard actually has. If this weekend left you more breathless than you expected, or if it confirmed something you'd already been noticing, that's worth a real conversation, not a "guess I'm getting older" shrug and a second helping of potato salad.

Our pulmonary and sleep medicine team spends every day helping people figure out the difference between "out of shape" and "something we should actually look at" — and we'd genuinely rather see you now, with your questions, than in October, with your symptoms.

Enjoy the long weekend. Wear the white pants if you must. Just don't let the labored part of Labor Day become your new normal.

Why Am I Huffing Like a Cartoon Wolf Just Walking to the Mailbox? A Serious Look at Shortness of Breath

Fri, 04 Sep 2026 14:00:19 GMT

I want to talk to you today about a medical symptom that has ended more promising rounds of golf, church-choir solos, and "I'll just carry all the grocery bags in one trip" plans than any other single phenomenon in human history: shortness of breath.

You know the feeling. You climb one flight of stairs — not the stairs of Machu Picchu, not the stairs leading to the Eiffel Tower's observation deck, just the stairs in your own house, the ones you built or bought specifically so you would not have to sleep on the first floor forever — and suddenly you are breathing like a marathon runner who has just been informed the marathon was actually 47 miles long and also uphill and also on fire.

Most of us respond to this the way we respond to most bodily warning signs, which is to say: we ignore it, blame it on something else, and continue living exactly as we were before. This is a mistake. Not a moral failing — I am not here to insult you, the reader, who I respect enormously and would trust to watch my car in a parking lot — but a genuine strategic error, the medical equivalent of hearing your smoke detector chirp and responding by removing the battery.

The "Reality-Based Shortness of Breath" Q&A

Q: I get winded walking to my mailbox now. Is that normal?

A: It might be. It also might not be. This is the maddening thing about shortness of breath: it is not one symptom, it is roughly four hundred symptoms wearing a single trench coat. It can mean you're out of shape. It can mean you have asthma. It can mean your heart is working harder than it should. It can mean fluid where fluid should not be. The only way to know which one you've got is to have someone with actual medical training look at you, rather than WebMD, whose diagnostic range runs the gamut from "mild dehydration" to "an extremely rare tropical parasite," with no stops in between.

Q: But I've always been "a little out of shape." Couldn't that just be it?

A: Sure! It could! Chronic conditions also love to disguise themselves as "just being out of shape," the same way a raccoon in a trench coat can, under sufficiently dim lighting and sufficiently low expectations, pass for a very small, oddly confident man. The trick is that real deconditioning develops gradually and predictably. New, worsening, or sudden shortness of breath — especially if it's showing up at rest, or waking you up at night, or coming with chest tightness, swelling, or a cough that won't quit — is your body sending a memo. Memos deserve to be read.

Q: I read online that it's probably just anxiety.

A: It might be anxiety! Anxiety is real, common, and absolutely capable of making your chest feel like it's in a vise grip operated by a very anxious blacksmith. But "it's probably anxiety" is also the internet's favorite way of letting you off the hook, right up there with "you probably just need more water" and "have you tried essential oils." A doctor can actually tell the difference between anxiety and, say, a lung or heart issue that needs treatment. Your search history cannot.

Q: Are you a senior citizen?

A: This question appears to have wandered in from a different questionnaire. But since you ask: shortness of breath does become more common with age, which many people quietly accept as a fair trade for four more decades of complaining about the government. It is not, however, something you're supposed to just accept. "I'm just getting older" has diagnosed exactly zero medical conditions.

Why This One's Worth Taking Seriously

Here's where I stop being funny for a minute, because this deserves it.

Shortness of breath is one of the body's most important alarm signals. It can be the first sign of asthma or COPD, a heart condition, a blood clot, or a lung problem that's been quietly progressing while you told yourself you were "just tired." The earlier a pulmonary or cardiac issue is caught, the more treatment options you have and the better those options tend to work. Waiting it out doesn't make the underlying cause disappear — it just gives it more time to work.

If your shortness of breath comes on suddenly, is severe, or arrives with chest pain, fainting, or blue-tinged lips, that's not a "schedule something for next month" situation — that's an emergency room situation, tonight, no exceptions.

