Revealing the mysteries of Sleep Apnea

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Understanding Sleep Apnea

Understanding Sleep Apnea

What is Sleep Apnea? | What Causes Sleep Apnea? | What are the Effects of Sleep Apnea?

What is Sleep Apnea?

Apnea is derived from a Greek word meaning "want of breath". Sleep apnea occurs when a person stops breathing while sleeping due to the airway collapsing preventing air from reaching the lungs. It is a serious, potentially life threatening and a life-altering condition that is both easy to diagnose and treat. Furthermore, it is as common as adult asthma, but not readily understood. Three types of sleep apnea exist:

  • Obstructive sleep apnea: most common and the main focus of this site, occurs when air is unable to flow in or out of a persons nose or mouth despite efforts by the body to breath.
  • Central sleep apnea: less common, occurs when the brain does not send appropriate signals to the breathing muscles in order to start respirations.
  • Mixed sleep apnea: not as common, it is a combination of both Central and Obstructive apneas. It starts as a central event and becomes obstructive when the brain recognizes the lack of oxygen.

Normal; Obstructive Airway Figure 1 depicts normal breathing with an open airway allowing air to flow into the lungs. Figure 2 depicts a collapsed airway, or OSA, blocking air flow to the lungs. Apnea episodes can range from 20 to 60 or more per hour, can last 10 seconds or more, and may be more prominent with certain sleeping positions or stages of sleep. All of this adds up to a fragmented sleeping pattern which prevents a person with sleep apnea from achieving a recuperative sleep. Over time and left untreated, this will lead to excessive daytime sleepiness or fatigue, potential cardiac problems, and a reduced quality of life.

Although sleep apnea can occur in all age groups and both sexes, it is more common in men than women. It is estimated that up to 18 million Americans suffer from OSA with many more currently undiagnosed and untreated due to a lack of awareness by both the public and healthcare professionals. Statistics reveal that 4% of middle-aged men and 2% of middle-aged women have OSA.

Those most likely to have or develop sleep apnea are those who snore loudly and are overweight, have high blood pressure, or have a physical abnormality in the nose, throat or other parts of the upper airway. It has been found that sleep apnea may also be hereditary.

What Causes Sleep Apnea?

There are several potential contributing factors that can cause the airway to collapse as shown in Figure 2. In some cases, the throat muscles and tongue relax during sleep and block the airway. Extra tissue in the back of the throat, for example large tonsils or uvula (small fleshy tissue, hangs in back center of throat) relaxes and sags, blocking the airway. A narrow airway, nasal obstruction, and some facial structures can also be contributing factors. One or a combination of these factors can cause the airway to collapse and prevent proper breathing during sleep. The cycle of heavy snoring, episodes of no breathing, and abrupt changes from deep to light sleep are normally unknown to the OSA sufferer until diagnosed.

Normal breathing is restored during sleep when the brain recognizes a lack of oxygen and an increase in carbon dioxide and arouses the body to resume proper breathing. Each arousal by the brain signals the relaxed upper airway muscles to open and unblock the airway resulting in normal breathing normally with a gasp or snort. Multiple arousals, although needed for breathing to resume, prevent the OSA sufferer from obtaining enough restorative sleep.

What are the Effects of Sleep Apnea?

Over time, the disrupted sleep patterns will lead to the OSA person to feeling very sleepy during the day with both concentration and daytime performance problems. Depending on how long the sleep apnea has gone on, it can range from annoying to life-threatening. Symptoms usually include depression, irritability, learning and memory difficulties, sexual dysfunction, and falling asleep at work, on the phone, or while driving. Estimates have shown that prolonged sleep apnea contributes to high blood pressure and increases the chances of both heart attack and strokes. Left untreated, the body will become so tired that it will ignore the brain arousals and the OSA sufferer will not wake up - essentially suffocating in their sleep.

Respironics, a leader in the sleep disorders equipment market, has provided a complete online symptoms checklist for OSA. Another good test available for determining your sleep deprivation level is the Epworth Sleepiness Scale. I highly recommend taking both of these tests if you feel you are experiencing any of the sleep issues described thus far.

Many who suffer from OSA are normally unaware and unwilling to accept that a problem exists. In most cases, sleep apnea patients will receive feedback from their spouse and family members who hear the snoring and struggles to breathe. At work, people will notice you are falling asleep at inappropriate times (for example, while talking, driving or working). It is very important that you make an appointment with your doctor if you are receiving feedback of this nature and "passed" the Respironics and Epworth tests. Be sure to share the feedback you received and any problems you have been experiencing while sleeping.

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