Joan Siegel reached the tipping point of husband Alan's snoring on their trip to China.
For the past three years, Siegel could bear her husband's snoring and waking in the middle of the night. It was simple: just sleep peacefully in another bedroom.
But when she found herself stuck in the same hotel room on their big trip, there was no escape.
"She told me she'd never go on vacation with me again unless I got help," said Siegel, 61 of Jericho, N.Y. "She really meant it and that did it for me."
Siegel suffered from obstructive sleep apnea, a condition in which Siegel's blocked airways caused him to stop breathing in the middle of the night. For many patients with sleep apnea, each pause in breathing typically lasts 10 to 20 seconds or more, and the pauses can occur 20 to 30 times or more an hour, according to the American Sleep Association.
If left untreated, sleep apnea can lead to high blood pressure, heart disease, obesity and stroke. "I was getting tired during the day," Siegel said. "Let's just say I needed a lot of coffee."
After his diagnosis, Siegel's specialist, Dr. Lisa Liberatore, recommended a continuous positive airway pressure mask (CPAP), a device worn while sleeping to open the airways and keeps the oxygen flowing.
It's considered the gold-standard treatment for sleep apnea, but the mask can be a source of disdain for many patients who are advised to wear it. It can be irritating, itchy, loud and, for some, can lead to headaches.
"Initially, I didn't care for it," said Siegel, who was first offered the larger model of the mask that covered his nose and mouth.
But there's a reason it's the first-line treatment for sleep apnea. A new study suggests only three months of CPAP therapy can dramatically lower blood pressure and decrease the risk and even treat signs that can lead to metabolic disorders such as heart disease and diabetes.
Eighty-six patients with moderate to severe sleep apnea were randomly assigned to undergo standard CPAP therapy or a sham CPAP therapy, according to the study that was published today in the New England Journal of Medicine. Eighty-seven percent of the group already had signs of a metabolic disorder at the start of the study.
After three months, 20 percent of patients who completed CPAP therapy for the first time were more likely to have lower blood pressure, lower cholesterol and a lower body mass index (BMI), compared to those on the false therapy. A lower BMI and smaller waistline may have been the result of participants' being less likely to fall asleep during the daytime and therefore more physically active, the researchers said.
Patients who wore the CPAP mask for five or more hours a night were also more likely to see the most improvement in their overall health.
Still, the stigma of sleeping with a large ventilated mask holds many patients back from even trying the treatment. "It's not the most attractive for couples," said Liberatore, otolaryngoloist at Lenox Hill Hospital in New York. "Sometimes, they feel like they're choking."
But there are many models of the mask. And Siegel chose one he said was smaller and less intrusive.
The initial fitting trial with CPAP offers some the best sleep they've had in a long time, and that will win them over, Liberatore said.
"I tell them not to think of it as the treatment that you'll need for the rest of your life," Liberatore said.
Alternatives to CPAP therapy include surgery to clear the obstructive airways. But Liberatore says surgery is the last resort, and some patients, depending on the reasons causing their sleep apnea, might not qualify.
The overall goal for many patients is to lose the weight that might be bringing on the sleep apnea, Liberatore said. Sleep disruption caused by sleep apnea and the lack of oxygen to vital organs can cause changes in hormones involved in appetite regulation and fat retention.
"If you get into a better stage of sleep, your hormones will be regulated, and your ability to lose weight will be optimized," she said. "The goal is not to sleep with a machine for the rest of your life."
Siegel, who exercises regularly and is not considered overweight, says other parts of his health have improved dramatically. After two months, Siegel no longer snores, sleeps through the night, and feels more energized during the day. What's better, he says, is that is wife is happy.
"Look, if I could do without [CPAP], it would be better" he said, "but for now, I'm glad I have it."