SLEEP APNEA

What is Sleep Apnea?

Obstructive sleep apnea, OSA, is a breathing related sleep disorder which can cause people to snore, as well as pose serious health threats. OSA is a condition that occurs when a person regularly stops breathing (apnea) for 10 seconds or longer during sleep. It is usually caused by either the tongue or the soft palate falling back against the back of the throat when the muscles in the neck and throat relax during sleep.

There are three vital things that you need to know about sleep apnea:

• Not only does sleep apnea result in sleep deprivation, but it can also threaten your life.
• Sleep apnea is a progressive sleep disorder (it gets worse as you age).
• Treatment for sleep apnea is necessary and usually successful

Are Snoring and Sleep Apnea the Same Thing?

Snoring and sleep apnea are not the same thing. Snoring is simply a loud sound that you make during breathing while asleep. Snoring may accompany sleep apnea, but snoring by itself does not mean that breathing has stopped.

Warning signs and symptoms of sleep apnea are:

• Frequent cessation of breathing (apnea) during sleep. Your sleep partner may notice repeated silences from your side of the bed.
• Choking or gasping during sleep to get air into the lungs
• Loud snoring
• Sudden awakenings to restart breathing
• Waking up in a sweat during the night
• Feeling unrefreshed in the morning after a night’s sleep
• Headaches, sore throat, or dry mouth in the mornings after waking up
• Daytime sleepiness, including falling asleep at inappropriate times, such as during driving or at work
• Lethargy
• Rapid weight gain
• Memory loss and learning difficulties
• Short attention span

Diagnosis of Sleep Apnea:

A sleep study is the only way to positively diagnose sleep apnea.. The polysomnography (sleep study) is a standard lab test that measures and records specific body functions during sleep. The test is painless and usually performed overnight in a comfortably appointed suite.

Types of Sleep Apnea

Obstructive Sleep Apnea (OSA)
The most common type of sleep apnea. Caused by a breathing obstruction, which stops the air flow in the nose and mouth.

Central Sleep Apnea (CSA)
A much less common type of sleep apnea. The brain signal that instructs the body to breathe is delayed. This central nervous system disorder can be caused by disease or injury involving the brain stem, such as a stroke, a brain tumor, a viral brain infection, or a chronic respiratory disease.

Mixed sleep apnea
A combination of the two other types of sleep apnea, Obstructive Sleep Apnea and Central Sleep Apnea.

Causes of Sleep Apnea

Sleep apnea is caused by the throat being blocked during sleep. The soft tissues of the upper airway collapse and the tongue falls back, blocking the flow of air during sleep. These periods can last from 10 to 90 seconds during which the body receives no oxygen. While there is no cure for sleep apnea, certain factors can contribute to the disorder. Making some lifestyle changes and seeking medical treatment can alleviate most or all of the symptoms.

Risk Factors

Various risk factors can predispose you to have an obstructed airway and therefore cause sleep apnea. If you have a number of the risk factors below, and you are not sleeping well, you might consult a doctor for a diagnosis of sleep apnea. The risk factors for sleep apnea are:

Obesity or excessive fat in the neck and throat
However, note that almost half of people with sleep apnea are not obese.

Age

Male gender

Irregular sleep hours
An irregular sleep schedule can throw off your sleep cycles. Disruptions include work days vs. non-work days; a snoring bed partner; a new baby; aggravation from the day’s events; not following a natural preference for sleep during unconventional hours; and overuse of caffeinated products. Particularly affected are Stage 1 sleep (when you first fall asleep) and REM sleep (when you dream). The result of disruption can be unstable breathing and sleep apnea during these phases of sleep.

Anatomical anomalies that narrow your airway
For example, a deviated septum, an enlarged tongue, or a receding chin.

Snoring
Snoring itself is not only a result of sleep apnea, but also a cause. The repeated vibrations of the soft palate during snoring can cause the soft palate to lengthen, which can obstruct the airway.

Enlarged tonsils or adenoids
Especially can cause sleep apnea in children.

Use of alcohol and sedatives before bedtime

Smoking or exposure to secondhand smoke

Nasal congestion, nasal blockages, and nasal irritants
For example, household dust and dander can inhibit breathing through the nose and force breathing through the throat, which may also be blocked.

Family history of sleep apnea
No specific genetic marker for sleep apnea has been discovered, but obstructive sleep apnea seems to run in families. This may be a result of facial and neck characteristics or anatomic abnormalities that are passed along to succeeding generations.

Other disorders and syndromes
Hypothyroidism, acromegaly, amyloidosis, vocal cord paralysis, post-polio syndrome, neuromuscular disorders, Marfan's syndrome, and Down Syndrome.

Effects of Sleep Apnea

Periods of not breathing cause an alarming drop in the blood oxygen level and can lead to high blood pressure, cardiovascular disease, and stroke. Sleep apnea episodes can happen from 5 to more than 100 times an hour, and sometimes breathing stops hundreds of times each night. Additionally, from the interrupted loss of sleep, excessive daytime sleepiness can occur. This may put a person experiencing obstructive sleep apnea symptoms at even greater risk by causing them to fall asleep while driving or working.

Treatment of Sleep Apnea

Once diagnosed, there are several types of sleep apnea aids and treatment that can offer patients a clear and open airway during sleep. For some people, developing good sleeping habits, losing weight, and avoiding sleep medications and alcohol may cure the sleep apnea syndrome. Other people may need to use a breathing device called aCPAP machine (Continuous Positive Airway Pressure). Worn while the patient sleeps the CPAP uses air pressure to keep the upper airway from collapsing. For patients that cannot wear a CPAP machine, a dental appliance is the most common prevention & relief for sleep apnea. Dentists use a small appliance much like an orthodontic retainer to prevents the tongue from falling back and blocking the airway.

Classifications

Apnea severity is usually categorized by the frequency of apnea episodes:

mild 5 to 19 episodes per hour
moderate 20 to 39 episodes per hour
severe more than 40 episodes per hour

These episodes can last anywhere between 10 to 90 seconds each, terminating with at least a partial awakening. A severe apnea patient may have more than 300 episodes per night!