What is Sleep Apnea?
Sleep apnea is a sleep disorder that occurs when a person’s breathing is interrupted by repeated periods of cessation of breathing during sleep.
These disturbances can last from a few seconds to more than a minute and can occur dozens to hundreds of times throughout the night.
As a result of this disorder, the brain and other organs of the body do not receive sufficient oxygen supply.
When breathing stops, the oxygen level in the blood drops drastically, triggering the brain to wake the body briefly so that breathing can return to normal.
These awakenings are often so brief that the sufferer may not be aware of them, but they are enough to disrupt the sleep cycle and overall sleep quality.
Symptoms of Sleep Apnea
The symptoms that sufferers can experience are as follows:
- Loud snoring.
- Episodes of respiratory arrest that are often noticed by others.
- Gasping in sleep.
- Woke up with a dry mouth.
- Headache when waking up.
- Difficulty maintaining sleep.
- Sleepy during the day.
- Difficulty concentrating.
- Irritability.
Sleep Apnea Risk Factors
This condition can affect anyone, even children. But certain factors increase the risk.
1. Obstructive sleep apnea
Factors that increase the risk of this condition include:
- Being overweight. Obesity greatly increases the risk. Fat deposits around the upper airway can obstruct breathing.
- Neck circumference. People with thicker necks may have narrower airways.
- Having narrow airways. Some people may inherit a narrow throat. Tonsils or adenoids can also enlarge and block the airway, especially in children.
- Being male. In fact, men are two to three times more likely to develop this sleep disorder than women. However, women are at increased risk if they are overweight and their risk also appears to increase after menopause.
- Age. This sleep disorder occurs more often in older adults.
- Family history. People who have family members with sleep apnea are at higher risk of developing the condition.
- Use of alcohol or sedatives. These substances relax the muscles in the throat which can make the condition worse.
- Smoking. Smokers are three times more likely to develop this sleep disorder than people who have never smoked. This is because smoking can increase the amount of inflammation and fluid retention in the upper airway.
- Having a stuffy nose. If you have difficulty breathing through your nose – whether from anatomical issues or allergies – you may have this condition.
2. Central sleep apnea
Risk factors for this form of sleep apnea include:
- Older adults. Middle-aged and older adults are at higher risk for this type of sleep disorder.
- Male. This condition is more common in men than in women.
- Having heart problems. Having congestive heart failure increases the risk.
- Using pain medications or narcotics. Taking opioid medications, especially long-acting ones, can increase the risk of this condition.
- Having a stroke. Having a stroke increases the risk of developing this condition.
Causes of Sleep Apnea
There are three types of sleep apnea based on the cause:
- Obstructive Sleep Apnea (OSA): is the most common type of sleep disorder caused by a blockage in the airway, usually due to soft tissue at the back of the throat collapsing during sleep.
- Central Sleep Apnea (CSA): there is no obstruction in the airway in this type, but this type occurs due to the brain’s failure to send a message to the respiratory muscles to breathe, related to instability of the respiratory control center in the brain.
- Complex Sleep Apnea Syndrome: known as treatment-emergent central Sleep Apnea, which occurs when a person has both OSA and CSA.
Sleep Apnea Diagnosis
If you experience the above symptoms, your doctor may ask you to undergo a special test called a Polysomnogram.
These procedures can be performed at a sleep disorders center or even at home.
A polysomnogram or sleep study is a multi-component test that electronically transmits and records certain physical activities during sleep.
The recordings will then be analyzed by a sleep specialist to determine whether the sufferer has sleep apnea or another type of sleep disorder.
You can also do a sleep test at home. Your doctor will give you a simplified test to diagnose this condition at home.
These tests typically measure heart rate, blood oxygen levels, airflow, and breathing patterns.
If the results are abnormal, your doctor may be able to prescribe therapy without further testing. Unfortunately, portable monitoring devices cannot detect all cases of sleep apnea.
However, the doctor may still recommend polysomnography even if the initial results are normal.
If the doctor knows the cause, the sufferer may be asked to undergo further sleep studies to determine the best treatment options.
Complications of Sleep Apnea
Do not underestimate sleep apnea, because this sleep disorder can cause various serious complications that affect overall health.
