The Skeptical Cardiologist has been analyzing the data on sleep apnea (OSA) and cardiovascular disease, utilizing his spectacular skeptical skills.
Recent guidelines from the American Academy of Sleep Medicine suggest that 30 million adults in the US have OSA and that OSA is causing all manner of problems.
I note patient awareness of the possibility of OSA is rising exponentially and many of my patient’s are being subjected to sleep studies because their wives are bothered by their excessive snoring.
The AASM guidelines state that
Increased risk of moderate to severe OSA is indicated by the presence of excessive daytime sleepiness and at least two of the following three criteria: habitual loud snoring; witnessed apnea or gasping or choking; or diagnosed hypertension
Although I have no reason to suspect that I have sleep disordered breathing (SDB-I feel like this term is becoming popular as it avoids the stigma of apnea), I decided to determine my Epworth Sleepiness Scale which is often utilized to measure excessive daytime sleepiness.
Developed by Dr. Murray Johns, this scale has its own website where you will learn that:
Johns (2002) introduced the term somnificity to describe the effects of different postures and activities on sleep propensity.
The somnificity of any particular posture, activity and situation is a measure of its ability to facilitate or impede sleep onset in the majority of people. It is not a characteristic of individual people or their sleep disorders.
and (no doubt after years of intense sleepiness research) Dr. Johns has discovered that:
Simply to lie down rather than stand up increases one’s likelihood of falling asleep – the change of posture increases one’s sleep propensity at the time.
After stumbling up on this revelation I have decided to test my hypothesis that playing electric guitar while standing has extremely low somnificity. (I also hope to use the word somnificity in a normal daily conversation without biting my tongue.)
This self-administered questionnaire asks you to rate how likely you are (on a scale of 0=never to 3=high chance of dozing) to doze off or fall asleep in certain situations. What follows are the situations with my observations and my self-rated score.
Sitting and reading (Principles of Nuclear Medicine=3, Brave New World=0) 1
Watching TV 1
Sitting, inactive in a public place (theatre or a meeting) 1
As a passenger in a car for an hour without a break 2
Lying down to rest in the afternoon when circumstances permit 3
sitting and talking to someone 1
sitting quietly after a lunch without alcohol 1
In a car while stopped for a few minutes in the traffic 2
They don’t ask about falling asleep while driving which seems much more important than the other situations. I’ve done that a lot.
The biggest soporific situation for me is sitting in a barber’s chair. No matter what small talk the hairdresser throws at me, I am asleep within 5 minutes. My bobbing head requires the rare skill of trimming a moving target.
My total score was 12 which puts me solidly in the land of sleep disordered breathing. In the original study by Johns the patient’s with sleep apnea (OSA-line 3 in below chart) had an average score of 11.7.
The AASM guidelines indicate that I could have gotten into some OSA studies with my score, especially if I add in that I have been caught snoring, gasping and choking (sometimes all three simultaneously!) and I have hypertension.
The Eternal fiancée got a respectable score of 7. Apparently she never falls asleep at traffic lights, watching TV/movie or sitting after lunch and believes these are masculine traits. However, I think she should get double points for taking long, intentional naps throughout the day.