Sleep Apnea

Sleep Apnea

Sleep Apnea

What is Sleep Apnea?

Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. Sensing you have stopped breathing, a control center in your brain triggers you to wake up just enough to take a breath. Then you fall back to sleep and the cycle begins again. In some people, this can happen over 30 times every hour even though you may not remember waking up. As you can imagine, constantly being triggered back into breathing, hour after hour, night after night, can put a strain on your body. You may feel very tired day after day yet not realize that you’ve been waking up so many times at night as a result of having sleep apnea.

Common types of sleep apnea are:

  • Obstructive sleep apnea (OSA): The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
  • Central sleep apnea: Unlike OSA, the airway is not blocked, but the brain fails to signal the muscles to breathe, due to instability in the respiratory control center.
  • Complex sleep apnea syndrome: Also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea.

Adverse Effects of sleep apnea:

  • High Blood Pressure: If you already have it, sleep apnea can make it worse. When you wake up often during the night, your body gets stressed. That makes your hormone systems go into overdrive, which boosts your blood pressure levels. Also, the level of oxygen in your blood drops when you can’t breathe well, which may add to the problem.
  • Heart disease: A Yale University study found that sleep apnea is associated with double the risk of having a stroke! People with OSA are more likely to have heart attacks. The causes may be low oxygen or the stress of waking up often. Strokes and atrial fibrillation — a fast, fluttering heartbeat — are also linked with the condition. Sleep apnea disrupts how your body takes in oxygen, which makes it hard for your brain to control how blood flows in your arteries and the brain itself.
  • Weight gain: Extra pounds raise your chances of getting sleep apnea, and the condition also makes it harder to slim down. When you’re overweight, you can have fatty deposits in your neck that block breathing at night. On the flip side, sleep apnea can make your body release more of the hormone ghrelin, which makes you crave carbs and sweets. And when you’re tired all the time, you might not be able to turn the food you eat into energy as efficiently, which can lead to weight gain.
  • Difficulty concentrating: OSA can reduce your ability to think clearly, leading to poor work performance and reliance on stimulants such as caffeine and sugary foods.
  • Emotional concerns: OSA is associated with emotional disturbances and may increase the risk of mental health conditions such as anxiety and depression.

What Causes Sleep Apnea?

In adults, the most common cause of obstructive sleep apnea are:

  • Excess weight and obesity, which is associated with the soft tissue of the mouth and throat.
  • Neck circumference. People with thicker necks might have narrower airways.
  • Family history. Having family members with sleep apnea might increase your risk.
  • Smokers are three times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.
  • Nasal congestion. If you have difficulty breathing through your nose — whether from an anatomical problem or allergies — you’re more likely to develop obstructive sleep apnea.

In children, causes of obstructive sleep apnea often include:

  • Enlarged tonsils or adenoids.
  • Dental conditions such as a large overbite.
  • Tumor or growth in the airway.
  • Birth defects such as:
    • Down syndrome: Down Syndrome causes enlargement of the tongue, adenoids, and tonsils and there is decreased muscle tone in the upper airway.
    • Pierre-Robin syndrome: Pierre-Robin syndrome actually has a small lower jaw and the tongue tends to ball up and fall to the back of the throat.
  • Childhood obesity may cause obstructive sleep apnea, it’s much less commonly associated with the condition than adult obesity.

Symptoms of Sleep Apnea

  • Loud or frequent snoring.
  • Episodes in which you stop breathing during sleep — which would be reported by another person.
  • Gasping for air during sleep.
  • Waking up with a very sore or dry throat.
  • Morning headache.
  • Difficulty staying asleep (insomnia).
  • Excessive daytime sleepiness (hypersomnia).
  • Sleepiness or lack of energy during the day.
  • Uncharacteristic moodiness, irritability, or depression.
  • Occasionally waking up with a choking or gasping sensation.
  • Sleepiness while driving.
  • sexual dysfunction.
  • Frequent visits to the bathroom.
  • Weight gain.

Treatment for Sleep Apnea

If you suspect you may have sleep apnea, the first thing to do is see your doctor. Once the doctor confirms that you suffer from Sleep Apnea there are multiple treatment options which might differ from one patient to other. Some of them are:

  • Continuous positive airway pressure device (CPAP): CPAP is a mask that fits over the nose and/or mouth, and gently blows air into the airway to help keep it open during sleep. This method of treatment is highly effective. Using the CPAP as recommended by your doctor is very important.
  • Hypoglossal nerve stimulation: Here a stimulator is implanted in the patient’s chest with leads connected to the hypoglossal nerve that controls tongue movement as well as to a breathing sensor. The sensor monitors breathing patterns during sleep and stimulates the hypoglossal nerve to move the tongue to maintain an open airway.
  • Dental appliances which reposition the lower jaw and tongue.
  • Upper airway surgery to remove tissue in the airway.
  • Nasal expiratory positive airway pressure where a disposable valve covers the nostrils.
  • If you have nasal allergies, your doctor will recommend treatment for your allergies.

Apart from these treatment options, patients can undergo a lifestyle change in order to control the degree of Sleep Apnea. Some of the tips to mitigate symptoms of Sleep Apnea are:

  • Lose weight: If you are overweight, this is the most important action you can take to cure your sleep apnea (CPAP only treats it; weight loss can cure it if it is the cause of sleep apnea).
  • Avoid alcohol: It causes frequent night-time awakenings and makes the upper airway breathing muscles relax.
  • Quit smoking: Cigarette smoking worsens swelling in the upper airway, making apnea (and snoring) worse.
  • Some patients with mild sleep apnea or heavy snoring have fewer breathing problems when they are lying on their sides instead of their backs.

 

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