Sleep Apnea: The Ultimate Guide

Sleep Apnea
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Sleep Apnea

Sleep apnea is a sleep disorder that occurs when breathing repetitively stops and start during sleep. If left untreated, the person’s breathing might get interrupted repeatedly when he is asleep and sometimes, hundreds of times a night which means the brain and the body may not be getting enough oxygen to breathe. Loud snoring indicates a health problem however, not everyone who has sleep apnea snores.

Types of Sleep Apnea

  • Obstructive sleep apnea:  It occurs when the throat muscles relax during sleep and block the airway which causes to snore loudly.
  • Central sleep apnea: It occurs when the brain does not send the signal to muscles that control breathing.
  • Complex sleep apnea: It is a combination of obstructive sleep apnea and central sleep apnea.

Consult your Doctor if you suspect sleep apnea. Identifying sleep apnea and proper treatment can ease sleep apnea symptoms and reduce the chances of heart problems and other complications.

Sleep Apnea Symptoms:

  • Loud and Chronic Snoring
  • Silent pauses in breathing
  • Daytime sleepiness or exhaustion
  • Unrefreshing sleep
  • Insomnia (difficulty in sleeping)
  • Morning headaches
  • Waking up at night due to feeling short of breath
  • Difficulty in concentrating
  • Memory loss
  • Irritability, Depression
  • Going to the bathroom frequently during the night
  • Waking up with a dry mouth

Risk Factors for Sleep Apnea

The factors that can increase the risk of sleep apnea are:

  • Obesity: People who are overweight or obese are more vulnerable to sleep apnea as fat deposits around their upper airway that can block breathing.
  • Family History: It is basically hereditary, which means if your family member has sleep apnea there are more chances that you are at higher risk. Family factors such as physical activity and eating habits also play an important role in sleep apnea.
  • Smoking: Smokers are more prone to this disease as it increases the amount of inflammation and fluid retention in the throat and upper airway that contributes to sleep apnea.
  • Large Neck size: People with a larger neck are more prone to this disease as they have more soft tissue that can block the airway during sleep.
  • Hypertension: People suffering from High Blood Pressure are more likely to have sleep apnea.
  • Consuming Alcohol: Alcohol consumption relaxes the throat muscle that can cause difficulty in breathing due to which it can worsen sleep apnea.
  • Nasal Congestion: If you have a problem in breathing through the nose due to some allergy or by anatomical problem you are more likely to develop obstructive sleep apnea.
  • Age above 40: Sleep apnea is more common in older, middle-aged adults. However, it can occur at any age.
  • Sleep apnea in Male: Men are more vulnerable to this disease than women. However, for women, the risk of this syndrome increases with menopause.

Sleep Apnea Causes:

If it’s not diagnosed and treated it can cause many health problems and may lead to poor performance in day-to-day activities.

  • High Blood Pressure:  Sleep apnea causes hypertension or high BP  that increases the risk of heart diseases and strokes.
  • Stroke:  It can also cause a stroke that occurs when there is bleeding in the brain or when the blood vessel gets blocked.
  • Heart disease:  Sleep apnea can lead to heart disease like heart stroke, Heart failure, irregular heartbeats. To avoid this, it is very important to get treated.
  • Diabetes: There are more chances that a person may suffer from diabetes if he is already suffering from Sleep apnea. Diabetes is a disease that occurs when the pancreas produces very less or no insulin or when the body doesn’t respond to insulin.
  • Depression:  Depression is a mood disorder where a person has a persistent feeling of constant sadness, negative thoughts, anxiety, and hopelessness which occurs due to sleep apnea. Sleep apnea causes depression.

Sleep Apnea Diagnosis:

The doctor may ask you to go for a sleep apnea test (also known as polysomnogram)  if there are sleep apnea symptoms. The test can be done at a sleep disorder center or at home.

A sleep study consists of multiple component tests that electronically transmits and records specific physical activities while you sleep. A qualified sleep specialist will analyze the recording to find whether you are suffering from sleep apnea or another type of sleep disorder.

The doctor will also examine the sleep patterns to get clues about the correct sleep problem and determine if something else is causing the problem or making it worse. If it is diagnosed you might need to go for further sleep apnea test to determine the best treatment option.

During a sleep study, if you are in a sleep center lab, there will be a central monitoring area near the bedroom where sleep specialist will monitor patients.

