by Geoff Rand

In Part 1 of Sleep On It, we explored the effects of lack of sleep and explained why it is so important to get adequate sleep, not only as it relates to seeing results from your workouts, but also as it pertains to your overall health.  For many, making a few daily schedule adjustments may be all they need to get a few more hours of shuteye.  But what if no matter how much you sleep you are still waking up tired?

It is estimated that 22 million Americans have sleep apnea and up to 80 percent of the cases of moderate to severe sleep apnea go undiagnosed.  Many people just accept that they or their partner are loud snorers and fail to recognize sleep apnea for the life damaging and life shortening disease that it is.

There are three types of sleep apnea.  Obstructive sleep apnea is caused when the tongue and soft palate collapse during sleep and block the airway.  Central sleep apnea occurs when the brain fails to signal the muscles to breathe.  Complex sleep apnea is a combination of obstructive and central sleep apnea.


There are many causes/risk factors of sleep apnea, but the most common are weight gain and obesity, smoking, and large neck circumference (17 inches for men, 15 inches for women).  Note that the large neck circumference risk is not necessarily due to obesity.  Muscular body builders are just as susceptible to developing sleep apnea even though it is not fat surrounding their airway.

So how do you tell if you have sleep apnea?  Only a doctor who specializes in sleep medicine can definitively tell you if you have sleep apnea and diagnose the severity of it, but it’s worth getting checked out if you have one or more of these symptoms:

Loud snoring/choking while sleeping        Frequently waking up tired

Falling asleep while sitting in traffic           Waking with a dry mouth or sore throat

Waking up several times a night                 Difficulty concentrating

Frequent heartburn                                     Memory problems

A sleep medicine doctor will conduct a physical evaluation of your condition and likely schedule a sleep study for you if your symptoms warrant it.  The sleep study can either be in a special sleep study facility or an at-home study.  The at-home study wasn’t available when I did mine.

In my sleep study, about 20 wires were attached to my head chest and leg and a box that they all fed into sat on the nightstand next to me.  Being hooked up to all this, sleeping in a strange bed and place, and the time of the study (much earlier than I usually go to sleep) all combined for a horrible night’s sleep for me.  I did get a couple hours of sleep and that was enough to compile adequate data to diagnose me with moderate sleep apnea.  Had I been able to sleep longer, they would have woken me up to fit a CPAP machine that would have forced air into my nose and mouth keeping my airway open during sleep.  Some of the doctors will prescribe a second sleep study done with a CPAP in place if they feel it is necessary.  I have heard that the at-home studies are less equipment-heavy, and I’d recommend them if they are offered to you.

The CPAP is a device that fits over the face similar to a fighter pilot’s facemask, although smaller, less obtrusive devices are now coming out, and a hose attaches from it to a machine that forces air into your airway.

Other options to treat sleep apnea are surgically implanting rigid plastic strips into the soft palate to keep the airway from closing during sleep, or a mouthpiece worn at night that modifies the way the jaw sits and keeps the airway open while worn.


My doctor gave me a choice between the CPAP and the mouthpiece, and I chose the mouthpiece.  Both devices take some dialing in to get the adjustments right.  I’m still getting used to the mouthpiece, but so far, I seem to be sleeping better.  I know people who use the CPAP who have reported drastic improvements in their sleep.

The CPAP can take come getting used to, as it’s not very natural to strap a mask and hoses on your face each night.  Many never get used to it and up to 50 percent of people who try CPAP machines eventually abandon them.  My doctor told me I could try out the mouthpiece and switch to the CPAP machine if I wanted to.  So far, I don’t feel I need to do that.

Note that there are sleep mouthpieces available through the internet.  These are not the same as ones that a dentist fits you for.  Definitely have a dentist fit you properly if that is the remedy you choose to try.  I tried an internet mouthpiece before doing my sleep study and it was junk.  The dentist-fitted one is adjusted gradually and over time you get used to the increasing distance it keeps between your upper and lower jaw. 

The first step to overcoming sleep apnea is recognizing you have a potential sleep disorder and getting in to see a sleep medicine doctor.  Sleep disorders are serious health issues that only get worse over time, causing severe health problems if left untreated.  Do it for yourself and your loved ones.  Get checked out if you are having frequent sleep issues.