What is Sleep Apnea?
Sleep apnea is a serious sleep disorder in which pauses in breathing or instances of shallow breathing occur during sleep. Each pause in breathing is called an apnea, and can last for several seconds to several minutes. They may occur 30 times or more per hour. Typically, normal breathing starts again, sometimes with a loud snort or choking sound. Each abnormal shallow breathing even is called a hypopnea. When breathing is paused, carbon monoxide builds up in the bloodstream. Sensory extensions in the blood called chemoreceptors notice the high carbon monoxide levels. The brain is then signaled too wake the sleeper and breathe in air. Breathing normally will restore oxygen levels and the person will fall asleep again. The disorder is often diagnosed with an overnight sleep test called a polysomnogram, or “sleep study.” Sleep apnea often goes undiagnosed. Doctors usually can’t detect the condition during routine office visits. Also, there is no blood test available to help diagnose the condition. A diagnosis often results after a family member or bed partner has noticed the signs of the disorder.
What are the Different Types of Sleep Apnea?
Obstructive Sleep Apnea: This is the most common category of sleep-disordered breathing, affecting about 12 million Americans. In OSA, breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common. The muscle tone of the body ordinarily relaxes during sleep, and at the level of the throat the human airway is made up of collapsible walls of soft tissue which can obstruct breathing during sleep. Individuals with low muscle tone and soft tissue around the airway (possibly due to obesity) and structural features that give rise to a narrowed airway are at high risk for OSA. The elderly are more likely to have OSA than young people.
Central Sleep Apnea: This is a less common type of sleep apnea in comparison to OSA. It occurs if the area of the brain that controls breathing does not send the correct signals to muscles responsible for breathing. CSA can affect anyone, however, it is more common in people who have certain medical conditions or use certain medications. Snoring typically does not occur with this type of the disorder.
Mixed Apnea/Complex Sleep Apnea: Some people with the disorder have a combination of both types. The presence of this type of apnea ranges from .56% to 18%. It is generally detected when OSA is treated with CPAP treatment and CSA emerges. The mechanism of the loss of central respiratory drive during sleep in OSA is not known but is most likely related to incorrect settings of the CPAP treatment and other medical conditions the person may have.
What are the Symptoms of Sleep Apnea?
One of the most common signs of OSA is loud and chronic snoring. Pauses may occur in the snoring and choking or gasping may follow these pauses. Another common sign of the disorder is constantly fighting sleepiness during the day, at work, or while driving. Other signs and symptoms of sleep apnea include: morning headaches, memory or learning problems and not being able to concentrate, feeling irritable/depressed/having mood swings, waking up frequently to urinate, dry mouth or sore throat upon waking up. In children, the disorder can cause hyperactivity, poor school performance, and angry or hostile behavior. Children with the disorder also may breathe through their mouths instead of their noses during the day.
Treatment and Living with Sleep Apnea
Sleep apnea is treated with lifestyle changes, mouthpieces, breathing devices, and surgery. Medication typically is not used to treat the condition. Lifestyle changes and/or mouthpieces may relieve mild sleep apnea. People who have moderate to severe sleep apnea may need a breathing device or surgery. The most common treatment for moderate to severe cases of the disorder in adults is a CPAP (continuous positive airway pressure) machine. This device uses a mask that fits over your mouth and nose. It gently blows air into your throat. The pressure from the air helps keep your airway open while you sleep. Some people with sleep apnea might benefit from surgery. The type of surgery and how effective it is will depend on the cause of the sleep apnea. Surgery is performed to widen breathing passages. It usually involves shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw. If you have mild sleep apnea, some changes in daily activities or habits might be all the treatment that is necessary. Make the following changes to improve your apnea-related symptoms: avoid alcohol and sleeping medications, lose weight, sleep on your side instead of your back, keep nasal passages open at night with nasal sprays or allergy medicines, if you smoke- quit.