TORONTO, ONTARIO, CANADA – 2014/04/12: Female wearing the CPAP mask for treating the sleep apnea … [+] which is a type of sleep disorder characterized by pauses in breathing or instances of shallow or infrequent breathing during sleep. (Photo by Roberto Machado Noa/LightRocket via Getty Images)
LightRocket via Getty Images
A clinical trial is underway to evaluate the efficacy of Zepbound, a popular weight-loss drug, to also treat obstructive sleep apnea. If shown to be effective, Zepbound could potentially be covered by Medicare in the future, similar to how Wegovy will be covered since its manufacturer showed a clinical benefit in treating disease beyond just obesity; namely cardiovascular disease.
Nearly 30 million Americans have obstructive sleep apnea, but only 6 million are diagnosed with the condition according to the American Medical Association. The disease occurs when breathing is interrupted during sleep for longer than ten seconds for at least five times per hour. This typically occurs because the muscles around the throat relax during sleep, causing the airway to block and disrupt breathing. During normal daytime hours, the throat muscles keep the airway open to facilitate breathing. Given the millions of cases that go undiagnosed among Americans, providing awareness about the disease is crucial.
Although anyone can eventually get obstructive sleep apnea, it is more common among middle-aged and elderly individuals, as well as males. Additional risk factors for developing the disease include being overweight or obese, having a large or thick neck, having chronic nasal congestion, smoking and having anatomic abnormalities that result in blockage of the airway such as enlarged tonsils or adenoids.
Some patients will be diagnosed with obstructive sleep apnea and have no symptoms. However, most individuals with the disease may snore, feel unrested after sleep since the quality of sleep is fragmented due to interruptions in breathing and may be irritable. Additional symptoms include morning headache, depression and frequently falling asleep during the day.
Being diagnosed with obstructive sleep apnea usually requires visiting your doctor and participating in a detailed history and physical where your doctor would likely ask you questions about your sleep and bedtime routine. In addition, your doctor will do a detailed physical exam of your throat, neck and mouth. The definitive way to diagnose the disease is through a sleep study, which could be done at a specialized sleep center or even in the comfort of your home.
Various treatments for obstructive sleep apnea aim to improve the quality of sleep and resolve breathing disruptions. The primary treatment includes continuous positive airway pressure, or a machine that is connected to a mask that a patient puts on to deliver continuous air to help keep the airway open during sleep. Additional treatments could include oral appliances and even surgery in more severe cases. Finally, behavioral changes such as losing weight and sleeping on one’s side can be very helpful in mitigating the severity of the disease.
The condition does not only disrupt sleep, but can have profound effects on overall health. Repeated interruptions in sleep can result in fatigue and excessive daytime sleepiness which can result in irritability, as well as difficulty concentrating and impaired cognitive function. This can undoubtedly affect productivity at work or concentration at school for students. Obstructive sleep apnea can also increase the risk of cardiovascular disease. When breathing is interrupted for a period of time, blood oxygen levels drop, putting a strain on the heart that leads to increased blood pressure. The heart needs to work harder to provide adequate oxygenation to the blood, increasing the risk of high blood pressure which then invariably increases the risk of heart disease.
Importantly, many Americans with obstructive sleep apnea dismiss their symptoms as a part of normal aging or may not be fully aware of the condition itself; as 90% of people who have the disease don’t even know they have it, according to Johns Hopkins medicine. Raising awareness of this critical public health condition should be of paramount importance in helping Americans understand, treat and cope with the disease.
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