Sleep Apnea: Every Breath you Take I'll be Watching you

Sleep apnea is a sleep disorder which is defined by periods of shallow breathing during sleeping hours. Pauses in breathing can happen multiple times during sleep and can last from just a few seconds to a few minutes. Commonly, these disruptions are followed by sounds of snoring, choking and snorting. There are two kinds of sleep apnea, obstructive sleep apnea (OSA) and central sleep apnea. OSA is more common of the two and affects about 6% of adults and 2% of children. Males tend to suffer from sleep apnea almost twice as much as females. People over 55 are more like to suffer from apnea than other age brackets. Central sleep apnea is much less common in comparison, affecting only about 1% of the population.

To learn more about sleep apnea (specifically about its OSA variant) including what are its symptoms, causes, associated complications, and how it is diagnosed and treated, explore the rest of the following article.

Symptoms

There are several symptoms associated with sleep apnea, but are not exclusive to it. Some occur during sleep like loud snoring, gasping for air followed by abrupt awakenings or difficulty staying awake. Other commonly appear upon awakening, like dry mouth and morning headaches. Throughout the day, it also common to experience sleepiness, a lack of energy, decreases in attention, vigilance, concentration, motor skills and visuospatial memory. There are even cases where the sex drive is affected, leading to dysfunction and a general disinterest in sex.

Since there are many causes which can lead to the listed effects, people are often unaware that they are suffering from obstructive sleep apnea. Additionally, the symptoms outlined above are often shared between OSA and central sleep apnea, making it difficult to distinguish between the two without a diagnosis by a medical expert.

Causes

Sleep apnea can be caused by a person’s physical structure or medical conditions. The etiology of sleep apnea includes the number of causes. For starters, children that are born early have an increased risk of developing sleep apnea. Obese people (those with BMI > 30) are more likely to suffer from obstructive apnea due to excess soft tissue in the throat. Enlarged tonsils can have the same effect as well.

Individuals who have suffered heart or kidney failure tend to develop sleep apnea. Endocrine disorders such as hypothyroidism, polycystic ovary syndrome or acromegaly, neuromuscular conditions such as stroke, post-polio syndrome, amyotrophic lateral sclerosis, and genetic syndromes including cleft palate and Down syndrome have strong causal correlations with sleep apnea, in addition to other problems they cause.

Complications

If left untreated, sleep apnea can lead to further health complications, including life-threatening ones in extreme cases. Increases in blood pressure and straining of the cardiovascular system can occur due to sudden drops in blood oxygen that happen during sleep apnea. This can lead to heart-related issues such as hypertension, irregular heartbeat, and even heart attacks. Sleep apnea also increases the likelihood of suffering a stroke. People that have pre-existing heart conditions can have their problems exacerbated by sleep apnea, potentially leading to death due to heartbeat disturbances.

Sleep apnea causes a number of issues related to the liver, including developing the nonalcoholic fatty liver disease, reducing liver functionality, and producing liver scarring. Undergoing surgery while suffering from sleep apnea can be dangerous due to breathing problems which get exacerbated under anesthesia . Finally, individuals with sleep apnea are more likely to develop pancreatic, renal, and skin cancers.

Diagnosis

Only certified medical experts can diagnose sleep apnea. This is done through a multi-step examination which includes going through your medical history, undergoing a physical exam, and finally going through a sleep study. Since sleep apnea shares many common symptoms with other diseases, it is important to run other tests as well to rule out other possible conditions.

Examining a patient's medical history for signs of apnea is accomplished in a number of steps. First, the patient has to describe the signs and symptoms he is experiencing to the doctor. Afterwards, they need to specify whether there were any occurrences of sleep apnea and other sleep disorders in the family . Finally, the existence of conditions such as atrial fibrillation, type 2 diabetes, and high blood pressure is determined, as they can arise due to complications related to sleep apnea.

Next comes the physical exam, which involves a number of throat and mouth-related tests. These include measuring the size of the tonsils, the narrowness of the upper airway, the circumference of the neck, jaw size and structure, and tongue size and position. These tests are followed by more standardized tests for determining the state of heart and lungs. Obesity is commonly measured at this stage as well. In cases where central sleep apnea is suspected, tests involving the nervous system also have to be performed.

The final phase of establishing sleep apnea is a polysomnogram – a multiple-component test which involves recording particular physical activities during your sleep. The results are then analyzed to establish whether you have sleep apnea and of which kind. Other related sleep disorders might be diagnosed as well, or instead of sleep apnea.

Prevention And Treatment

There are several common ways of preventing and treating sleep apnea, and associated complications that might arise. They include changes in lifestyle, CPAP therapy, surgery, and medication.

The best place to start is by trying to reduce risk factors which come up as a result of an everyday activity. Exercising and maintaining a proper diet are the most direct ways of ensuring the body-mass index stays below the threshold for obesity , which is one of the more common causes of sleep apnea. Excessive alcohol consumption can cause or aggravate sleep apnea by disturbing normal sleep patterns, so reducing intake can have positive benefits. The same goes for using sleeping pills and other sleep-inducing products. The risk of developing sleep apnea can be reduced by giving up smoking, as it can lead to a great number of throat and mouth-related problems. Finally, a simple change in sleeping posture can do wonders in some cases. Resting on an inclination or lying sideways puts less pressure on the airways, which makes sleep apnea less likely to arise.

In some cases, surgery is the best option to permanently remove the causes which lead to obstructive sleep apnea. These include enlarged tonsils, deviated nasal septum, small lower jaws with an overbite. Depending on the type of surgery a patient undergoes, a follow-up rhinoplasty procedure might be necessary for quality-of-life and aesthetic reasons.

Continuous positive airway pressure (CPAP) is a practice whereby a mask is worn over the nose during sleeping hours. The mask is linked with a device that creates a continuous air-flow into the nostrils. This air flow keeps the airways open so that breathing can proceed regularly. Continuous positive airway pressure treatment became the most common treatment for sleep apnea ever since it was discovered.

Conclusion

Sleep apnea is a well-documented condition in the medical discourse. Measures for diagnosing, preventing and treating sleep apnea are at the level where the ailment can be controlled reasonably well in most cases. Complications that arise due to sleep apnea are mostly the result of being ill-informed on the part of the public, which is why raising awareness about the condition, both offline and online, is the necessary first step towards making sound sleeping a reality for more people.