Sleep Apnea Treatment:

It is a sleep disorder that needs to be treated by choosing the treatment plan for a positive outcome. The sleep apnea treatment may range from lifestyle changes, such as losing or gaining weight or changing sleep positions, to CPAP therapy to surgery.

CPAP (Continuous Positive Airway Pressure):

CPAP is a machine that keeps your airway open during the night by providing a continuous stream of air through a mask that is worn over the nose while you are asleep. It eliminates breathing interruption, and chances of snoring. By wearing a CPAP machine you will be able to sleep freely throughout the night without waking up from a lack of oxygen.

Using CPAP each night will keep you active and fresh throughout the day and there will be an improvement in mood and memory power. CPAP also reverses a serious health problem that is directly linked to sleep apnea such as heart disease and stroke.

Dental Device for Sleep Apnea:

It is basically a dental device that fits your mouth over teeth while you are asleep. The device keeps the airway open by preventing it from collapsing by holding the tongue in position or by sliding your jaw forward which makes patient breathe during sleep.

This appliance is designed by dentists with special expertise in treating sleep apnea. After diagnosing, a dentist trained in dental sleep apnea can fit you with an oral appliance. It is recommended for patients with mild-to-moderate apnea who cannot tolerate CPAP.

Surgery

There are many varieties of surgical options if CPAP and oral appliance do not work then you might need to opt for surgery. These surgeries focus on Soft palate and uvula, Tonsils and adenoids, Tongue, Upper, and lower jaw.

It reduces or eliminates the extra tissue in the throat that collapses and interrupts the airway during sleep. Other complex procedures include adjusting your bone structures, jaw, nose, and facial bones, etc.

  • Nasal Surgery: To correct a nasal related problem such as a deviated septum- wherein the nasal cavity of the nose is off center, or crooked making it difficult to breathe.
  • Uvulopalatopharyngoplasty (UPPP):  This procedure is used to remove excess tissue from the soft palate and pharynx.  After removal of the tissue, the width of the airway opens widely and prevent collapse.
  • Mandibular maxillomandibular advancement surgery: This surgery can be used to correct facial problems or throat obstruction that leads to sleep apnea.

Weight Loss Management

Weight loss can help sometimes to improve or eliminate sleep apnea symptoms if you are obese. People having an excess weight often have thick necks with extra tissue in the throat that may block the airway. However, it’s not proven that losing weight can eliminate sleep apnea, though it might help.

Positional Therapy

Positional treatment is a behavioral methodology to treat positional sleep apnea. Some people have sleep apnea specifically if they sleeping on their back. This is known as the “supine” position. Their breathing comes back to normal when they sleep on their side.

Positional treatment may include wearing a special device around the waist or back that lets you sleep in the side position. Another choice is a small device that uses “vibrotactile feedback”  technology.

It can be worn on the back of the neck, it tenderly vibrates when you sleep on your back. Without awakening you, the vibration cautions your body to change positions. Positional treatment can be implemented alone or together with another sleep apnea treatment.

Lifestyle Changes

The change in lifestyle can help you reduce snoring and improve your sleep apnea symptoms. Behavioral changes such as quitting smoking or drinking alcohol improve sleep apnea symptoms. Alcohol relaxes throat muscles that cause snoring or collapsing airway.

Myths and Facts on Sleep Apnea:

Myths:

  • Snoring is the only symptom for sleep apnea is untrue. Most people who are not suffering from sleep apnea also snore however, people who have sleep apnea snore.
  • Only old people can get it is a myth since it can occur at any age.
  • Alcohol helps you to sleep is untrue, it rather relaxes the muscles in the back of the throat and makes easier for airway to get blocked.
  • Sleep apnea is not dangerous is a myth as it can increase the risk of increases health issues like heart disease, stroke, etc.

Facts

  • Sleep Apnea can block your Breathing.
  • Losing weight can help in defeating Sleep Apnea.
  • Lying on your side can help in preventing sleep apnea as it opens your throat. However, if you sleep on your back the gravity can pull the tissues in the throat down and is likely to block your airway.
  • CPAP mask is effective in treating Sleep Apnea since it blows a steady stream of air into your airway.
  • A dentist can fit you with a dental device which is a custom made and can adjust the position of lower jaw and tongue can ease sleep apnea.

Author:

Dr. Srikanth Reddy

  • M.S(GOLD MEDALIST), M.Ch(Neurosurgery, NIMS)
  • Consultant Neuro & Spine Surgeon
  • Medical Registration No: 68934
  •   Mon – Sat: 10 AM – 4 PM*
  •   Hitech city, Madhapur

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