For everything less dramatic but still persistent or worsening, it's still worth a real evaluation. You don't need to be certain something is wrong to get checked out. That's what we're here for.

What To Do About It

Track it. When does it happen — at rest, on exertion, lying flat? Write it down. Doctors love details almost as much as they love patients who show up to appointments on time.
Don't self-diagnose based on a symptom checker. A symptom checker's job is to cover every possibility simultaneously, which is why it will suggest both "mild allergies" and "a condition affecting fourteen people worldwide" with equal confidence.
Mention the small stuff too. A cough, mild swelling in your ankles, snoring your spouse complains about — these might be connected. Bring them all up.
Schedule the appointment. Not "eventually." Now. Future You will be extremely grateful to Present You for this one.

The Kicker

Your lungs have been quietly doing about 20,000 breaths a day for you without complaint, without a raise, without so much as a thank-you card. When they finally speak up, the least you can do is listen — and then call us, so we can help you breathe easier for the other 20,000 tomorrow.

If shortness of breath has been showing up uninvited, don't wait for it to explain itself. Schedule a consultation with our pulmonary specialists today — because "probably nothing" is a diagnosis nobody in this building is qualified to give you, and neither is your Wi-Fi router.

Your Lungs Do Not Care About Your Plans

Thu, 03 Sep 2026 13:45:32 GMT

Here is a fact about asthma that nobody tells you until you are wheezing in a Walgreens parking lot at 2 a.m.: your lungs do not care that you have plans. You could be halfway through mowing the lawn, halfway through a nice romantic evening, or halfway through explaining to your boss why the quarterly report is late, and your airways will simply announce, with zero warning and zero regard for your calendar, that they have decided to close for renovations.

I am bringing this up because a lot of people treat asthma the way they treat a "check engine" light: as a suggestion. It is not a suggestion. Roughly 25 million Americans have asthma, according to the Centers for Disease Control, which is a government agency that I assume also has asthma, given how often it wheezes to a halt right before a shutdown.

Asthma, for those lucky enough not to know, is a condition where your airways get inflamed and twitchy and narrow up in response to triggers, making it hard to breathe. It ranges from "mild annoyance" to "genuine medical emergency," and the tricky part is you don't always get to pick which one shows up.

The triggers themselves are a whole personality. Some people's lungs object to pollen. Some object to cats. Some object to cold air, which means their lungs are essentially small, judgmental Floridians. And some people's asthma is triggered by exercise, which — speaking as someone who has met my own gym membership card exactly four times — feels less like a medical condition and more like a valid excuse I wish I'd had in gym class.

Let's talk set piece, because your lungs deserve one. Here is a Frequently Asked Questions session, conducted entirely with your own respiratory system, which, based on my experience, answers everything in a tone of weary disappointment.

Q: Why now? I was fine five minutes ago.

A: You were never fine. You were simply between episodes.

Q: I feel a little tight in the chest, but I'm sure it will pass.

A: It will not pass. It will, however, get much more interesting around 3 a.m.

Q: Can I just use my inhaler from 2019 that I found in a jacket pocket?

A: You may use it. It will do roughly as much good as waving the jacket at your face.

Q: Do I really need an action plan from my doctor?

A: Yes. I am not a plan. I am weather.

That last answer, unfortunately, is the truest thing your lungs will ever say to you. Asthma behaves like weather — it has patterns, it has seasons, and it can absolutely still surprise you, which is exactly why a written asthma action plan from your physician matters so much. It tells you, in advance, what to do at each stage: what your daily control medication is, what to do when symptoms creep up, and when "creep up" has turned into "go to the emergency room, and do not stop for gas."

Here is the escalation nobody enjoys admitting to. Stage one is denial: a little cough here, a little tightness there, easily blamed on "allergies" or "that thing going around." Stage two is negotiation: rationing puffs from an inhaler like it's the last helicopter out of a war movie. Stage three is the part where you are gripping a steering wheel with both hands, driving yourself to urgent care because you didn't want to "make a big deal out of it," which is a sentence that has personally cost more lung tissue than every cigarette commercial from 1962 combined.

