The LIGHT Center, T-90, College of the Redwoods (476-4290) - September 18, 2000

I had the opportunity to take a road trip down to the San Diego area over the summer to visit a friend. For those of you who have been reading this newsletter regularly, you will recognize this as the friend who responded to my newsletter about disability related grief, someone who is not unfamiliar to health problems. However, my friend is also very bright and very conscious of internal and cognitive changes.

I was a bit put off during the first few days of my visit by what appeared to me as an avoidance of extended conversation. In addition, my friend who is typically very verbal, was uncharacteristically quiet and distant. There were other things that I noticed including cognitive confusion, sensory hallucinations, inability to remember names of people well known to us, and episodes of tearfulness. Sometimes my friend would seemingly lose track of a conversation midstream, or forget where we were…Edmonton or San Diego.

Perhaps those of us who have been trained in the medical field are at a disadvantage, as there is the tendency to self-diagnose. It is gut wrenching to watch someone you have known for many years fall ill. It is also painful to see they themselves grapple with what might be wrong. In this case my friend, now 63, feared dementia, a slow deterioration of cognitive function like in Alzheimer’s. There exist many other types of dementia. My friend also feared mental illness. My friend’s biggest fear was to see the neurologist and be told "it’s all in your head".

Well after a great deal of testing a couple of things are clear. There appears to be no evidence of either mental illness or dementia. For my friend just about any other diagnosis would be a relief. However, a firm diagnosis is still pending. During an MRI in which the patient is strapped down and unable to move, my friend stopped breathing several times. Further diagnostic testing has revealed that this is happening numerous times during the night. This condition is called Central Sleep Apnea, and for those of you familiar with it, you will know that this is only one of many sleep disorders. Moreover, there are three primary types of Sleep Apnea; Obstructive, Central and Mixed.

It was amazing to me to think that a sleep disorder could create at least some of the severe symptoms that I observed. Given that Central Sleep Apnea is only a symptom of an underlying neurological problem, there is likely something else contributing to my friend’s problem. I was also surprised to learn that there are types of sleep disorders beyond the more common insomnia, narcolepsy and sleep apnea. Given that, it was not a giant leap to realize how both staff and students rely on a good night’s sleep for our cognitive, emotional and physical health.

Please send any comments to trish-blair@redwoods.edu

"Work like you don't need the money.  Love like you've never been hurt. Dance like nobody is watching."

--Mark Twain

This is the most common type of sleep apnea, and is caused by an obstruction in the throat during sleep. This involves brief periods of time when the individual stops breathing. In the obstructive type, this happens anywhere from every 10 to 60 seconds, or between snores. The obstruction referred to in the name can be due to a large tongue, enlarged tonsils, excess weight, or alcohol consumption prior to going to bed. Symptoms include:

• Loud snoring
• Morning headaches
• High blood pressure
• Dry mouth upon waking
• Depression
• Difficulty concentrating
• Rapid weight gain
• Excessive sweating at night

If left untreated, this can lead to heart attacks, strokes, impotence, irregular heartbeat and heart disease. There are tests and effective treatments for the condition.

This is characterized by the cessation of breathing during sleep, due to lack of effort. It is difficult to diagnose and is likely due to some other underlying neurological problem. Treatment is more difficult as the underlying problem must also be identified.

This is a combination of the above.