Sleep Apnea
By Naomie Natasha
This is a disorder that causes the upper airway to become blocked repeatedly. People with this disorder stop breathing repeatedly during their sleep. This will cause the brain and the rest of the body to lack oxygen. There are 2 types of sleep apnea (1) and they include the following;
Obstructive Sleep apnea; this is the most frequent type of sleep apnea that is caused by blockage of airways.
Central Sleep apnea; it occurs when the brain fails to signal the muscles responsible for breathing.
If you feel tired after having a full night’s sleep, gasp for air during sleep, snore loudly or stop breathing during sleep, you might have this disorder.
Who is at risk of getting Sleep Apnea?
Sleep apnea can affect anybody and at any age. Having unhealthy lifestyle habits can increase your risk for developing sleep apnea. Other risk factors include being overweight, having nasal obstruction, having large tonsils or tongue and having parents with sleep apnea.
If sleep apnea is left untreated, it increases the risk of other health problems like high blood pressure, headaches, stroke, worsening of ADHD, heart failure and depression.
Causes of Sleep Apnea
Obstructive Sleep Apnea
When your airway narrows due to back muscles of your throat relaxing, you cannot get enough air. This makes the oxygen level in your blood to lower and this alerts your brain that you are not breathing. Your brain rouses you from sleep so your airway can be opened and breathe again.
In the process of sleep apnea, you might choke or gasp for air. Waking up to breath can repeat itself 5 to 30 times impairing you to sleep properly.
Factors that increase this type of apnea include obesity. Excess weight or fat deposits around your upper airway can affect your breathing. If you inherited a narrow airway, or have tonsils, this can block the airway.
People with family who have sleep apnea could be at risk of getting it. Smoking is another factor that can increase the risk of developing this disorder. Smoking can lead to inflammation in the upper airway causing blockage (2).
Central Sleep Apnea
It occurs when the brain fails to communicate to breathing muscles and this leaves someone gasping for air during sleep.
Signs and Symptoms of Sleep Apnea
- Loud snoring
- Recurrent awakening
- Gasping for air during sleep
- Restless sleep
- waking up with a dry throat
- morning headaches
- irritability
See a doctor if you have these signs and symptoms because this is a serious medical condition which can cause complications such as;
Heart problems or high blood pressure; low levels of oxygen in the blood increases blood pressure and this strains the heart. This disorder might lead to heart attack or abnormal heartbeats so it is important to seek medical help to prevent these complications.
Daytime Fatigue; Waking up at night repeatedly will leave you fatigue and feeling sleepy during the day. Repeated awakening connected with sleep apnea makes someone to sleep abnormally hence one feels drowsiness and fatigue during the daytime.
This will automatically affect your life functioning whereby you will find it difficult concentrating at work and can fall asleep while driving or watching TV. Sleep apnea patients are at a high risk of getting into workplace or vehicle accidents due to feeling sleepy (3).
Diagnosis
An evaluation will be made based on your symptoms. Your doctor will need to know your sleep history and your partner or family who shares your bed can help with this. A sleep specialist may be needed to monitor your sleep and breathing in order to detect if you have sleep apnea. The sleep tests to be done include the following;
Nocturnal polysomnography; This is a test with equipment that will examine your lungs, breathing patterns, blood oxygen levels and brain activity. This is conducted at a sleep center by a sleep specialist and it is often an overnight monitoring.
Home Sleep Tests; this type of test is conducted where your doctor will give you portable tests to measure blood oxygen level, breathing patterns and heart rate. Abnormal results might indicate sleep apnea where further testing can be done to conclude that it is sleep apnea.
You might be referred to an ear, throat and nose doctor to determine if you have blockage in your nose.
Treatment
There are several therapies to treat sleep apnea. First is continuous positive airway pressure (CPAP). It is one of the effective treatments of sleep apnea and delivers air pressure via a face mask.
Continuous positive airway pressure is a machine that gives pressurized air thus maintaining an open airway. This prevents its collapse and it is effective in eliminating snoring. With a small motor, it uses your room air to generate pressure and deliver it through a face mask.
There are newer machines that are small, quiet and can run on electricity or battery.
There are other airway pressure devices such as bilevel positive airway pressure (BPAP) and auto-CPAP that automatically adjusts air pressure when sleeping. Bilevel positive airway pressure (BPAP) is used to treat central sleep apnea and obstructive sleep apnea by delivering 2 alternating pressures through a facemask (4).
For cases of sleep apnea that are mild, a doctor may suggest change of lifestyle, quit smoking and losing weight. If allergies are the cause of your nasal blockage, a doctor may recommend treatments to eliminate them.
A doctor can recommend oral appliances that are designed to keep your throat open. These are easier to use but not as effective as a CPAP. There are many types of oral appliances so it is advisable to try which device will work for you before purchasing from a dentist (4).
Surgery may be done if other treatments are not successful. Surgery might include tissue removal that is causing blockage. Tonsils might be removed and other throat structures that might be causing snoring.
Tissue shrinkage might be done to treat sleep apnea. This has fewer surgical risks. There are other home and lifestyle remedies that can help you to deal with sleep apnea. They include losing of weight to relieve constriction of throat caused by fat, regular exercise to help ease symptoms and avoiding smoking.
References
Harrington, C. The Complete Guide to a Good night’s Sleep. Pan MacMillan Australia 2014.
Palnitkar G, et al. Obstructive sleep apnea in adults: identifying risk factors and tailoring therapy. Medicine Today 2012, 13(8):14-23
Peppard P.E et al. Increased Prevalence of Sleep-Disordered Breathing in Adults. Am J Epidemiol. 2013 (5.17)
Wong S.H., Ng BY. Review of sleep studies of patients with chronic insomnia at a sleep disorder unit. Singapore Med J. 2015 Jun; 56(6):317-23.