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Sleep Apnea: Cognitive Consequences

You may think you have learned to function while sleep deprived but the science shows that sleep deprivation compromises your performance. And it gets worse in unfamiliar circumstances or emergencies.

I didn’t know how tired I really was….

This is what I hear from patients that I treat for their sleep apnea. We adapt to many physical limitations over time; that ache in the neck, inability to sit without fidgeting due to back or hip discomfort, etc. What we often don’t notice or fail to acknowledge is a decline in our executive skills. The ability to “multitask” in familiar settings is fairly easy to maintain. New or occasional tasks however, show our decline in what is called “executive function”.

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Professional pilots practice emergency procedures often. Private pilots not so much. Sleep Apnea is a condition where during sleep the relaxed throat muscle and tongue block the airway for seconds at a time, causing fragmentation of sleep. One of the hallmark symptoms in Sleep Apnea is a decline in “cognitive function” or “executive functioning”. Pilots have high levels of executive functioning. Untreated sleep apnea can significantly affect that level of “multitasking”.

The report, Neurocognitive Consequences of Sleep Deprivation, details the decline of cognitive function as it relates to sleep deprivation. This is an excerpt from the report.

Accidents related to sleep deprivation have been estimated to have an annual economic impact of $43 to $56 billion.9 Motor vehicle accidents related to fatigue, drowsy driving, and falling asleep at the wheel are particularly common but often underestimated.10,11 Increased time awake, nocturnal circadian phase, reduced sleep duration, prolonged driving duration, and use of soporific medications have all been found to contribute to the occurrence of drowsy-driving and fatigue-related motor vehicle crashes.6,12,13 Studies of shift workers,14–16 truck drivers,17–19 medical residents,20–22 and airline pilots23–26 show an increased risk of crashes or near misses due to sleep deprivation.

 

Most people think they will have to go to a hospital into a sleep lab in order to be tested and then wear a CPAP machine at night for the rest of their lives. If you have apnea, you will have to manage it, as it worsens with age and weight. But, at least one of those factors you can minimize.

Great strides have been made in testing for Sleep Apnea. Today, diagnosis can be done with a home sleep test. This involves a small device, the size of a cell phone with a couple elastic straps that fit around the waist and an oxygen-like tubing to the nose and a finger clip. This device can effectively diagnose sleep apnea in the comfort of your own home and is often mailed to you and returned via mail.

Treatment options include CPAP, a breathing machine for those who want optimal treatment. Oral appliances, similar to a night guard can also be effective as an alternative to CPAP for those patients not wanting to wear CPAP or when traveling (such as work-related flying for pilots).

Diagnosis and treatment can be done and show that you are effectively treated, thereby negating any consequences for the commercial license of pilots, truck drivers, public transit personnel, or other professions involved with public transportation.

Dentists trained and experienced in treating sleep apnea with oral appliances work in conjunction with sleep physicians to manage apnea and help restore restful, restorative sleep to the brain and cardiovascular system.

If you are experiencing daytime sleepiness or your sleep mate complains of significant snoring, you may want to investigate diagnosis for sleep apnea. Give us a call to get started.

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