You do not have to get to stage three. That is really the whole point of this column, buried under the jokes like a vegetable under mashed potatoes. A pulmonologist can identify your specific triggers, get you on the right combination of controller and rescue medications, and build you a plan so that a bad asthma day is a manageable event instead of a plot twist.

Modern asthma treatment, by the way, is genuinely good. We're not in the era of "breathe into this paper bag and hope." There are inhaled corticosteroids, combination inhalers, and for more severe or stubborn cases, biologic medications that target the specific inflammation driving your symptoms — the kind of targeted treatment that, twenty years ago, would have sounded like science fiction, and now is just a Tuesday appointment.

If you are someone who has been quietly white-knuckling your way through wheezy nights, blaming it on being "out of shape," or treating your inhaler as a once-a-summer emergency flare rather than part of an actual plan — that is worth a real conversation with a pulmonologist, not just a pep talk from a guy writing jokes about your trachea.

Your lungs work every single minute of every single day without asking for a raise, a vacation, or so much as a thank-you card. The least you can do is not wait until 2 a.m. to take them seriously.

Breathe accordingly.

So You've Been Sentenced to a CPAP Machine: A Survival Guide

Mon, 31 Aug 2026 17:35:32 GMT

I want you to picture something. It is 11:47 p.m. You are lying in bed. Strapped to your face is a device that looks like it was designed by NASA engineers who were told to make something "vaguely elephant-adjacent," and it is connected by a tube to a machine on your nightstand that hums with the quiet confidence of a small, judgmental robot. This is your life now. Congratulations. You have sleep apnea, and your doctor has prescribed you a CPAP machine, which stands for Continuous Positive Airway Pressure, though most first-time users translate it as Consistently Perplexing Apparatus Predicament.

I am not making that up about the elephant thing. Go look at one. I'll wait.

Here is the situation, in case you are new to this: a whole lot of people who get handed a CPAP machine try it for a night or two, decide it feels like sleeping next to Darth Vader gargling, and quietly shove it in a closet, never to be spoken of again. This is a problem, because CPAP is spectacularly effective at treating obstructive sleep apnea, which is a condition where your throat tissue collapses at night and repeatedly cuts off your breathing, sometimes hundreds of times, which is not the sort of thing you want happening while you are unconscious and defenseless.

But getting used to CPAP is, for many people, roughly as smooth and dignified as teaching a raccoon to use a napkin. So let's talk about why, and what you can actually do about it.

The Big Three Struggles

The Mask. CPAP masks come in roughly nine hundred varieties — full-face masks, nasal masks, nasal pillow masks, and at least one design that appears to have been inspired by a jousting helmet. Whichever one your sleep lab handed you, there is an excellent chance it does not fit correctly, because fitting a mask to a sleeping human face is a bit like fitting a saddle to a cloud. Straps end up too tight, leaving a red groove across your forehead that makes you look like you lost a fight with a waffle iron. Or the straps are too loose, and air escapes with a sound best described as a tiny, furious whistle aimed directly into your eyeball at 3 a.m.

The Air. The machine pushes air into your nose and throat at a pressure that has been mathematically calculated by a sleep physician to keep your airway open. Your body, which has never seen this before and does not appreciate surprises, initially reacts as though someone is trying to inflate you like a pool float. Some people feel like they're fighting the machine to exhale. Some people swallow air and wake up feeling like they've eaten a hot air balloon.

Everything Else. Dry mouth. Stuffy nose. Feeling like a fighter pilot who somehow ended up in a Motel 6. A spouse who, for the first week, treats the whole apparatus as a delightful new hobby ("Show me the tube again!") and by week three has begun sleeping in the guest room. Claustrophobia. The distinct sensation, upon first putting it on, that you have joined a support group for people who used to have faces.

A Word From Our Sponsors: The CPAP Adjustment Q&A

Q: I put the mask on for four minutes last night before ripping it off in a panic. Is that progress?

A: Yes. Four minutes is more than three minutes. This is how the whole thing works. Nobody sleeps eight full hours on night one. Nobody.

