Sleep Apnea: An Overview
What is Sleep Apnea?
Sleep Apnea is a common nighttime breathing disorder that affects more than 15 million Americans. Sleep apnea affects men and women of all ages; even children can suffer from sleep apnea. Without treatment, living with the disorder may cause significant complications including daytime sleepiness, increased risk of heart attack and stroke, mood disorders and poor daytime function. Most people who have sleep apnea do not realize that they have the condition; even though their sleep is frequently interrupted throughout the night. People suffering from sleep apnea will wake often through out the night due to their oxygen being restricted or completely cut off. When apnea sufferers awaken, normal breathing is restored; however, they do not enter a state of complete wakefulness. The apneic events can continue unnoticed because sufferers do not fully awake or recognize they are waking though out the night. With sleep apnea, breathing may temporarily stop or become shallow hundreds of times during a night's sleep.
A frequently reported symptom related to sleep apnea is daytime sleepiness, some times being so extreme people have reported drifting off at work or while driving. Other common complaints include lack of concentration and poor mental agility that can lead to poor performance at work and an unfulfilling life. In Greek, "apnea" means "with out breath". There are two types of Sleep Apnea, Obstructive Sleep Apnea (OSA), which is the most common, and Central Sleep Apnea.
The cause of Obstructive Sleep Apnea occurs when the air passage at the back of the throat becomes blocked. When muscles in the throat relax, this causes the soft palate to relax as well, which then narrows the airway. This same course of events also causes snoring, although, not all people who snore have obstructive sleep apnea. As one breathes in through the mouth or nose, the airway narrows further or completely closes and cuts breath short. The airflow restriction causes a gasping sensation, which prompts a period of shallow wakefulness. While partially awake, normal breathing is restored. This persistent blockage of the airway can happen several times an hour, replaying the course of events through out the night, causing a fragmented night of sleep.
Central Sleep Apnea occurs when your brain fails to send impulses to the body to breath. Central Sleep Apnea takes its name from the Central Nervous System, which regulates the body's necessary functions. This instability in the brain's respiratory control center can have several causes, the most common being central nervous system dysfunctions or individuals who have suffered a stroke. People who suffer from heart failure or other heart and lung conditions may also develop Central Sleep Apnea.
Who apnea affects...
Obstructive Sleep Apnea can affect men and women, at any age, and even children can develop sleep apnea. Men are at greater risk. The risk increases if you are over weight and over forty years of age. Other risk factors include a large neck size; 17 inches or greater for men or 16 inches or greater for women. Large tonsils or a large amount of tissue at the back of your throat can cause increased blockage and higher risk as well. Obstructive Sleep Apnea can run in families, suggesting that there may be a genetic component.
How apnea affects your body and mind...
There are many different effects sleep apnea can have on you, both physically and mentally, ranging from mildly irritating to life threatening. One effect is excessive daytime sleepiness. Most people do not realize when they drift off for a moment or two, but the effects can be devastating. Sufferers may notice they have a problem concentrating and an increase in forgetfulness or trouble learning new things. Some of these symptoms of sleep apnea can be confused with symptoms of depression because they are so similar; personality changes, irritability, mood swings, memory problems, feeling lethargic and perhaps even feeling depressed are some of the shared similarities.
Signs and Symptoms...
A common sign of obstructive sleep apnea is a sore or dry throat in the morning upon waking. Frequently people with apnea will wake several times during the night, sometimes by their own snoring, or from a choking or gasping sensation caused by their airway being blocked. These wakeful periods during the night interrupt their sleep and cause daytime sleepiness, which is another well documented symptom. Some other symptoms may be observed; such as forgetfulness, mood changes, headaches or a decreased sex drive. People with central sleep apnea may experience many of the same symptoms as people with obstructive sleep apnea.
How is it diagnosed?
Only a medical professional can diagnose Sleep Apnea. If you're suspicious you have sleep apnea or suffer from the common symptoms, see your health care provider. Your health care provider may suggest that you have a sleep test done to determine the cause of your symptoms; the test usually includes a polysomnogram or a Multiple Sleep Latency Test. A polysomnogram will electrically monitor your heart rate, breathing and muscle activity throughout a night of sleep. A sleep specialist and your health care provider will analyze the electronic records created. A Multiple Sleep Latency Test (MSLT) will simply measure how long it takes you to fall asleep or if you are apt to fall asleep when you would normally be awake. If sleep apnea is discovered during the sleep study, you may be asked back for further testing to detect the most appropriate treatment.
What to expect...
Sleep tests are typically done at sleep centers or hospitals. When you arrive, you will have a private room, which may be decorated to feel more like home than a medical facility. Some hospitals or centers allow you to bring your own clothes to sleep in, to promote relaxation and a sense of ease. Your room will be near the monitoring area where the sleep technicians can monitor the information collected by the polysomnograph. When you are ready to sleep the technicians will attach the monitoring devices. Most people have little trouble sleeping with them on as they consist of a few electrodes, a belt to monitor your heart rate and breathing, and an oximeter fitted over a fingertip to measure the oxygen level in your blood.
If your health care provider desires you to have a MSLT, it will most likely be done at a sleep center or hospital as well. The test is done to measure the amount of time it takes for you to achieve sleep, or to determine if you are predisposed to fall asleep when you should be fully awake. A sleep technologist will video tape you while you sleep to record your movements during the night or to note the number of times you drift off during your normal waking hours.
What can be done?
There are several different treatment options for sleep apnea ranging from conservative therapy to major surgery.
The most common treatment is Continuous Positive Airway Pressure (CPAP). A CPAP machine consists of a specially fitted mask that covers your mouth and/or nose while you sleep. The machine delivers a continuous flow of air into your nostrils. The pressurized air flowing into your airways promotes open airways so breathing is not impaired while you sleep.
Some people with obstructive sleep apnea find their cure with dental devices. These appliances are specially designed to keep airways open during sleep. Dentists that have a specialty dealing with obstructive sleep apnea, customize the devices for the wearer.
Surgery is a treatment option for apnea as well. Surgical options often involve procedures that attempt to increase the diameter of the upper airway.
Individuals with sleep apnea may be instructed to make lifestyle changes. Some suggestions may include weight loss to alleviate constriction of the throat. Avoidance of alcohol, over-the-counter sedatives and other unnecessary sedating agents is also recommended, as these may further relax the muscles at the back of your throat.
What to do?
See your doctor for an evaluation if you feel that you are experiencing the symptoms mentioned above like daytime sleepiness, snoring and gasping, morning headaches, or waking through out the night. Only a trained health care provider can diagnose sleep apnea. Your health care provider will evaluate your sleep troubles and may refer you to a sleep specialist, who has special training in sleep medicine. Sleep apnea is a serious medical condition that may lead to other conditions such as high blood pressure, heart attack, irregular heartbeat or stroke so early treatment is desirable.
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