Sleep Apnea is a serious sleep disorder in which a person repeatedly stops and starts breathing during their sleep.
It happens involuntarily and when your breathing stops, oxygen levels in your bloodstream drop, prompting your brain to send a signal to wake you up long enough for you to breathe. This happens over and over again, making you lose sleep without you even remembering these episodes of waking. If you wake up tired after a full night sleep and snore loudly, you might have sleep apnea.
What are the types of sleep apnea?
- Obstructive sleep apnea (OSA): It happens when throat muscles relax and block the airflow to lungs.
- Central sleep apnea (CSA): When this happens, the brain isn’t sending adequate signals to the breathing-control muscles.
- Treatment-emergent central sleep apnea: This is also called complex sleep apnea, and it happens when someone with OSA converts to CSA when receiving therapy for OSA.
How to tell if you have sleep apnea?
Symptoms of different kinds of sleep apnea may be very similar making it difficult to determine the one that you have. Some of the symptoms are –
- Snoring very loudly
- Another person may report that you stop breathing during your sleep
- Gasping for air while sleeping
- Having a dry mouth when you wake up
- Having a headache in the morning
- Insomnia, or difficulty staying asleep
- Hypersomnia, or excessive sleepiness during the day
- Difficulty in concentrating
- Being irritable
If you have a couple of these symptoms, you should see a doctor.
What causes sleep apnea?
Causes for OSA and CSA are different.
Obstructive sleep apnea is caused when the muscles at the back of the throat relax and block the airway. As the airway narrows or close, you can’t get enough air and the oxygen level in your blood falls. When the brain senses that you can’t breathe, it sends a signal to wake you up briefly, long enough for you to breathe. Most of the time you won’t remember having woken up because it happens for a very short time. During this period, you might gasp, choke or snort and someone sleeping next to you may be able to notice it. This waking up frequently keeps you from feeling rested and getting deep sleep.
Certain factors have been seen to contribute to causing OSA. These include being overweight which means fat deposits around the airway that cause obstruction in breathing; a thicker neck which might mean a narrower airway; a hereditary narrow throat; tonsils or adenoids; being male makes you 2 to 3 times more susceptible to sleep apnea; smoking; alcohol use,; use of sedatives or tranquilizer; and nasal congestion or allergies. Being older also contributes to your chances of getting OSA, as does family history and certain medical conditions such as congestive heart failure, hypertension, Type II diabetes, PCOS, chronic lung disease, etc.
In case of central sleep apnea, the brain does not send signals to your breathing muscles. When you feel shortness of breath, you wake up and may have difficulty falling or staying asleep again. Being older and male enhances your risk of central sleep apnea; as to heart disorders; having had a stroke and using narcotic pain medicines.
Why is it important to treat sleep apnea?
At Pulmo Vista, once we have diagnosed you with sleep apnea, we treat it like any serious disease. There are many complications that can arise due to it. Some of these are –
- Feeling tired during the day
- Getting up repeatedly during the night causing lack of sleep and constant irritability
- Lack of concentration that can have serious implications such as during driving
- Becoming forgetful
- Negative impact on performance such as deteriorating grades of children at school
- Becoming depressed or quick tempered
- Developing hypertension or other heart problems
- Increased risk of heart attack, stroke and irregular heartbeat
- Increased risk of developing Type II diabetes and insulin resistance
- Higher risk of developing metabolic syndrome
- Increased chance of complications arising during surgery or with medication
- Chance of developing non-alcoholic fatty liver disease and getting irregular liver function test results
Another side effect which does not directly affect the patient is having sleep-deprived partners who can feel so disturbed by the noise that they have to shift to another room.
How do doctors diagnose sleep apnea?
At a specialty clinic like Pulmo Vista, you get guidance from a pulmonologist and sleep specialist. You would be advised sleep studies that will help track your breathing patterns, blood oxygen levels and heart rate using a monitor while you sleep. This gives your doctor clues about your condition. An overnight study or a polysomnogram (PSG) might be advised that checks not just the breathing but also the brain, heart and lung activity. It also tracks the movement of your arms and legs. A sleep technician will monitor the test. On the basis of these results, adequate treatment is recommended.
How can sleep apnea be treated?
Treatment focuses on reducing the severity of the problem and managing it. Milder cases might get relief from lifestyle changes such as weight loss, allergy treatment or stopping smoking, while severe cases may require more intervention. Some of the ways of managing sleep apnea are –
Sleep apnea masks or machines involve wearing mask over your face during the night to deliver air into your airway regularly.
Continuous positive airway pressure (CPAP) device blows air into your airway to keep your upper airway open through a mask covering your nose and mouth.
Bilevel positive airway pressure (BPAP or BiPAP) uses greater force than CPAP as you inhale.
Auto-positive airway pressure machine (auto-pap or APAP) adjusts the air pressure to respond to changes in your breathing while you sleep.
Adaptive servo-ventilation (ASV) is a computerised device that customises its air pressure levels to normalise your breathing.
Oral appliance such as sleep mouth guard or tongue retaining device help keep the throat open.
Supplemental oxygen proves helpful for certain central sleep apnea patients.
Treating secondary diseases such as heart or neurotransmitter disorders can also help you get relief from sleep apnea.
Medicines don’t necessarily offer relief but doctors may prescribe medicines that will help you sleep better.
Surgery maybe an option if other treatments don’t work. These include nerve stimulation, tissue shrinkage, tissue removal, jaw repositioning, tracheostomy, and/or surgery to remove tonsils or adenoids.
With the right diagnostic tools and tests, and adequate therapies, sleep apnea can be treated and the patient may live a wholesome life again.
