June 29, 2023
For the last few weeks, President Joe Biden has been using a continuous positive airway pressure, or CPAP, machine each night to help with his sleep apnea, White House officials said earlier this week.
Biden was seen with indentations on his face left by the machine as he left the White House on Wednesday. He has disclosed his diagnosis through medical reports since 2008, White House spokesperson Andrew Bates told NPR. While he has revealed his condition multiple times throughout the last decade, his presidential doctor did not mention it in Biden's health assessments in 2021 or 2022, The New York Times reported.
About 30 million American adults suffer from sleep apnea, a potentially dangerous sleep disorder in which breathing stops and starts many times throughout the night, preventing the body from getting enough oxygen. This often triggers a survival reflex that wakes a person up during the night, disrupting the sleep cycle.
"Sleep apnea is essentially a disorder where while we're sleeping at night, the airway either closes off completely or becomes so narrowed that the oxygen level drops," Dr. Ilene Rosen, associate professor of medicine at the Perelman School of Medicine at Penn, told the American Medical Association. This occurs "because not enough air gets in. As the oxygen level is dropping — maybe not to dangerous levels — the brain says, 'Hey, you're going to do this thing I don't like,' and wakes you up."
There are two types of sleep apnea. Obstructive sleep apnea, which impacts about 25 million Americans, is when the upper respiratory tract (nose, mouth, sinuses, pharynx and larynx) becomes blocked many times during sleep, reducing or completely stopping airflow. Central sleep apnea, which is less common, is when the brain does not send the signals needed to breathe, according to the National Heart, Lung, and Blood Institute.
The symptoms of obstructive and central sleep apnea overlap, sometimes making it difficult to determine which condition a person is suffering from. The most common symptoms of sleep apnea include loud snoring, episodes of not breathing during sleep, gasping for air during sleep, waking up with a dry mouth, morning headaches, difficulty staying asleep, excessive daytime sleepiness, difficulty paying attention and irritability, according to the American Lung Association.
Sleep apnea can impact anyone, even children. However, certain genetic and lifestyle factors may increase the risk of developing the sleep disorder. Obesity, larger neck circumference, a narrowed airway, smoking, use of alcohol and nasal congestion can all contribute to an increased risk of sleep apnea.
Having family members with sleep apnea or being over 50 years old may also increase the risk of developing the disorder. Men are about two times more likely than women to have sleep apnea, though women who are overweight or have gone through menopause are more at risk than other women.
Medical conditions like congestive heart failure, high blood pressure, type 2 diabetes, polycystic ovarian syndrome, hormonal disorders, prior stroke and chronic lung diseases may also put people at higher risk.
"Many of our patients come in because a bed partner or roommate notices snoring and disrupted sleep," said Dr. Sreelatha Naik, a sleep medicine physician at Geisinger. "However, many patients are referred to us by cardiologists, neurologists, and other specialists who recognize some of the effects of sleep apnea, such as heart disease and stroke. Recognizing the symptoms early can help you get treatment before the related health issues go from bad to worse."
Those who believe they may have sleep apnea should talk to a doctor. Sleep apnea is often diagnosed through a sleep study and is most often treated using a CPAP machine, which uses air pressure to keep airways open. The device, which involves wearing a mask over the nose and mouth during sleep, is connected to a bedside machine by a small hose. Lifestyle changes, particularly for those with multiple risk factors, are often recommended for easing symptoms.
For those new to using a CPAP machine, it may take time to get used to the device and be able to sleep soundly. Making multiple follow-up appointments and getting assistance from a sleep center can help, according to Penn Medicine.
Biden has undergone multiple sinus and nasal passage surgeries over the last several years, CNN reported, which can be another treatment option. While the surgeries did not eliminate the disorder, they did ease some symptoms.
If left untreated, sleep apnea can lead to an increased risk of heart disease, high blood pressure, diabetes, asthma, heart failure, irregular and rapid heartbeat, heart attack, stroke and a shortened lifespan. Untreated sleep apnea is also linked to depression, anxiety and drowsy driving.
