April Naples Health 2019

Ask the Experts

Q :

My physician suspects I have obstructive sleep apnea. Why have I been referred to a sleep lab? Jose Ruben Valle, M.D., NCH Physician Group, Sleep Medicine, answers: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. It can affect a person’s ability to safely perform normal daily activi- ties and can affect long-term health. Approximately 15 to 25 percent of adults are at risk for sleep apnea. Men are more commonly affected than women. The main symptoms of OSA are loud snoring, fatigue and daytime sleepiness. A proper study is key to treating OSA. Testing is usually performed in a sleep laboratory. A full sleep study is called a polysomnography. A polysom- nography measures breathing effort and airflow, oxygen level in your blood, heart rate and rhythm, duration of the various stages of sleep, body position and movement of the arms/legs. Dur- ing the test, you are monitored by a technician and your results are read by a board-certified sleep physician. Home monitoring devices are also available. The devices are an alterna- tive to conventional testing in a sleep laboratory if the clinician strongly sus- pects moderate or severe sleep apnea and the patient does not have other ill- nesses or sleep disorders. You may be referred to a sleep lab instead of a home sleep test if you have underlying medical problems such as asthma, heart failure, COPD and sei- zure disorder.

not have hypertension and/or a cardio- vascular condition. However, current research suggests otherwise. Based on a recent study in The New England Journal of Medi- cine , physicians now think white coat hypertension might signal that you are at risk of developing high blood pres- sure as a long-term condition. You may also have a higher risk of developing certain cardiovascular problems com- pared with people who have normal blood pressure. This study concluded that ambula- tory blood pressure measurements are a stronger predictor of all-cause and cardiovascular mortality than in-office blood pressure measurements are. If you suspect you have white coat hypertension or experience blood pressure fluctuations in other settings, talk to your doctor. You may be asked to wear an ambulatory blood pressure monitor for up to 24 hours to track your blood pressure and determine if you need treatment. Diagnosing and managing blood pressure is key to good cardiovascular health.

APPROXIMATELY 15 TO 25 PERCENT OF ADULTS ARE AT RISK FOR SLEEP APNEA.

What is white coat hypertension? Shona Velamakanni, M.D., FACC,

Cardiologist, NCH Heart Institute, answers: Healthcare professionals who take your blood pressure in a physician’s office often wear white coats. Previ- ously, experts considered that poten- tial stress or anxiety created by a doc- tor’s appointment resulted in a higher blood pressure than would result in a more relaxed environment such as your home. If your blood pressure returned to normal after your doctor’s visit, the assumption was that you did

14 NAPLES HEALTH APRIL - JUNE 2019

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