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SLEEP APNEA

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SLEEP APNEA

Sleep apnea is a serious sleeping disorder characterized by an interruption in breathing or shallow breathing while an individual is asleep.

  • Each interruption can happen many times in a night and may take a few seconds to a few minutes.
  • It is common among adults and becoming more common among children.
  • If left untreated, it can lead to serious health conditions such as high blood pressure, type 2 diabetes, stroke.
  • There are three types of sleep apnea:
  • Obstructive sleep apnea (OSA), it is the most common form and is caused by a blockage of the airway, usually when the throat muscle relaxes.
  • People of any age can be affected. However, it is more common among adults around 55 to 60 years old.
  • Central sleep apnea (CSA), this happens when the brain fails to transmit signal to the muscles that controls breathing.
  • CSA affects less than 1% of people.
  • Mixed sleep apnea, this occurs when an individual has both central sleep apnea and obstructive sleep apnea

CAUSES

Obstructive sleep apnea occurs when the muscles in the back of your throat relax causing a blocked airway. There are factors that can predispose an individual to this form of sleep apnea, this factor includes:

  • Smoking
  • Nasal congestion
  • A narrowed airway
  • Obesity
  • Aging
  • Family history
  • Use of alcohol, or sedatives

Central sleep apnea occurs when the brain fails to send a signal to the breathing muscles.  Factors that can predispose an individual to such condition includes:

  • Aging
  • Stroke
  • Heart disorders
  • Using narcotics pain medications.

SYMPTOMS

Loud snoring

Morning headaches

Attention problems

Excessive daytime sleepiness and fatigue

Insomnia

Awakening with a dry mouth or a sore throat

Episodes of breathing cessation

Awakenings at night accompanied by short breath.

DIAGNOSIS

Sleep apnea may be diagnosed by the assessment of symptoms, and risk factors. Such assessment may involve overnight monitoring of your sleeping and other body activities while sleeping.

The standard test for sleep apnea is polysomnography, also called sleep study.

In a polysomnography, you are observed overnight while connected to many sensors. During this study, the following information is recorded: sleep stages, heart rate, blood oxygen level, muscle activity, brain waves and breathing rate, eye movements, and audio recording of loudness of snoring.

For some, Home Sleep Apnea Testing (HSAT) may be done. The severity of apnea is determined by the number of apnea episodes that occur per hour.

  • For normal, 0-5 apnea episode per hour
  • Mild, 5-15 episodes per hour
  • Moderate, 16-30 episodes per hour
  • Severe, more than 31 episodes per hour

If you have obstructive sleep apnea, an ear, nose and throat doctor may have to test you to rule out any blockage in your nose or throat.

TREATMENT

For less severe cases, your doctor may suggest only lifestyle changes such as smoking cessation, losing weight and treating your nasal congestion.

If these measures don’t improve your symptoms, a number of other available treatments can be used.

Continuous positive airway pressure (CPAP), oral appliances, or expiratory positive airway pressure (EPAP) can all be used to open blocked airways.

Surgery may be recommended after all other treatments have failed. Surgical options may include tissue removal, implants, jaw repositioning, or creating a new passageway.

For central and mixed sleep apnea treatment may include: supplemental oxygen,  adaptive servo-ventilation, continuous positive airway pressure (CPAP), or bilevel positive airway pressure