Sleep apnea is a serious problem that needs medical attention. The condition causes you to stop breathing while you sleep. It is accompanied by loud snoring. But, most people who suffer from the problem may not snore. The sleep disorder is also known as sleep apnoea, which causes you to feel tired after a full night’s sleep. If you feel drowsy or irritable in the morning, then see a doctor to detect the problem.
About Sleep Apnea
Obstructive Sleep Apnea (OSA)
It is the common type that occurs due to the relaxing of throat muscles.
Central Sleep Apnea (CSA)
CAS affects people when the brain fails to send proper signals to the muscles controlling your breathing.
Complex Sleep Apnea Syndrome
The condition also referred to as treatment-emergent central sleep apnea. It occurs when an individual suffers from CSA and OSA.
If you think you might have sleep apnea, see your doctor. Treatment can ease your symptoms and might help prevent heart problems and other complications.
Symptoms Associated With Sleep Apnea
The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include:
- Loud snoring
- Stop breathing during sleep (the episodes are reported by partners who sleep alongside)
- Waking up with a dry mouth
- Gasping for air during sleep
- Morning headache
- Insomnia (difficulty staying asleep)
- Hypersomnia (Feeling sleepy during daytime sleepiness)
- Trouble paying attention when awake
- Irritability
Causes Of Sleep Apnea
The different types of sleep apnoea have different underlying causes. So, the different causes leading to the condition are:
Cause Of Obstructive Sleep Apnea (OSA)
OSA occurs due to the relaxing of the muscles in the back of the throat. These muscles are responsible for supporting the soft palate and the uvula (the triangle piece that hangs from the soft palate). The muscles also support the tongue, the sidewalls of the throat, and tonsils. When the muscles at the back of the throat relax, it closes or narrows the airway while you inhale. So, you cannot get enough air. It results in low oxygen levels in your blood. Your brain senses the inability to breathe and awakes you briefly from your sleep. It is to reopen the airway to breathe properly. But, you never remember waking up as it is for a small period. OSA makes you gasp, snort or choke. The pattern repeats itself more than five times in an hour. So, you find it difficult to sleep properly. The inability to reach a deep and restful phase of sleep can lead to severe complications.
Cause Of Central Sleep Apnea (CSA)
It is the less common type of sleeping disorder. Central sleep apnea occurs when the breathing muscles never receive signals from your brain. The brain fails to send these signals. So, you make no effort to breathe for a short time. It can make you wake up due to shortness of breath. The condition can also make it difficult to stay asleep or try to get some sleep.
Risk Factors Associated With Sleep Apnea
The condition can affect anyone. Even children can face the risk of developing specific sleeping disorders. But, certain factors put you at risk of developing it.
Risk Factors Of Obstructive Sleep Apnea
The factors that increase the risk of developing the form of sleep apnea include:
Excess Weight
Obesity or excess body weight increases the risk of developing a sleeping disorder. It is because of the fat deposits around your upper airway. It can cause breathing problems.
Neck Circumference
People with thicker necks have arrow airways. So, it can lead to shortness of breath while sleeping and result in sleep apnoea.
Narrowed Airway
In some cases, people may inherit a narrow throat. When adenoids or tonsils enlarge, it blocks the airway. So, it causes breathing difficulty. The condition is common among children.
Men
Men are more prone to developing the condition compared to women. The likelihood of developing the problem is two to three times more. But, women who are overweight can face the risk of sleep apnoea. The condition is also prevalent among women who have reached menopause.
Old People
As people age, it increases the risk of developing different problems, including sleeping disorders.
Family History
Having close relatives who suffer from the problem increases your possibility of developing the condition.
Using Sedatives
The use of substances with sedative effects can relax your throat muscles. So, it can worsen OSA. People who use sedatives, alcohol or tranquilizers results in the problem.
Smoking
Smoking is not good for your health. Inhaling nicotine can increase your risk of developing OSA three times more compared to people who never smoke. Smoking increases fluid retention and inflammation in your upper airway. So, it makes you susceptible to sleep apnoea.
Nasal Congestion
People who experience nasal congestion can develop OSA. The congestion can make it difficult to breathe. You can experience nasal congestion due to allergies or anatomical problems.
Risk Factor Of Central Sleep Apnea
Central sleep apnea is more prominent among people who face the following risk factors:
Advanced Age
Middle-aged and older people have a higher risk of central sleep apnea. People who are above 65 years can develop the condition. It is because they suffer from other medical conditions or suffer from sleep pattern that leads to the problem.
Sex
Males are more likely to develop a sleep problem compared to females.
Heart Disorder
Heart problems like irregular heartbeats or have trouble with heart muscles (congestive heart failure) can face the risk of developing CSA.
Stroke
Problems affecting the brain like stroke, brain tumor or structural lesion can impair the ability of the organ. So, it affects breathing.