Q: My mask leaks air directly into my eyeball every night at approximately 2:15 a.m. Is this a design flaw?

A: No, this is a fit flaw, and it is fixable. It is not, in fact, a permanent feature of your marriage to this machine.

Q: I feel like I'm suffocating, even though the machine is technically providing me with more air than I would otherwise be getting.

A: This sensation is extremely common and almost never reflects what is actually happening. Most modern machines have a feature that lowers pressure the moment you exhale, specifically so you don't feel like you're breathing into a hurricane. If yours doesn't have this and it's driving you nuts, that's a conversation for your provider, not a reason to give up.

Q: Are you a senior citizen who has never operated a piece of medical equipment more advanced than a thermometer?

A: You're in good company. So is roughly a third of everyone starting CPAP. The machine does not know or care how old you are. It just wants to help you breathe. Try to feel the same way about it.

Q: My mouth is drier than a legal deposition by the time I wake up.

A: Either you are mouth breathing while trying to use a nasal mask, or your humidifier may need some adjustment. It's best to talk to your healthcare provider to help resolve this issue to make sure you are addressing the root problem.

Okay, Seriously For a Minute

Here's the part where the jokes step aside, because this matters. Untreated sleep apnea is not a minor inconvenience. It's linked to high blood pressure, heart disease, stroke, type 2 diabetes, and daytime fatigue severe enough to make driving genuinely dangerous. CPAP, when it's used consistently, dramatically reduces those risks and — this is the part patients often don't expect — tends to change how they feel almost immediately. People describe waking up without a headache for the first time in years. Spouses describe getting a full night's sleep for the first time in years, mostly because the snoring stops.

The struggles in the first few weeks are real, but they are also almost always solvable. A poor mask fit isn't something to white-knuckle through — it's something to bring back to your provider so they can try a different style or size. Nasal congestion often improves with a humidified, heated tube. Claustrophobia responds well to simply wearing the mask for short stretches while awake and watching TV, before ever trying to sleep in it. None of this requires heroics. It requires troubleshooting, and troubleshooting is exactly what a good pulmonary and sleep medicine team is for.

What Actually Helps

Start small. Wear the mask while reading or watching television before attempting sleep in it. Let your face and brain get bored of it.
Get refitted, not frustrated. If it leaks, hurts, or leaves marks, that is a sizing or style problem, not a you problem.
Turn on the humidifier. Yes, again. It really is that important.
Use the ramp feature , if your machine has one — it starts at low pressure and gradually increases as you fall asleep, instead of blasting you the moment you lie down.
Track your data. Most machines report how many hours you used it and how effective it was. Bring that information to your follow-up appointment instead of guessing.
Give it time, and give your provider a call. Almost every common CPAP complaint has a known fix. You just have to ask.

If you've been prescribed CPAP and you're struggling — or if you suspect you have sleep apnea and haven't been evaluated yet — that's exactly the kind of thing our sleep medicine specialists handle every single day. You are not the first person to feel like you're wrestling an elephant at bedtime, and you will not be the last, but with the right adjustments, most people get there.

Sleep well. Or at least better than you did last night wearing that thing sideways.

So You Snore Like a Chainsaw Falling Down a Staircase: A Guide to Sleep Apnea

Fri, 28 Aug 2026 11:01:09 GMT

I want to tell you about the night my wife filmed me sleeping.

She did not do this because she is a filmmaker, or because we were making some kind of tender home movie for our anniversary. She did it because she wanted proof, admissible in a court of law, that the sound coming out of my face at 2 a.m. was not, as I had long claimed, "just a little snoring." It was, she said, "a sound like a dump truck backing over a family of geese." She showed me the video. I watched myself stop breathing. Then I watched myself gasp, snort, thrash slightly, and resume breathing, all without waking up, while she lay next to me fully awake and reconsidering her vows.

This, it turns out, is a real medical condition, and not — as I had hoped — a personality quirk. It is called obstructive sleep apnea, and if you have ever been elbowed awake by a loved one who is holding up a phone with a video on it, you may have it too.

