Sleep Apnea - recent information you should know
Sleep apnea is a condition in which you stop breathing while sleeping. Your brain tries to maintain you by waking you awake frequently to breathe, but this disrupts comfortable, healthy sleep. Over time, this syndrome can lead to major consequences. However, this illness is frequently highly controllable, particularly with strict attention to prescribed therapy.
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| Sleep Apnea - recent information you should know |
The consequent lack of oxygen triggers a survival reaction, waking you up just enough to resume breathing. While this response keeps you alive, it disrupts your sleep pattern. This impairs healthy sleep and can have severe implications, such as stressing your heart, which can be fatal.
What is sleep apnea?
Sleep apnea is an occurrence when you stop breathing while sleeping. The word "apnea" is derived from the Greek word for "breathless." Sleep apnea occurs when you stop breathing during your sleep. This occurs when your airway becomes blocked (obstructive sleep apnea) or when your brain fails to effectively regulate your breathing (central apnea).
Who does sleep apnea affect?
Obstructive sleep apnea is more prevalent in various situations and categories of people:
- Before the age of 50, it is more common in men.
- After age 50, it affects both women.
- Individuals are more likely to acquire it as they age.
- Being overweight or obese significantly raises the risk of getting it.
- It is more common among people of Black, Hispanic, and Asian origin.
Central sleep apnea is particularly common in specific types of people:
- Individuals who use opioid pain medicines.
- Adults older than 60.
- People suffering from congestive heart failure or atrial fibrillation.
- Some persons who use CPAP or have obstructive sleep apnea may experience treatment-emergent central sleep apnea.
- Living at high altitudes might lead to central apneas.
How does sleep apnea affect the way the body functions?
Understanding sleep apnea requires a basic
understanding of the human sleep cycle. Sleep occurs in several stages:
- Stage 1: light sleep. This is a brief stage that begins just after you fall asleep. It accounts for approximately 5% of your whole sleep time.
- Stage 2 involves deeper slumber. This stage is more in-depth and accounts for approximately 45% to 50% of your total sleep time.
- Stage 3: Slow-wave sleep. This is the deepest sleep stage, accounting for approximately 25% of your sleep time (this percentage decreases with age). It is extremely difficult to wake someone up from stage 3 sleep, and waking up immediately frequently results in "sleep inertia," a state of "mental fog," and sluggish thinking. Sleepwalking and sleeptalking are common parasomnias during this stage.
- REM Sleep: REM stands for "rapid eye movement." This is the stage in which you dream. When someone is in REM sleep, their eyes move beneath their eyelids.
When you fall asleep, you usually enter Stage 1 and then go to and cycle between Stages 2 and 3. After cycling through those stages, you'll eventually enter REM sleep and begin dreaming. After the initial REM cycle, you start a new one and return to Stage 1 or 2. Typically, one cycle lasts 90 to 110 minutes before the next begins. Most people experience four or five cycles during the night (considering they get 8 hours of sleep).
How does sleep apnea interrupt your Sleep Cycle?
Your brain constantly checks your body's condition and regulates your heart
rate, blood pressure, breathing, and so on. Your blood oxygen levels can
decline if you stop breathing due to apnea or hypopnea.
- Apnea: occurs when you cease breathing while sleeping or have very little airflow. It combines the Greek roots "a," meaning "not," and "apnea," which means "breathing." Combined, it signifies "breathless."
- Hypopnea: comes from the Greek words "hypo" and "pnea." The term "hypo" signifies "low" or "under." Combining these root phrases yields "under-breathing" or "low breathing," indicating that you are not breathing enough to keep your blood oxygen levels stable.
When your blood oxygen levels drop because of
apnea or hypopnea, your brain responds by triggering a failsafe-like response
that wakes you awake enough to breathe. When you resume breathing, your brain
instinctively attempts to restart your sleep cycle.
The severity of your sleep apnea determines how frequently these interruptions
occur. The apnea/hypopnea index (AHI) is the average hourly number of apnea or
hypopnea events, which occur when a person stops breathing. The AHI is the
primary component that determines the severity of sleep apnea. The severity is
given below:
- Mild sleep apnea is defined as an AHI of 5 to 15. That
indicates they experience 5 to 15 apnea or hypopnea occurrences every hour.
However, healthcare providers take into account symptoms at this level. If you
have no additional symptoms, they may not think it is serious enough to treat.
- Moderate sleep apnea causes 15 to 29 episodes per hour. That suggests that a person who sleeps for eight hours will stop breathing and/or wake up 120 to 239 times.
- Severe sleep apnea causes people to wake up 30 times or more each hour. That indicates they stop breathing and/or wake up at least 240 times during an eight-hour sleep cycle.
Obstructive events, which are very brief, can disrupt any stage of sleep. They are most common during Stages 1, 2, and REM sleep. That's why it's typical for people to forget apnea incidents, which means they may not realize they have a problem until the symptoms appear. Central events are most common in stages 1 and 2 of sleep, but they can occur at any time.