High Altitude
When you sleep in places at high altitudes, it increases the risk of sleeping disorders. But, it resolves a few days after returning to a lower altitude.
Opioid Use
Using opioid medication increases your risk of CSA.
Complications Due To Sleep Apnea
You may never feel the seriousness of the condition. But sleep apnoea is a serious medical condition that requires immediate medical attention. If you fail to seek medical help, you can face the following complications:
Daytime Fatigue
You cannot sleep properly for eight hours due to a sleep disorder. The lack of normal and restorative sleep can result in the following during the daytime:
- Fatigue
- Drowsiness
- Irritability
- Trouble concentrating
- Mood swings
- Quick-tempered nature
- Depression
People who fail to get proper sleep feel sleepy or drowsy during their work, study or while driving. It increases the risk of vehicular or workplace accidents that results in severe complications, including death. Children or adolescents suffering from the condition can lose focus and perform poorly in school. They also tend to experience behavior issues.
Heart Problems/ High Blood Pressure
Apnea during the night can cause a sudden drop in your blood oxygen levels. It can raise your blood pressure and put a strain on your heart. So, the sleep disorder can lead to hypertension as well as heart problems. The extra pressure on your heart can lead to abnormal left side chest pain. It can increase your risk of recurrent heart attack, abnormal heartbeats (like atrial fibrillation), or stroke. People suffering from heart disease or face multiple episodes of low blood oxygen can lead to fatal complications. Low blood oxygen also referred to as hypoxemia or hypoxia lead to sudden death due to irregular heartbeat.
Type 2 Diabetes
Suffering from a sleep disorder can put you at risk of developing insulin resistance as well as type 2 diabetes.
Metabolic Syndrome
It refers to the cluster of health conditions that put you at risk of developing fatal complications. The condition can cause the following:
- Increase waist circumference
- High blood sugar
- Abnormal cholesterol levels
- High blood pressure
Issues With Medications And Surgery
Apnea can affect the medication you take or cause problems with general anesthesia. So, people suffering from a sleep disorder can face complications after major complications. It is because they face breathing problems, especially when lying on their backs or are under sedation. Therefore, before you undergo surgery, you need to inform your doctor about your condition and the treatment you undergo to manage the problem.
Liver Problems
Sleep obstruction can lead to liver problems. It shows abnormal results when you undergo liver function tests. People with sleep apnoea show signs of scarring or evidence of nonalcoholic fatty liver disease.
Sleep-Deprived Partners
Loud snoring can make it impossible for your partner to sleep properly. It prevents them from getting a good rest. So, many partners tend to shift their rooms. Some may even change their room to another floor of the house to sleep properly.
Diagnosis Of Sleep Apnea
You have to see a doctor when you suffer from the symptoms associated with the sleep disorder. In most cases, the doctor makes a diagnosis after examining you thoroughly. The following ways help your doctor diagnose the problem:
Physical Evaluation
The doctor performs a thorough physical assessment to check for problems leading to the condition. You need to take your partner when you consult a doctor as they can shed light on your sleeping history. A person who shares your bed can help identify the symptoms and make a conclusive diagnosis. If the doctor suspects a problem, then you are mostly referred to a sleep disorder center. A specialist can determine the need for further evaluation and treatment.
Other Tests
You can stay in the sleep center for overnight monitoring. It monitors your breathing pattern as well as other body function when sleep.
Nocturnal Polysomnography
The test records your heart rate, the oxygen levels in the blood, the brain waves and breathing pattern. It also records the eye and your leg movement during the sleep study. You are hooked up to instruments that monitor different functions and brain activities.
Home Sleep Tests
Instead of suggested tests in a sleep center, your doctor can provide simple tests. These simple tests help your doctor identify the sleeping disorder. The tests measure your blood oxygen levels, heart rate, airflow, and breathing pattern.
If the results of the tests come back abnormal, then your doctor suggests therapy for the condition without further testing. Even if home sleep tests come back normal, you need to undergo polysomnography if your doctor suspects sleep apnoea. It is because the portable monitoring devices used for home tests may not detect all cases of sleep apnoea.
Check For Blocks
If your doctor suspects blockage in your nose, ear or throat leading to the condition, then you are referred to ENT specialist. In some cases, your doctor might suspect central sleep apnea. So, you need to see a cardiologist or a neurologist check the nervous system.
