Hey, Doc, I'm so tired during the day, I just I don't know what's going on. Can you help me out here? Can you? Can you tell me what's wrong? That's one of the most common questions I get on an almost daily basis from my patients. And a major driver behind this is sleep apnea or, in medical terms, obstructive sleep apnea.

So we're going to blow through this pretty quick here. So the reality is that about 40% of people over 40 snore, and 70% of those people who snore have at least some degree of blockage of their airway or apnea when they sleep. It's estimated about 87 million Americans are at risk for sleep apnea. Unfortunately, only about 10% or less are ever evaluated for it. And of those that actually get evaluated, we're talking about 25% or less are successfully successfully treated. Can you see Pap, you can use drugs, more drugs, more sleep aids.

The reality of it is that it's a vicious problem with some huge implications. A lot of people say yeah, so what I snore, my wife has a quick breathing I'm not dead. It's not any big issue, right? Well, it is a big issue because from traffic data, we know that about $12.5 billion result in sleep related traffic accidents every year. And unfortunately, about 50% of deaths due to car accidents are in some shape or form due to sleep deprivation of the driver. The reality is a sleep deprivation and sleep apnea really increased the risk of having a fatal car accident.

The other thing that should kill your interest if you're a male, and some females as well is depression, sleep apnea and depression are closely tied together. And we know that people who have sleep apnea and some degree of depression have about a 50% chance of having erectile dysfunction. So seems a peculiar that the sleep would be tied to wrecked tile dysfunction, but it's well documented in the literature. So in reality, time will tell you know, people say it's just miles no big deal, right? Well, unfortunately it progresses with time. I've seen plenty of people that have gotten tested.

Maybe when they They're early 40s, or even 30s. And it's mild, not enough to really justify c pap rather intervention, and that they carry that label with them for the rest of their lives. They say why I was tested for sleep apnea, and it's no big deal. Well, it progresses sleep apnea, like most medical conditions, worsens, if it's untreated over time. And so what was true for a person in their late 30s, early 40s is unlikely to be true when they're 50 and 60, and snoring and fatigue and all the other things that go along with that. So some of the issues I want you to know about is sleep deprivation is tied to weight gain increased for diabetes increased was for high blood pressure, reptile dysfunction, hormone dysregulation, a whole host of things that nobody wants.

So what about a solution? Is there something simple that we can use? c pap and bipap. This is continuous positive airway pressure, and bipap is just basically there's more force on the inspiration and less force pushing back against the person on the exhalation. So those are the two most common things, but not so quick because things need to be re evaluated over time. Unfortunately, they set it and forget it mentality prevails in a lot of sleep centers around the country.

And so a person gets diagnosed with sleep apnea, they get a machine out the door, they go and they don't get re evaluated or retested to see where they're at, they may get some new equipment from time to time or have their machine adjusted. But really, I think the standard of care in the future is going to be bringing these people back and retesting them at some point to make sure that they're really truly getting the benefit from the machine. Unfortunately, a lot of people you know, they don't like to see Pap, it's uncomfortable. It takes a period of adjustment. You're sleeping with toe tubes and hoses and cords and some machine and it's a headache and a hassle. I totally get that.

But ignoring this really puts you at risk for death, just to put it in plain terms. The other thing to note that a lot of people are totally unaware of, is that long term use of these devices can cause what's called central apnea. And that really just affects how the brain triggers breathing. And this is a huge problem. This certainly has an increased risk for dying, having a stroke, having a heart attack while you sleep, a whole host of things. And so that's why getting retested at some point is important.

If you're a C pap user, talk to your doctor, the person gave you the machine and ask about retesting at some point in the future. Unfortunately, a lot of these machines are sitting on the shelves or in the closet collecting dust. There are some other options, some dual therapy. And what I mean by that is that dentists can fashion what's called an oral sleep appliance. And basically this just helps reposition the lower jaw in the tongue a little bit forward, opening up the airway and eliminating some of the snoring and decreasing or hopefully in some cases, even eliminating the app. Yeah, and some people who have severe problems need You know, a person who is 375 pounds and is five seven is going to have a lot different airway challenges and breathing challenges.

And somebody who say is, you know, six feet tall, 150 pounds, it's just the function of anatomy. There are some other things like tongue size. And the big takeaway point here, at least for men is that if your neck circumference is greater than 17 centimeters, this really increases the chance of having sleep apnea. So a simple measurement you can do right now at home with a tape measure. And if you're snoring and you have a neck that's bigger than 17 centimeters really behooves you to talk to your doctor about getting a sleep test done. The take home point is that if you suspect or you know that you have sleep apnea and you ignore it, it's at your own peril.

It's a huge issue with huge long term and devastating health consequences.