What are the signs and symptoms of sleep apnea?
Sleep apnea has several signs and symptoms,
some of which are more obvious than others. Symptoms include:
- Feeling fatigued or even exhausted when you wake up. Even after a full night's sleep, persons with sleep apnea frequently feel exhausted.
- Daytime drowsiness. In more extreme cases, this might cause drowsiness when driving, working, or engaging in other activities.
- Snoring. This is a typical feature of sleep apnea (albeit not in all cases). Sleep apnea can occur without snoring.
- Mood shifts. Sleep apnea patients frequently experience depression and anxiety.
- Brain function disruptions occur. These can include memory loss, difficulty concentrating, and other brain-related difficulties.
- Waking multiple times during the night. This symptom may be more difficult to detect because people rarely remember when or why they awoke. People who do this frequently recall waking up for another cause, such as heartburn or needing to use the restroom.
- Others witness pauses in breathing while asleep. Your spouse, partner, or other loved one may notice these signs while you are sleeping.
- Unusual breathing patterns. Cheyne-Stokes breathing (CSB) is a characteristic breathing pattern associated with central sleep apnea. CSB induces rapid breathing that deepens and then shallows again until breathing ceases completely. They'll stop breathing for a few seconds before restarting, repeating the pattern.
- Insomnia.
- Night sweats and restlessness at night.
- Sexual dysfunctional behavior.
- waking up with shortness of breath or choking sensations.
- Headaches, especially upon waking.
Sleep apnea symptoms in women
Women (including those designated as female at birth) with the disease may be less likely to snore than men. For them, symptoms of sleep apnea may include:- Fatigue.
- Morning drowsiness.
- Anxiety or Depression.
- Headaches, particularly in the morning.
- Trouble sleeping, especially frequently waking up during the night.
Sleep Apnea among children
- Hyperactivity, inability to focus, or poor academic performance. This may resemble symptoms of attention-deficit/hyperactivity disorder (ADHD).
- Snoring loudly.
- Bedwetting.
- Frequent arm or leg movements while sleeping.
- Sleeping in strange positions or with the neck extended.
- Reflux (heartburn), or nighttime sweats.
Warning indicators symptoms in the children include:
- Sluggishness or tiredness, which could be misinterpreted as laziness in the classroom.
- Hyperactivity or difficulty focusing at school.
- Poor academic achievement.
- Trouble swallowing.
- Daytime mouth breathing.
- During inhalation, the rib cage moves inward.
- Sweating excessively at night.
- Heartburn.
- Unconventional sleeping locations, such as hands and knees or outstretched neck.
- They frequently move their arms and legs while sleeping.
- Excessive snoring and bedwetting.
What causes sleep apnea?
Sleep apnea typically has particular causes,
and there is evidence that it may run in families. Overall, there are three
types of sleep apnea, each with its own set of characteristics and causes. The
types are:
- Obstructive Sleep Apnea (OSA).
- Central Sleep Apnea (CSA).
- Mixed or complex sleep apnea.
Obstructive Sleep Apnea (OSA).
This is the most common form. Obstructive sleep apnea happens when the skeletal muscles in your head and neck relax as you sleep, enabling the surrounding tissue to press against your windpipe. That prevents air from passing through it.
Central Sleep Apnea
This type of sleep apnea results from a neurological dysfunction. Under normal circumstances, your brain controls your breathing all the time, even when you sleep. Central sleep apnea occurs when your brain fails to send signals that keep breathing-related muscles functional.Central sleep apnea may occur for a variety of reasons, including:
- Heart failure.
- High altitude causes low blood oxygen levels (hypoxia).
- Nervous system damage, particularly in the brainstem (which controls your breathing) or sections of the spinal cord.
- Treating obstructive sleep apnea with CPAP initially (this usually resolves with consistent CPAP use).
- Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's illness, is a neurological disorder.
Mixed or complicated sleep apnea
There is also a mixed or complex variety of sleep apnea. This kind consists of both obstructive and central occurrences.
Note read more about congestive heart failure.
what are the risk factors of sleep apnea?
Obstructive Sleep Apnea
- Excess weight. Obesity significantly raises the risk of OSA. Fat deposits in the upper airway might hinder your breathing.
- Neck circumference. Individuals
with broader necks may have constricted airways.
A narrowed airway. You might have inherited a narrow throat. Tonsils or adenoids can grow and restrict the airway, especially in children.
Being Male. Men are 2-3 times as likely than women to experience sleep apnea. Women, on the other hand, are more likely to be at risk if they are overweight or have experienced menopause.
Being old. Sleep apnea is substantially more common in older persons. - A narrowed airway. You might have inherited a narrow throat. Tonsils or adenoids can grow and restrict the airway, especially in children.
- Being Male. Men are 2-3 times as likely than women to experience sleep apnea. Women, on the other hand, are more likely to be at risk if they are overweight or have experienced menopause.
- Being old. Sleep apnea is substantially more common in older persons.
