Steve McGough loves being outside, whether working in his garden or tinkering with his cars. But about five years ago, Steve was diagnosed with Lyme disease, from a tick bite – that he may have gotten while working in the garden he loves. His doctor emphasized the importance of getting good quality sleep to enable his body to fight the Lyme disease. When he asked Steve how well he slept, Steve knew there would be a problem.
“I knew that I snored and that my snoring woke me up throughout the night. I would wake up not feeling refreshed in the morning. Looking back, I had all the classic signs of sleep apnea,” Steve said.
Steve’s doctor referred him to neurologist and sleep specialist Eric Sklar, MD, Medical Director of Inova’s Sleep Disorders Program. Dr. Sklar recommended that Steve do an overnight sleep study at Inova to find out whether anything was disturbing his sleep.
“When Steve came into my office in January 2017, he reported that he had less energy during the day and didn’t feel refreshed in the morning. Because he had a history of snoring and some risk factors for sleep apnea, I recommended a sleep study,” Dr. Sklar said.
It turned out that Steve was suffering from moderate obstructive sleep apnea, a condition that causes a person’s airway to become blocked during sleep, causing the individual to stop breathing for brief periods. In addition to reducing the quality of a person’s sleep, obstructive sleep apnea increases the risk of serious conditions like stroke, high blood pressure, and heart attack.
Because sleep apnea sufferers can have complex medical needs, Inova Neuroscience’s sleep disorders program employs a multidisciplinary approach, collaborating with bariatrics, cardiology, and other departments as needed. Sleep studies can be conducted at one of Inova’s sleep labs, or patients can choose to have a home sleep study. It’s important for people to know whether they have sleep apnea, because it intersects with so many other conditions, from heart disease to obesity. Sleep is a key piece of the puzzle, and an integrated sleep disorders program can help identify sleep disturbances such as sleep apnea, consider the patient’s holistic needs, and put together a treatment plan to reduce risks before serious problems emerge.
Fortunately, Steve’s sleep apnea was caught early enough. After reviewing the results of Steve’s sleep study, Dr. Sklar prescribed a continuous positive airway pressure (CPAP) machine. A CPAP treats sleep apnea by providing air pressure in the airway during sleep, keeping the airway open. Initially, Steve had reservations. “I was horrified at first,” he said. “But luckily for me, my wife is very understanding.”
Steve was reassured when he learned that there are several different CPAP device options, many of which are quite comfortable. He was fitted with a small apparatus that sits right below his nostrils during sleep. It took him about a week to get used to wearing the CPAP at night, but the benefits quickly became obvious. “I really started experiencing restful sleep around the second week of using it. The first things I noticed was that I wasn’t waking up at night and I felt better in the morning. I’ve had great success with the CPAP,” he said.
Steve appreciated Dr. Sklar’s patient-focused approach. “His strongest point is listening – and that’s not common in healthcare. I’ve been to a lot of doctors, and he is among the best in listening to what I say,” Steve said.
His trust in Dr. Sklar led him to return for help with another issue in the fall of 2017. Steve had developed a hemifacial spasm, a kind of facial tic. “Having a facial twitch is like a nightmare. After all, you can’t hide your face. It made me extremely self-conscious,” Steve said.
Dr. Sklar offered Steve the option of Botox injections four times a year. It may sound surprising, but the same paralyzing effect that gets rid of wrinkles can also help stop a hemifacial spasm. “It takes a bit of trial and error to find the best dosage and injection locations, but this treatment has really settled things down. Today, I’m totally symptom-free,” Steve said.
Steve continues to use his CPAP faithfully every night. To ensure that his sleep apnea is still well controlled, he periodically follows up with Dr. Sklar to make sure the machine is set at the optimal level for his unique needs. Steve has also enjoyed making good use of his increased energy, whether weeding a flower bed or taking a ride in his classic Shelby GT convertible. He and Dr. Sklar both encourage anyone with signs of sleep apnea not to wait – get checked out by a specialist.
“People tend to explain away sleep apnea symptoms, putting sleep changes down to stress at work or other reasons,” Dr. Sklar said. “But if you have symptoms like snoring and feeling sluggish during the day – and especially if you have risk factors for sleep apnea, like high blood pressure or obesity – then you should be evaluated by a neurologist who specializes in sleep disorders.”
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