Sleep Apnea
What is it?
Apnea means "without breath." The commoner form, obstructive sleep
apnea, results in interrupted sleep and is characterized by loud
snoring and ten to sixty or more second pauses in breathing during
sleep. These pauses in breathing may occur as many as 500 times in
one night.
Sleep apnea is very common, as
common as adult diabetes, affecting more than 12 million Americans.
Yet, because of a lack of awareness by the public and healthcare
professionals, it often remains undiagnosed and therefore untreated.
Sleep apnea affects people of all ages, but is seen increasingly as
we age. Significant apnea is found twice as often in men until the
age of 50, but after menopause women nearly catch up. Obstructive
sleep apnea is often associated with being overweight.
Untreated long-term, this disorder can cause high blood pressure,
cardiovascular disease, memory problems, weight gain, impotency and
headaches. Short-term effects include poor job performance and
accidents due to fatigue.
What are the causes?
There are two types of sleep apnea - central sleep apnea and
obstructive sleep apnea.
Central sleep apnea is less common and is caused by the brain's
respiratory centers ceasing the signals to breathe. Lacking these
signals, the chest and abdominal muscles do not contract so no air
is pulled in. Obstructive sleep apnea is caused by a blockage in the
mouth or throat and is far more common. A typical blockage may be a
person's tongue, tonsils, or fatty soft tissues in the throat. Each
time breathing is blocked, oxygen in the bloodstream falls and the
heart has to work harder to circulate blood. When the brain senses
the decrease of oxygen, the sleeper is partially aroused just enough
to gasp for air or to briefly startle, occasionally to a full
wakening.
What are the signs and symptoms?
Someone watching a person suffering
from sleep apnea will often but not always observe a pattern of loud
snoring (which indicates the airway is not fully open) interrupted
by pauses in breathing and gasps for breath during sleep.
The snoring and apnea sufferer will
often have symptoms of sleepiness during daytime hours, trouble
concentrating, forgetfulness, irritability, headaches (especially in
the morning hours), decreased sexual energy and mood swings. But not
everyone experiences these symptoms to the same degree.
How is it diagnosed?
There are many types of sleep disorders that have the same signs and
symptoms. A polysomnogram (sleep study) can determine if a patient
has sleep apnea, and if it is the more common obstructive type.
How is it treated?
The most common treatment for obstructive sleep apnea is continuous
positive airway pressure (CPAP). CPAP treats obstructive sleep apnea
by providing a gentle flow of air under positive pressure through a
nasal mask. The air splints the airway open during sleep. The result
is that breathing becomes regular, snoring stops, and restful sleep
is restored.
Other less common treatments of
obstructive sleep apnea include surgery and oral appliances, which
may be effective in certain individuals. A surgical procedure can be
done to increase the size of the airway by removing any obstruction
such as enlarged tonsils, polyps or growths that may be blocking it.
An unusually formed jaw may be causing the problem and can be
corrected with surgery. Some patients may benefit from an oral
appliance that repositions the tongue or jaw so that airflow is not
restricted.
Additional advice given to people
with sleep apnea to minimize the effects of the disorder:
Avoid bedtime alcohol and sleeping
pills
Lose weight (if you are over weight)
Avoid sleeping on your back
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