- Family history. Having
relatives with sleep apnea may raise your risk.
Consumption of alcohol, sedatives, or tranquilizers. -
Consumption of alcohol, sedatives, or tranquilizers. These drugs relax the airway
muscles, which could worsen obstructive sleep apnea.
Smoking. People who smoke are three times more likely to suffer obstructive sleep apnea than non-smokers. Smoking can cause inflammation and retention of fluid in the upper airway.
Nasal congestion. Suppose you have difficulty breathing through your nose, whether due to an anatomical condition or allergies, you are more prone to develop obstructive sleep apnea. - Smoking. People who smoke are three times more likely to suffer obstructive sleep apnea than non-smokers. Smoking can cause inflammation and retention of fluid in the upper airway.
- Nasal congestion. Suppose you have difficulty breathing through your nose, whether due to an anatomical condition or allergies, you are more prone to develop obstructive sleep apnea.
Central Sleep Apnea
- Being old. Middle-aged and elderly persons are more likely to suffer central sleep apnea.
- Being Male. Central sleep apnea is more prevalent in men than in women.
- Heart diseases. Having congestive heart failure raises the risk.
- Using narcotic painkillers. Opioid medications, particularly long-acting ones like methadone, raise the risk of central sleep apnea.
- Stroke. A stroke raises the chance of central sleep apnea.
What tests will be used to diagnose sleep apnea?
- Overnight sleep study (polysomnography). This is an overnight test in which you sleep in a medical facility (sometimes known as a "sleep lab") that is carefully designed to be as comfortable as possible while also monitoring your sleep. Sensors in this exam detect your heart rate, respiration, blood oxygen levels, brain waves, and other parameters. Experts consider this test to be the gold standard for identifying sleep apnea.
- Household sleep apnea testing. This type of testing allows a person to perform a sleep study at home. It is similar to an overnight sleep study but does not include brain wave monitoring. This test cannot diagnose central sleep apnea, and it is typically not used when doctors suspect more severe sleep apnea, or if you have other sleep problems or medical concerns. When a home study does not reveal sleep apnea, specialists often recommend an overnight sleep study to confirm the diagnosis.
What are the treatments for sleep apnea?
The treatment seeks to restore regular breathing during sleep and address any
underlying health issues. The alternatives will vary based on the origin and
severity of the symptoms.
Lifestyle changes
- Maintaining a heart-healthy diet
- Developing Healthy Sleep Habits
- Limiting alcohol consumption.
- Quit smoking and manage weight.
- sleep on the side.
- Can home remedies help treat sleep apnea? Find out here.
Other therapy options are:
Continuous positive airway pressure therapy (CPAP).
This is the primary treatment for sleep apnea according to trusted sources. It maintains the airway open by gently delivering a continuous stream of positive pressure air through a mask.
Some patients have difficulty utilizing CPAP
and discontinue the treatment before seeing any long-term benefit. However,
several efforts can be taken to make the equipment more comfortable and the
adjustment time easier.
A person can change the mask and its settings. Adding moisture to the air that
travels through the mask can help reduce nasal discomfort.
Surgery.
Various surgical treatments can be used to enlarge the airway in persons with OSA. Surgery can be used to stiffen or shrink obstructive tissue, as well as to remove extra tissue or big tonsils.
Depending on the scope of the surgery, the person may have it performed in a doctor's office or a hospital.
Mandibular Repositioning Device (MRD).
This is a custom-made oral appliance designed for those with mild to moderate OSA. During sleep, the tip of the mouthpiece holds the jaw forward, expanding the area below the tongue. This helps to keep the upper airway open, which reduces apnea and snoring. An MRD may cause jaw or tooth pain, as well as aggravate temporomandibular joint disease.
Medication.
Some medications may help with CSA, but they should be used only after consulting with a sleep specialist. Examples include: Acetazolamide, Zolpidem, and Triazolam. However, these may have serious side effects and are not fit for everyone.
How can I lower my risk or avoid sleep apnea?
Sleep apnea may be preventable, particularly
when a person is overweight or obese. Even so, some people who are healthy or underweight
acquire sleep apnea. For some people, a structural issue is usually the source
of their apnea, therefore they cannot prevent it.
- Achieving and maintaining a healthy weight.
- Practice proper sleep hygiene.
- Manage any existing medical issues, such as high cholesterol, high blood pressure, and Type 2 diabetes.
- Visit your healthcare practitioner a minimum of once a year for an examination.
Finally, the most common and successful treatments, particularly positive airway pressure devices, are intended for use every night. The best results from these therapies are most likely to occur when you adhere to them and incorporate them into your daily life without exception. If you're having trouble sticking to your treatments, you should speak with your doctor right away about sleep apnea management. They can assist you in overcoming these challenges so that you can finally sleep well.
Dr. Haytham Mansour
Health Pulse blog covers important topics about health & wellness, Mental Health, healthy food, and special Diet. Strategies to enhance physical & mental health, and more.