Here is what is actually happening, minus the marital drama. When you have sleep apnea, the soft tissue in the back of your throat relaxes during sleep and partially or completely blocks your airway. Your brain notices you have stopped breathing — a thing brains tend to feel strongly about — and jolts you into a lighter stage of sleep just long enough to reopen the airway. Then you drop back into deep sleep, and the tissue collapses again, and the whole cycle repeats. Some people do this five times a night. Some people do this over 30 times an hour. I am not making that up: a person with severe sleep apnea can stop breathing more times in one night than I have finished a home improvement project in my entire life, which is zero.

You would think all this gasping and jolting would wake a person up. It does not, not really — which is the cruel genius of the disease. You sleep through the whole production, get eight hours of what you believe is sleep, and then spend your day feeling like a raccoon that has been shot with a tranquilizer dart but only a little bit.

The Symptoms, As Explained By People Who Are Not You

Sleep apnea has a public relations problem, in that the person who has it is the last to know. Below, for accuracy, is a straight-faced Q&A featuring the two authorities who actually know what's going on: your bed partner, and your own exhausted body.

Q: How will I know if I have sleep apnea?

A: You probably won't. But the person sleeping next to you will know immediately, will know at 1 a.m., 2 a.m., and 4 a.m., and will eventually know it well enough to describe your snoring in geological terms ("like tectonic plates").

Q: Are there other symptoms?

A: Yes. Waking up with a headache, as though your skull filed a complaint overnight. Waking up with a throat so dry you sound like a haunted door hinge. Falling asleep at your desk, in your car at red lights, or — and I say this with love, on behalf of every pulmonologist who has heard this exact story — during your own child's dance recital.

Q: Is daytime sleepiness really that big a deal?

A: According to actual research, drowsy driving contributes to tens of thousands of crashes every year, and untreated sleep apnea is one of the more common medical reasons a person nods off behind the wheel. So yes. It is that big a deal.

Q: What if I just push through it with coffee?

A: You can absolutely try this. Millions of Americans do, forming a proud, bleary-eyed brotherhood that treats caffeine less like a beverage and more like a life-support system. It does not fix sleep apnea. It just makes you a more jittery, more caffeinated version of a person who still isn't breathing properly at night.

Why This Is More Than a Snoring Problem

I want to pause the jokes here for one paragraph, because this next part matters and I am not going to be cute about it.

Every time your breathing stops, your oxygen level drops and your heart has to work harder. Do that dozens of times a night, for years, and the strain adds up. Sleep apnea is linked to high blood pressure, heart disease, stroke, type 2 diabetes, and — because the body is nothing if not thorough — a general fraying of your mood, memory, and patience for other human beings. This is a real medical condition with real consequences, and the fact that it comes packaged with funny snoring stories does not make it less serious. It just makes it more fixable if you actually deal with it, because, unlike a lot of things in medicine, this one has excellent, well-tested treatment options.

Which brings us to the good news.

What Actually Happens If You Get This Checked Out

You do not have to figure this out alone at 3 a.m. while your partner films you for evidence. Here, in the spirit of full disclosure, is roughly what happens if you come talk to us about it.

First, we talk. You describe your symptoms, and depending on what you say, we may not even need to send you to a video-adjacent lab experience — some patients qualify for a simplified sleep test they can do in the comfort of their own bed, no wires-to-a-machine-in-a-strange-room required. Other patients do a night at a formal sleep center, which I will describe honestly: you sleep in a room with roughly 40 wires attached to your head, chest, and legs, while someone in another room watches you sleep on a monitor, which sounds like the plot of a low-budget horror movie but is, in practice, just a very well-monitored nap.

Either way, we get data: how many times you stop breathing, how low your oxygen drops, how your body reacts. From there, the most common and most effective treatment is something called CPAP — continuous positive airway pressure — which is a small machine that gently pushes air through a mask to keep your airway open all night. I will be honest with you: the first night with a CPAP machine feels a little like Darth Vader has moved into your bedroom. But most people adjust within a few weeks, and the payoff is enormous: real deep sleep, a functioning brain the next day, a partner who no longer sleeps with one eye open, and a body that isn't quietly working overtime against you.

