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The "Bear" Facts About Sleep Apnea

by StephenKelly

Laugh and the world laughs with you; snore and you sleep alone. — Anthony Burgess

If you've ever loved or been close to a plus-size gay man, you're no doubt familiar with the nocturnal growling of the sleeping bear — characterized by loud, intense snoring and punctuated by minutes of silence, followed by snorting or gasping, as if the sleeper were fighting for breath.

It sounds that way because that's exactly what's happening. Welcome to the world of sleep apnea, a serious and progressive disorder that afflicts some 18 million Americans and countless others worldwide. More common than adult diabetes, sleep apnea is the result of collapsed tracheal airways that prevent air from getting to the lungs and circulatory system during sleep. This oxygen deprivation puts stress on the entire body, preventing the deep, restful sleep the body needs to operate efficiently.

During these "apneic events," breathing can stop for 10 seconds or more, sometimes 60 times an hour, hundreds of times per night. A potentially fatal condition, untreated sleep apnea has contributed to the deaths of Grateful Dead guitarist Jerry Garcia, football great Reggie White and actor and gay icon Divine (aka Glen Milstead).

Not surprisingly, oxygen deprivation from sleep apnea has been linked to a host of health disorders, including heart disease, stroke, hypertension, impotence and depression, the same conditions associated with obesity. In fact, the dramatic increase in sleep apnea can be directly paralleled to the worldwide rise in obesity.

Indeed, most overweight people suffer from sleep apnea, as the condition can be brought on by excess fat in the throat muscles and soft palette of the mouth, leading to blockage while sleeping. David Pisarra, whose Los Angeles-based Gateway SleepLabs specializes in the diagnosis of sleep apnea, calls the link between obesity and sleep apnea "a vicious cycle. Sleep deprivation affects metabolism. As metabolism is lowered, weight gain occurs. As weight in the throat increases, so does sleep apnea."

And while the bear community may be on the front line of this condition, sleep apnea can strike people of all ages, body types and walks of life. Yet very few people are aware that they have this potentially life-threatening disorder and even fewer seek treatment. According to Pisarra, men sometimes disregard the warning signs. "We do one of two things -- we either brag about being a 'world-class snorer' or we minimize its effect on our life. The problem is that snoring is nature's way of alerting us."

Ironically, while sufferers of sleep apnea rarely know they have this dangerous condition, very often it's their long-suffering partners, whose own sleep is constantly disrupted by the din of nighttime snoring, who bring it to their attention.

"Sleep apnea can put a huge strain on relationships," Pisarra said, noting that the partner can often lose an hour or two of sleep a night. "Usually one partner has normal sleep patterns. They're the alert ones who are being waken up by the snoring." Pisarra jokes about the "midnight jab" or an elbow to the ribs to wake the snorer. Still, the lack of efficient sleep for both parties can lead to frayed nerves and strained relationships.

Whether the sufferer seeks treatment because of relationship tensions or the obvious health risks, the good news is that there are many ways to alleviate, if not eliminate, this condition. Losing weight is one of them. A loss of 10 pounds may be all that's needed to drastically reduce the incidences of sleep apnea. Avoiding muscle relaxants such as alcohol, tobacco and drugs before bed and sleeping on your side can also help.

Those who seek professional diagnosis are usually administered a polysomnography, an overnight sleep test that monitors body functions like brain waves, muscle tension, eye movement and oxygen in the blood during sleep. This painless test can be administered at home or in professional facilities and can determine the type and severity of sleep apnea.

People diagnosed with moderate to sever sleep apnea are usually treated with a CPAP (continuous positive airway pressure) machine that blows air into the nose through a thin, light mask during sleep to keep the airways open and unobstructed. CPAP is considered the most effective treatment for snoring and obstructive sleep apnea. The drawback is that it must be used every night to ensure efficient sleep.

Despite these relatively easy ways of diagnosing and treating sleep apnea, it's surprising that millions of people go untreated. Pisarra acknowledges that, as society focuses on diseases such as west Nile virus and avian flu, the information needed to educate people about sleep apnea has been slow in coming. "We need a poster child," he said. "A way to put a face on this dangerous disorder." If only Divine were still around.