Part of the challenge of diagnosing sleep apnea is that many patients who suffer from it -- roughly abouty 30-40% of men over 40 and 10-15% of women over 40 -- don't know that they have it because the sleep interruptions most often occur within the deepest phases of sleep.   In the deep phases of sleepo we can often wake up from between a micro-second to several full seconds without being aware of it.   During the arousal -- because the brain reacts to the sudden cessation of breathiung -- there's a brief rush of adrenaline -- which raises blood pressure. But the patient is usually unaware of this.   If you have persistent depression,  tiredness upon waking,  a sense of dryness in the mouth upon waking,  or a history of dozing off for a nap during the day,  you could well have this disorder.   Psychiatric symotims most commonly include depression, irritability, low motivation,  poor memory, and of course sleepiness.  If you google the Epsworth scale this can give you valuable information to take to your doctor who can recommend a sleep study - the most definitive way to diagnose this.   

David Salvage, MD, FAPM

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