For patients who don't tolerate CPAP well, there are other options too — oral appliances that reposition your jaw, lifestyle changes, and in some cases surgical approaches. Nobody gets handed one solution and told to make it work or go home. This is exactly the kind of thing our team is built to sort through with you.

The Part Where I Stop Making Jokes and Just Tell You the Truth

If someone who loves you has ever elbowed you awake, held up a phone, and said "listen to this," please don't laugh it off the way I did for entirely too long. Get it checked. It is a simple test, a manageable condition, and an enormous, quiet improvement to your health, your mornings, and your marriage.

My wife, for the record, still has that video. She has never once let me forget it.

But she also says I don't sound like a dump truck anymore.

What is Sleep Apnea?

Sat, 29 Feb 2020 12:15:11 GMT

Obstructive Sleep Apnea (OSA) is a common sleep disorder that is estimated to impact 20 million adults in the United States. Unfortunately, according to the best estimates, approximately 80% of these patients remain undiagnosed.

What is obstructive sleep apnea syndrome?

Obstructive sleep apnea syndrome (OSAS) is a condition where your breathing stops for short spells when you are asleep. The word apnea means without breath, that is, the breathing stops. In the case of OSAS, the breathing stops because of an obstruction to the flow of air down your airway. The obstruction to the airflow occurs in the throat at the top of the airway.

You may also have episodes where your breathing becomes abnormally slow and shallow. This is called hypopnoea. Because there can also be these episodes of hypopnoea, doctors sometimes use the term obstructive sleep apnea/hypopnoea syndrome.

What happens in people with obstructive sleep apnea syndrome?

When we sleep, the throat muscles relax and become floppy (like other muscles). In most people, this does not affect breathing. If you have OSAS, the throat muscles become so relaxed and floppy during sleep that they cause a narrowing or even a complete blockage of the airway.

When your airway is narrowed and the airflow is restricted, at first this causes snoring. If there is a complete blockage then your breathing actually stops (apnea) for around 10 seconds. Your blood oxygen level then goes down and this is detected by your brain. Your brain then tells you to wake up and you make an extra effort to breathe. Then, you start to breathe again with a few deep breaths. You will normally go back off to sleep again quickly and will not even be aware that you have woken up.

Sometimes, the airway can just partially collapse and can lead to hypopnoea. Breathing becomes abnormally slow and shallow. If this happens, the amount of oxygen that is taken into your body can be halved. Hypopnoea episodes also usually last for around 10 seconds.

If someone watches you, he or she will notice that you stop breathing for a short time, and then make a loud snore and a snort, perhaps even sound as if you are briefly choking, briefly wake up, and then get straight back off to sleep.

It is quite common for many of us to have the odd episode of apnea when we are asleep, often finishing with a snort. This is of no concern. In fact, some people when they sleep have periods of 10-20 seconds when they do not breathe. However, people with OSAS have many such episodes during the night. For the diagnosis of OSAS you need to have at least five episodes of apnea, hypopnoea, or both events per hour of sleep. However, there are different levels of severity of OSAS (mild, moderate or severe). People with severe OSAS can have hundreds of episodes of apnea each night.

OSAS is classified as:

Mild OSAS - between 5-15 episodes an hour.
Moderate OSAS - between 16-30 episodes an hour.
Severe OSAS - more than 30 episodes an hour.

So, if you have OSAS, you wake up many times during the night. You will not remember most of these times but your sleep will have been greatly disturbed. As a consequence, you will usually feel sleepy during the day. Daytime sleepiness in someone who is a loud snorer at night is the classic hallmark of someone who has OSAS.

Who gets obstructive sleep apnea?

OSAS can occur at any age, including in children. However, it most commonly develops in middle aged men who are overweight or obese. It is thought that as many as 4 in 100 middle aged men and 2 in 100 middle aged women develop OSAS.

Due to the fact that the airway has an increased tendency to narrow more than normal, the following factors increase the risk of developing OSAS, or can make it worse.