Here are some complications that may arise due to sleep apnea:
- Daytime Fatigue. This sleep disorder causes sufferers to wake up frequently at night, so they do not get enough restful sleep. As a result, they feel tired, sleepy, and lack energy during daytime activities.
- High Blood Pressure or Heart Problems. While sleeping, people with sleep apnea often experience decreased oxygen levels in the blood. This triggers the release of stress hormones that can increase blood pressure.
- Type 2 Diabetes. Sleep disturbances due to sleep apnea can affect the body’s metabolism and increase the risk of developing type 2 diabetes. Lack of quality sleep can disrupt insulin regulation in the body, leading to insulin resistance and ultimately diabetes.
- Liver Problems. People with sleep apnea may experience periodic drops in oxygen levels, which can cause inflammation and damage to the liver. This condition can lead to the development of non-alcoholic fatty liver disease (NAFLD) and other liver disorders.
Good treatment can help reduce symptoms, prevent further complications, and improve the quality of life of sufferers.
Sleep Apnea Treatment
In milder cases, your doctor may simply suggest lifestyle changes, such as losing weight or quitting smoking.
If you have nasal allergies, your doctor will recommend allergy treatments.
If these measures do not improve the signs and symptoms or if the condition is in a moderate to severe phase, a number of other treatments may be available.
Certain devices can help open blocked airways. In other cases, you may need surgery.
Other therapies you may need include:
1. Continuous positive airway pressure (CPAP)
If you have moderate to severe sleep apnea, you may benefit from using a machine that delivers air pressure through a mask while you sleep.
With CPAP (SEE-pap), the air pressure is slightly greater than the surrounding air and is just enough to keep the upper airway open, preventing apnea and snoring.
2. Mouthpiece
The doctor will adjust this device to your specific needs when you sleep.
There are two types of mouthpieces that work differently to open the upper airway. Some hybrid mouthpieces have features of both types.
3. Mandibular repositioning mouthpieces
It is a device that covers the upper and lower teeth and holds the jaw in a position that prevents it from blocking the upper airway.
4. Tongue retaining device
This is an oral device that holds the tongue in a forward position to prevent it from blocking the upper airway.
In cases of mild sleep apnea or sleep apnea that only occurs when lying on your back, your doctor may prescribe an oral device.
To get the device, your doctor may refer you to a dentist. These specialists will make sure that the oral appliance fits your mouth and jaw.
Additionally, implants can help some people with sleep apnea. Some devices can treat both obstructive and central sleep apnea.
Patients must undergo surgery to place an implant in their body. The device detects breathing patterns and provides mild stimulation to certain muscles that open the airway during sleep.
5. Nerve stimulator
This device can also treat sleep apnea. This treatment also involves surgery. A surgeon will insert a stimulator for the hypoglossal nerve that controls tongue movement.
Increasing the stimulation of these nerves helps position the tongue to keep the upper airway open.
6. Therapy for mouth and facial muscles
This type of therapy can help improve muscle position and strengthen the muscles that control the lips, tongue, soft palate, lateral pharyngeal walls, and face.
7. Surgical therapy
This type of therapy includes tonsil removal (tonsillectomy), and maxillary or jaw advancement.
The doctor can perform surgery to move the position of the upper jaw (maxilla) and lower jaw (mandible) forward with the aim of widening the upper airway.
Doctors can also perform a tracheostomy by making a hole in the neck through to the trachea, after which a tracheal tube will be inserted to help facilitate breathing.
Sleep Apnea Prevention
Sleep apnea can sometimes be prevented, especially if the cause is being overweight or obese.
However, there are also people who have normal weight or are even underweight but still experience sleep apnea.
In this case, the cause is usually a structural problem, so it cannot be completely prevented.
To reduce the risk of sleep apnea, some steps that can be taken include:
- Achieve and maintain a healthy weight. Keeping your weight within a healthy range can help prevent sleep apnea caused by obesity or being overweight.
- Practice good sleep hygiene. Maintaining a consistent sleep routine and creating a comfortable, restful sleep environment can help improve sleep quality.
- Manage existing health conditions. Controlling health conditions such as high cholesterol, high blood pressure, and type 2 diabetes can help reduce your risk of sleep apnea.
- Regular health checks. Undergo annual health checks at least once a year to monitor your health and detect problems early.
By following these steps, the risk of sleep apnea can be reduced and overall quality of life can be improved.