Treatment For Sleep Apnea
The treatment option suggested by the doctor depends on the severity of the problem you face. For mild cases of the condition, your doctor suggests small changes. For severe cases, you need medical treatment to manage the condition. The treatment options available are:
Treatment For Mild Form Of Sleep Apnea
To treat mild cases of sleep apnoea, your doctor recommends lifestyle changes. The small yet significant changes can manage the problem effectively. So, the doctor can recommend the following methods:
- Lose Weight
- Treat Nasal Allergies
- Quit Smoking
Treatment For Moderate Form Of Sleep Apnea
In moderate cases of sleeping disorder, you may not get desired results from lifestyle changes. It needs other forms of treatment to get relief. So, the doctor suggests treatment options like:
Continuous Positive Airway Pressure (CPAP)
It is the common treatment suggested for sleep disorder. The treatment option uses a machine that delivers air pressure. You receive air pressure through the mask while you sleep. CPAP machine delivers higher air pressure compared to the surrounding. So, it is enough to keep your upper airway passages open. It aids in preventing apnea as well as snoring. CPAP is the most reliable method to treat moderate forms of the condition. But, it evokes discomfort and is burdensome to the people. Most people tend to adjust the tension caused by the mask straps. They try to obtain a comfortable position and fit it securely to get the best results. But, others give up on the machine.
To ensure the best fit, you need to try more than one type of mask. It will help you find the perfect one that makes you feel comfortable. Never discontinue the use of a CPAP machine when you encounter problems. You need to talk to your doctor to determine the changes to enhance your comfort levels while using the machine. Also, talk to your doctor if you still encounter a snoring problem despite using the machine. In some cases, you need to adjust the pressure setting to get the desired results. So, always consult a doctor before making any decisions.
Other Airway Pressure Devices
If using a CPAP machine becomes a big problem, then you can use other types of airway pressure devices. Certain devices can automatically adjust the pressure while you sleep. The auto-CPAP machine is a big boon for people finding it difficult to use CPAP. You can also try using bi-level positive airway pressure (BPAP) devices. It offers more pressure when you inhale while reduces the pressure when you exhale.
Oral Appliances
You have another option to keep the throat open and prevent the sleeping disorder. Wearing an oral appliance can offer relief. It is not better than CPAP but is easier to use. Some of the oral appliances are designed to bring your jaw forward that can open your throat. So, it can relieve mild OSA (Obstructive Sleep Apnea) and snore. You can talk to your dentist about the different devices available. Try those to determine the best one that works for you. You have to make follow up appointments with your dentist frequently during the first year you use the oral appliance. Then, check with your doctor to ensure it is the right fit and reassess the signs as well as symptoms.
Treatment For Severe Sleep Apnea
For severe cases of sleep apnoea, the regular treatment options may fail to show effects. Since invasive surgery is the last option, you need to test the other options for at least three months. Only after all the options fail to offer results, you need to consider surgery. In some cases, abnormal jaw structure can lead to sleep disorders. So, the doctor suggests surgery as the first line of treatment to prevent the disorder. The surgical option includes:
Tissue Removal
The procedure, also known as uvulopalatopharyngoplasty. During the procedure, the doctor removes the tissues from the top of the throat and rear part of the mouth. In most cases, the doctor also removes your tonsils as well as adenoids. The invasive procedure can successfully stop vibration from the throat structures that result in snoring. But, it is less effective compared to CPAP. So, it is not considered as a reliable treatment for obstructive sleep apnea (OSA).
Tissue Shrinkage
People who cannot tolerate oral appliances or CPAP can select shrinking their tissues at the back of the throat using radiofrequency ablation (radiofrequency ablation). It is the option that has few surgical risks compared to other surgical procedures.
Jaw Repositioning
The invasive procedure moves your jaw forward. The repositioning of the jaw from the remaining face bones can manage snoring and apnea. It is because the repositioning enlarges the space behind your soft palate and tongue. So, it leads to less obstruction. The procedure is also known as maxillomandibular advancement.
Implants
It is the invasive procedure that implants plastic rods into your soft palate. Your doctor gives local anesthetic before the procedure. It is not clear how well the implants can manage the condition. More research is required to determine its effectiveness.
Nerve Stimulation
You need to undergo a surgery to insert a stimulator into the nerve controlling your tongue movement. The nerve called a hypoglossal nerve is directly linked to apnea. With increased stimulation, you can keep the tongue in a position to make the airway open. But, the success of the procedure needs more research.
Tracheostomy
The invasive procedure creates a new air passageway to make breathing easier. It is the only option when all other methods have failed. So, the procedure can manage the severe and life-threatening form of sleep disorder. During the procedure, the surgeon makes an incision in your neck and inserts a plastic or metal tube to make breathing easier. You cover the opening during the day while uncovering it at night. So, it allows air to pass in and out of the lungs without obstruction by bypassing the blocked air passage in the throat.
Other Surgeries
Several other surgeries can help reduce snoring and manage the condition. The surgery can treat apnea by enlarging or clearing air passages. So, the different surgeries are:
- Tonsillectomy
- Surgery to remove adenoids
- Bariatric Surgery (weight loss surgery)
Conclusion
Untreated or undiagnosed sleep apnea can put your life at risk. So, to prevent serious as well as life-threatening complications, you need to see a doctor. Making an appointment with the doctor can help detect the problem and diagnose it conclusively. With ideal treatment, you can prevent any complications associated with the condition.
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