Overweight and obesity. Particularly if you have a thick neck as the extra fat in the neck can squash the airway.
Drinking alcohol in the evening. Alcohol relaxes muscles more than usual and makes the brain less responsive an apnea episode. This may lead to more severe apnea episodes in people who may otherwise have mild OSAS.
Enlarged tonsils.
Taking sedative drugs such as sleeping tablets or tranquilisers.
Sleeping on your back rather than on your side.
Having a small or receding lower jaw (a jaw that is set back further than normal).
Smoking.
You may also have a family history of OSAS.

What are the symptoms of obstructive sleep apnea?

People with OSAS may not be aware that they have this problem as they do not usually remember the waking times at night. It is often a sleeping partner or a parent of a child with OSAS that is concerned about the loud snoring and the recurring episodes of apnea that they notice.

One or more of the following also commonly occur:

Daytime sleepiness. This is often different to just being tired. People with severe OSAS may fall asleep during the day with serious consequences. For example, when driving, especially on long monotonous journeys such as on a motorway. A particular concern is the increased frequency of car crashes involving drivers with OSAS. Drivers with OSAS have a 7-12 increased risk of having a car crash compared to average. You should not drive or operate machinery if you feel sleepy.
Poor concentration and mental functioning during the day. This can lead to problems at work.
Not feeling refreshed on waking.
Morning headaches.
Depression.
Being irritable during the day.
Some people with OSAS find that they get up to pass urine frequently during the night. Less common symptoms also include night sweats, reduced sex drive, and gastro-oesophageal reflux disease.
People with untreated OSAS also have an increased risk of developing high blood pressure. Having high blood pressure can increase your risk of having a heart attack or stroke. People with untreated OSAS may also have an increased risk of developing problems with blood sugar regulation.

How is OSAS diagnosed?

Epworth Sleepiness Scale

If you have daytime tiredness, sometimes a questionnaire is used to measure where you are on the Epworth Sleepiness Scale. This helps to gauge the level of sleepiness that you feel during the daytime. A high score indicates that you may have a sleeping disorder such as OSAS.

Tests to confirm OSAS

If you have symptoms that suggest OSAS, or a high score on the Epworth Sleepiness Scale, your GP may refer you to a specialist for tests. There are various types of test that can be done whilst you sleep. The ones done may be determined by local policies and availability of equipment. For example:

Your airflow may be measured while you sleep by using a probe placed under your nose.
A sensor may record snoring volume and body movement whilst you sleep.
The oxygen level in your blood can be monitored by a probe clipped onto your finger.
Breathing can be monitored and recorded by the use of special belts placed around the chest and abdomen.
A video of you sleeping may be helpful.
You may be asked to spend a night in hospital for the tests to be done. However, some of the tests may be done in your own home from equipment supplied by the specialist. The information gained from the tests can help a specialist to firmly diagnose or rule out OSAS.
Your doctor will usually check your blood pressure. (OSAS is associated with high blood pressure.) They may also suggest other tests to exclude other causes of your sleepiness. For example, a blood test can check for an underactive thyroid gland.

What is the treatment for OSAS?

General measures - Things that can make a big difference include:

Losing some weight if you are overweight or obese.

Not drinking alcohol for 4-6 hours before going to bed.

Not using sedative drugs.

Stopping smoking if you are a smoker.

Sleeping on your side or in a semi-propped position.

Continuous positive airway pressure (CPAP) - This is the most effective treatment for moderate or severe OSAS. It may be used to treat mild OSAS if other treatments are not successful. This treatment involves wearing a mask when you sleep. A quiet electrical pump is connected to the mask to pump room air into your nose at a slight pressure. The slightly increased air pressure keeps the throat open when you are breathing at night and so prevents the blockage of airflow. The improvement with this treatment is often very good, if not dramatic.

If CPAP works, (as it does in most cases) then there is an immediate improvement in sleep. Also, there is an improvement in daytime wellbeing as daytime sleepiness is abolished the next day. Snoring is also reduced or stopped. The device may be cumbersome to wear at night, but the benefits are usually well worth it. Comments like "I haven't slept as well for years" have been reported from some people after starting treatment with CPAP.

Lifelong treatment is needed. Sometimes you can have problems with throat irritation or dryness or bleeding inside you nose. However, newer CPAP machines tend to have a humidifier fitted which helps to reduce these problems.

