If someone has the problem of sleep apnea, it means his breathing stops and starts repeatedly and thus is labelled as a potentially serious sleep disorder. It is more common than thought and is often undiagnosed. It is not restricted to overweight men who often have snoring problem. A recent study shows that people suffering from sleep apnea have problem in remembering small things like where the car is parked, where the house keys are kept, etc. In this article we will discuss more details about this disorder.
What Is Sleep Apnea?
"Apnea" means "without breath" in Greek. Involuntary stopping of breath when the person is asleep is referred to as sleep apnea. In sleep apnea, a person might stop breathing for a few seconds to few minutes. It can happen 30 times or more in an hour. This is followed by regular breathing which may start with a loud snort or choking sound.
Sleep apnea is a chronic condition which is ongoing and causes disruption of sleep. It causes changes in sleep pattern as well. Once the breathing pauses or becomes shallow, the person moves from deep sleep to light sleep. This results in poor quality of sleep and makes you feel tired during the day. It is the leading cause of daytime sleepiness.
What Are the Types of Sleep Apnea?
Sleep apnea is of three types: obstructive, central and mixed. Obstructive sleep apnea also referred to as OSA, which is the most common type. Details of the types are given below:
- Central sleep apnea. In this type, the brain does not signal the muscles to breath and hence there is no muscular effort in breathing.
- Obstructive sleep apnea. In this type, the signal from the brain is sent to the muscles to take a breath and the efforts are made by the muscles. However, breathing is prevented due to obstruction of the airway, affecting the flow of air.
- Mixed sleep apnea. In this type, both the condition of central sleep apnea and OSA occur.
What Causes Sleep Apnea?
1. Causes of Central Sleep Apnea
Central sleep apnea can be caused due to heart failure and sometimes even a stroke. The brain is unable to impart signal to the muscles for breathing and this causes the person to awaken due to shortness of breath. They are more likely to remember awakening from sleep than people suffering from OSA. Snoring and daytime sleepiness occur in central sleep apnea.
2. Causes of Obstructive Sleep Apnea
In this condition, the muscles at the back of the throat get relaxed. Relaxed muscles cause the airway to narrow or close, making it difficult to breathe in. It lowers the level of oxygen in the brain, which makes the brain send a signal to awaken you to reopen the airway. This awakening is very brief and difficult to remember. This can occur 5-30 times or more in an hour and it will not let you achieve desired sleep. People suffering from OSA might not remember being interrupted in sleep and can feel as if they have slept well.
What Are the Symptoms of Sleep Apnea?
If you have sleep apnea problem, you may feel some symptoms that are different when you are awake and asleep.
Loud & persistent snoring
Choking and gasping for air when in sleep
Witnessed pause in breathing
Frequently visiting the bathroom
Lack of concentration
Depression & irritability
Daytime sleepiness during routine activities
Excessive fatigue during daytime
Early morning headaches
How Can Sleep Apnea Be Diagnosed?
Sleep apnea can be evaluated by the symptoms presented or your doctor may suggest you to a sleep disorder center. Depending on the results, a further evaluation might be required. Some of the tests are given below:
1. Home Sleep Tests
Home sleep tests are simpler and less expensive. It usually involves measuring heart rate, blood oxygen level, airflow and breathing patterns. Blood oxygen level dips during apneas and rises on awakenings. Abnormal results will allow the doctor to prescribe therapy without further testing. Portable monitoring devices are not able to detect all types of apneas.
2. Nocturnal Polysomnography
In this test, a device monitors the heart, brain and lung function. Breathing pattern is recorded. Arm and leg movements, as well as blood oxygen levels, are monitored while the patient is asleep.
Note: If you are suffering from obstructive sleep apnea, your doctor may suggest you go to visit an otolaryngologist to rule out any blockage in the nose or throat. While if suffer from central sleep apnea, a neurologist or cardiologist is needed.
How Can Sleep Apnea Be Treated?
The right treatment will be prescribed by a board certified sleep physician. Other people involved in a sleep treating team are psychologists, physician assistants, nurses, dentists and technologists. Some common treatments are given below:
1. Continuous Positive Airway Pressure (CPAP)
A frontline treatment for OSA, it involves using a machine by which a steady stream of air is gently passed through the airway, which keeps it open. A mask is placed on the face, which is attached to a machine with a hose. The mask and machine can vary depending on treatment and comfort levels.
2. Oral Appliance Therapy
A device which looks similar to a sports mouth guard or orthodontic retainer, it fits in the mouth over the teeth. It holds the tongue in position and prevents the jaw from sliding forward, which does not allow the airway to collapse. It is prescribed for people who suffer from mild to moderate apnea and cannot tolerate CPAP.
3. Surgical Intervention
This treatment is not as effective as CPAP or oral devices. It helps in eliminating the throat's extra tissue which collapses and causes airway blockage. Some surgeries adjust bone structures of the jaw, nose and facial bones. This can be opted for when CPAP or oral device does not work.
4. Position Therapy
Behavioral strategy to treat positional sleep apnea is called positional therapy. If people experience apnea when in supine position, they can sleep on the side, so the symptoms might disappear. Devices can be used which help you in sleeping on the side. Vibrio-tactile feedback is a device which causes vibration on the back of the neck when in supine position, causing the person to sleep on the side. This therapy can be used alone or combined with other therapies.
5. Lifestyle Modification
Bringing about changes in the lifestyle can cause reduction in snoring and improve apnea symptoms. Cessation of smoking and abstaining from alcohol are helpful. Taking a decongestant prior to sleeping can help in case of allergies. Behavioral sleep specialist helps in dealing with eliminating thoughts and behavior which prevent from getting sound sleep.
6. Weight Loss
In case of overweight or obese individuals, losing weight can improve the symptoms associated with sleep apnea. With increased weight, there is extra tissue present in the throat which causes blockage in the airway. Weight loss may or may not help with apnea. It will also not be helpful when the person already has a narrow airway or passage.
You can get more information like risk factors and complications of sleep apnea in the video below: