More than 12 million Americans suffer from this potentially fatal condition, which occurs when the muscles in the back of the throat relax during sleep, narrowing or completely collapsing the airway. (Apnea, a Greek word, means "without breath.") When the brain senses that it's not getting enough oxygen, it briefly wakes the person up. This pattern, which may repeat hundreds of times each night, leads to shallow sleep, daytime sleepiness or fatigue, and cognitive dysfunction. It also increases the risk of heart-related disease such as high blood pressure, heart attack, arrhythmias, heart failure and stroke.
Upchurch was set up with a continuous positive airway pressure (CPAP) machine, which blows air into the upper respiratory tract through the nose to keep the airway open. But he found it uncomfortable. The air pressure felt too high, he said. He would wake up with a sore stomach and dry mouth. So he stopped using it.
Several months later, he received a notice in the mail about a new, monthly CPAP class to help Sleep Medicine Center patients adjust to their machines. "CPAP has always been the gold standard for treatment of obstructive sleep apnea, but adherence to the treatment varies a lot—from 20-80 percent, depending on the study," said Michelle Cao, DO, a Stanford Hospital pulmonologist and sleep expert who leads the class. "My goal was to try to help people who were having trouble with it solve their problems. I call it a CPAP boot camp."
Upchurch went to a meeting of the class in April. There were about 10 other participants. They all brought their machines. "Everyone had a different question, but we were all learning from each other," Upchurch said.
He told Cao about his troubles. She lowered the airflow pressure on his machine a few notches and also refitted his face mask, which looks a little like the oxygen mask a professional football player uses on the sidelines. She also showed him how to use the machine's humidifier to help prevent his mouth from drying out.
"I could have just walked away from it, but going to that class made a huge difference,” he said. "Now I'm getting a much deeper sleep. I feel more energetic, and my upper body feels more limber and relaxed."
Upchurch said he also has benefitted from the guidance he received at the center on adjusting his diet and his sleep schedule to help ensure better rest. In May, he ran the 100th Annual Bay to Breakers, a seven-and-a-half mile race in San Francisco, and felt so energized afterward that he went to a nearby hotel pool to swim laps. Now, he is preparing for San Francisco Marathon on July 31.
The Stanford Sleep Medicine Center offers a variety of other treatments for obstructive sleep apnea, including surgery to reduce anatomical obstruction in the nose, throat and/or tongue, and education about behavioral measures to alleviate the disorder, such as a change in sleeping position and weight loss.