Mandibular advancement devices

The mandible is the lower jaw. There are devices that you can wear inside your mouth when you sleep. They work by pulling the mandible forward a little so that your throat may not narrow as much in the night. These devices look a bit like gum shields that sports-people wear. Although you can buy these devices without a prescription, it is best to get one properly fitted by a dentist if one is recommended. These devices work well in some cases. They tend to be used in mild OSAS or in people who are unable to tolerate CPAP treatment.

Surgery

Surgery is not often used to treat OSAS. However, sometimes an operation may be helpful to increase the airflow into your airway. For example, if you have large tonsils or adenoids, it may help if these are removed. This is more commonly done in children with OSAS. If you have any nasal blockages, an operation may help to clear the blockage.

What is Asthma?

Sat, 29 Feb 2020 12:15:11 GMT

Asthma is a condition that can make it hard to breathe. Asthma does not always cause symptoms. But when symptoms occur, they can be scary. Asthma attacks happen when the airways in the lungs become narrow and inflamed. Asthma can run in families.

What are the symptoms of asthma?

Asthma symptoms can include:

Wheezing or noisy breathing
Coughing
A tight feeling in the chest
Shortness of breath

Symptoms can happen each day, each week, or less often. Symptoms can range from mild to severe. Although it is rare, an episode of asthma can sometimes even lead to death.

Is there a test for asthma?

Yes. Your doctor will ask you about your symptoms and have you do a breathing test to see how your lungs are working.

How is asthma treated?

Asthma is treated with different types of medicines. The medicines can be inhalers, liquids, or pills. Your doctor will prescribe medicine based on how often you have symptoms and how serious your symptoms are. Asthma medicines work in one of two ways:

Quick-relief medicines stop symptoms quickly — in 5 to 15 minutes. Almost everyone with asthma has a quick-relief inhaler that they carry with them. People use these medicines whenever they have asthma symptoms. Most people need these medicines 1 or 2 times a week—or less often. But when asthma symptoms get worse, more doses may be needed. Some people can feel shaky after taking these medicines.
Long-term controller medicines control asthma and prevent future symptoms. People with frequent asthma symptoms take these one or two times each day.

It is very important that you take all the medicines the doctor prescribes, exactly how you are supposed to take them. You might have to take medicines a few times a day. You might not feel a medicine working, but that does not mean it is not helping you.

Asthma that is not treated with the right medicines can damage the lungs. Plus, not taking your medicines correctly can cause symptoms to get worse and even require a trip to the hospital.

What is an asthma action plan?

An asthma action plan is a list of instructions that tell you:

Which medicines to use each day at home
Which medicines to take if your symptoms get worse
When to get help or call 9-1-1

If you have frequent or severe asthma symptoms, your doctor might suggest that you have an asthma action plan. If so, you and your doctor will work together to make one. As part of your action plan, you may need to use something called a “peak flow meter.” Breathing into this device will show how your lungs are working. Your doctor will show you the right way to use your inhaler and peak flow meter.

Should I see a doctor or nurse?

Yes. Call 9-1-1 for an ambulance if you have a severe asthma attack and your symptoms:

Get worse or
Do not improve after using a quick-relief medicine

What are some triggers of asthma?

Dust
Mold
Animals, such as dogs and cats
Pollen and plants
Cigarette smoke
Getting sick with a cold or flu (that’s why it’s important to get a flu shot)
Exercise
Stress

If you need asthma medicine every day, you should see your doctor every 6 months or more often.

Can asthma symptoms be prevented?

Yes. You can help prevent your asthma symptoms. You can stay away from things that cause your symptoms or make them worse. Doctors call these “triggers.” If you know what your triggers are, avoid them as much as possible. Some common triggers include:

If you can’t avoid certain triggers, talk with your doctor about what you can do. For example, exercise can be good for people with asthma. But you may need to take an extra dose of your quick-relief inhaler medicine before you exercise.

What if I want to get pregnant?

If you want to get pregnant, talk to your doctor about how to control your asthma. Keeping your asthma well-controlled is important for the health of your baby. Most asthma medicines are safe to take if you are pregnant