For years, Patrick Gaertner has slept so poorly that he felt sluggish and groggy all the time.
“I hadn’t slept great in so long that I thought it was normal,” he said.
Then, last fall, Gaertner, 30, went to see his primary care doctor about a lingering cold.
Gaertner told Wilk that all his life, he has dealt with frequent bouts of strep throat and doctors often noticed that he had large tonsils. Back in college, when Gaertner was a student at the University of Denver, he endured an especially bad case of tonsillitis and had to have a minor procedure. Ever since then, he had been sleeping poorly. Gaertner figured he was just a lousy sleeper and that he had to live with perpetual exhaustion.
What is sleep apnea?
Wilk found that Gaertner had a bacterial infection and treated him for it, but he also asked if Gaertner had ever been tested for sleep apnea, a condition which causes people stop and start breathing multiple times as they try to sleep.
He had not.
So, Wilk arranged for Gaertner to do a simple sleep test at home to monitor how well he was breathing throughout the night. Wilk ordered the sleep test and Gaertner picked up the equipment at the UCHealth Sleep Lab – Stapleton.
During sleep, it’s normal to occasionally relax and temporarily stop breathing. People who temporarily stop breathing fewer than five times an hour are considered normal. But, Gaertner’s results were stunning.
“I was having 130 events an hour. I was supposed to be averaging at least 90% oxygen saturation and I was averaging 70%,” he said.
“He had the worst sleep apnea I’ve seen in my career,” Wilk said. “His airway was closing off, on average, every 25 seconds. His oxygen levels were as low as 31%, and every time his airway would close, he would wake up. He never got into the deep stages of sleep. The amazing thing is that he was still functioning.”
Benefits of CPAP for sleep apnea
Wilk immediately recommended that Gaertner use a device that helps patients keep breathing overnight. It’s called a Continuous Positive Airway Pressure machine or a CPAP. Patients strap a mask over their mouths and noses and the CPAP delivers steady air pressure.
Some people find CPAPs awkward and uncomfortable. And, before trying the CPAP, Gaertner had his doubts about using a device to help him breathe at night for the rest of his life.
Overnight cure with CPAP
And, Gaertner easily adapted to the CPAP.
Overnight – literally on his first night – Gaertner slept deeply for eight hours and felt more rested than he had in years.
He loves his CPAP.
“It worked perfectly. I’m down to just three events (of halted breathing) an hour,” he said. “I sleep soundly now. I don’t need pills to sleep. It has been amazing.”
Gaertner said he hasn’t found the CPAP uncomfortable and the noise is minimal. He said the machine doesn’t bother his wife, who is thrilled that her husband is sleeping well and no longer snores.
As for Gaertner, he isn’t a big coffee drinker, but he used to need several cups of strong black tea to get going in the mornings. He often felt sleepy during the day at his medical insurance job, and had little energy for exercise or other hobbies.
Now, he wakes up refreshed and ready to go, and he’s excited about getting more exercise to boost his health overall.
Since getting his CPAP in October, Gaertner and his brother have been going on hikes together. His wife works to support researchers for the National Park Service. And, Gaertner sometimes gets to join her for trips to beautiful natural areas.
Symptoms of sleep apnea
Wilk thought Gaertner might need additional help beyond the CPAP and referred his patient to Dr. Katherine Green, an expert on sleep apnea and medical director of the Sleep Medicine Clinic at University of Colorado Hospital.
Green worked closely with Gaertner, but since he did so well with his CPAP, she recommended against any surgery on his tonsils for now.
Green said sleep apnea is a very common condition and most people are not getting the help they need.
“As many as 80-to-90% of people with sleep apnea are still undiagnosed,” Green said.
Among children, enlarged tonsils are the leading cause of sleep apnea. For adults, there can be additional causes.
Since sleep tests no longer require patients to spend a night in a sleep lab and can easily be done at home, Green urges anyone who is feeling exhausted to seek help. Other symptoms related to apnea include snoring, high blood pressure and obesity.
“The most classic symptom is a partner complaining about snoring. If a patient wakes up gasping, that can be a sign too. Daytime sleepiness is a big one, as is waking up and still being tried,” Green said.
She also said morning headaches can be a sign of sleep apnea.
Sleep apnea linked to high blood pressure and heart problems
While sleep apnea can make people feel lousy, it can also be quite dangerous for heart health.
When a patient repeatedly stops breathing, the body springs into action with a natural stress response. In addition to being exhausted, patients’ hearts can be working overtime all night, responding every few seconds to loss of oxygen.
“We think about 15% of all high blood pressure (cases) are due to sleep apnea. The sleep apnea triggers your fight or flight response and you have all this stimulation. You feel like your life is threatened,” Wilk said. “Untreated sleep apnea increases the risk of heart attack, stroke and congestive heart failure. And, it increases the risk of sudden death or falling asleep while driving.”
Wilk said he’s amazed that Gaertner has done so well with CPAP. He encourages all patients to discuss sleep issues and potential sleep apnea with their primary care providers. If they need additional help, they can see a specialist like Green. And, if patients are struggling with a CPAP, additional training or a better fit might help.
CPAP benefits: ‘Gold-standard treatment’
Green said CPAP is by far the most effective and least invasive cure for sleep apnea.
“The gold-standard treatment for sleep apnea is the CPAP machine. If you can wear it, it’s 100% effective. If you can sleep with a CPAP machine, it can provide a 100% correction,” Green said.
But, if the CPAP isn’t working well and additional training doesn’t resolve problems with the machine, Green has alternatives.
Sleep experts use a rating system to classify the severity of sleep apnea. People experiencing fewer than 5 events of halted breathing per hour are considered normal. Those with 5 to 15 events per hour are coping with mild sleep apnea. Those suffering 15 to 30 events per hour have moderate issues and anyone dealing with more than 30 events per hour has severe sleep apnea.
“Patrick’s rate of 132 per hour was really severe,” Green said.
She’s thrilled, but not surprised, that he has had such a dramatic turnaround. She has seen many patients achieve the same overnight relief.
“If you are having any symptoms, get checked out. The big benefit is that we can do something about sleep apnea. We have a lot of treatments. CPAP is risk-free and non-invasive. But, if you can’t tolerate it, we have other options like surgery or oral appliances,” Green said.
“Sleep is one of those quality of life issues. Good sleep quality can make a dramatic difference. I see people every day who say they haven’t gotten a good night’s sleep in 20 years. Sleep makes a difference in absolutely everything. Patrick is the perfect example of the kind of dramatic improvement we can see.”
CPAP can dramatically improve quality of life
Green thinks CPAP machines get a bad rap.
“But, many of my happiest patients are people like Patrick,” she said.
Some say if they had to race out of their homes during a fire, the first thing they’d grab would be their CPAP machine.
“The CPAP makes that much of a difference in their quality of life,” she said.
“Some people worry about their bed partner. But the partner is usually thrilled to get rid of the snoring,” she said.
Gaertner said neither he nor his wife have had any trouble getting used to the CPAP. He’s overjoyed to be sleeping well, loves his doctors and encourages anyone who is struggling to speak up.
“If you feel like you’re sleeping like crap, go talk to your doctor,” he said.
Now that Gaertner has more energy, Wilk is helping him find time for more exercise and a healthy lifestyle.
“This is changing my life. I was having to use sleeping pills every night. I don’t need anything and I have a little app on my phone that gives me results. I sleep soundly every night. I’m a lot more alert. I’m not dragging anymore. I’m going on more mid-day walks.
“It’s been great.”