What is Sleep Apnea?
During our sleep, breathing can be disrupted because of a narrowed or blocked airway, or a change in the breathing rhythm. This is called sleep apnea, a serious condition which, if untreated, can lead to high blood pressure, stroke, abnormal heart rhythms, or heart attack. Sleep apnea can be mild or severe. Each episode can occur for ten seconds up to several minutes, and can recur multiple times during sleep.
Obstructive Sleep Apnea
The most common type of this disorder is obstructive sleep apnea, where air movement is diminished due to the narrowing of the air passage. When you sleep, the muscles in the upper airway tend to relax, which can cause periodical closure of the throat. It can also occur when you are lying on your back, as gravity tends to pull back your tongue and block the airway. When breathing stops, a signal is sent to your brain to reactivate the muscles in the upper airway and clear the passage. This will cause you to wake up, and you may snore, snort or gasp for air.
Whilst this can happen several times during the night, most of these awakenings may not necessarily be remembered as it lasts for only one to two minutes. Other times, the person may wake up completely. Obstructive sleep apnea affects about 4% of men and 2% of women, although the numbers can be higher when other risk factors are considered.
Central Sleep Apnea
Central sleep apnea occurs when the brain fails to recognise the breathing rhythm due to the imbalances in the neurological controls. The brain is unable to transmit signals to the muscles that control breathing, causing a person to periodically stop breathing.
The degree of its effect can vary depending on how long the person has stopped breathing. This prolonged pause in breathing results in decreased blood oxygen levels and increased concentration of carbon dioxide. And because the brain cells need enough oxygen to properly function, reduced blood oxygen levels can cause brain damage and sudden death, in worst-case scenarios.
Low levels of blood oxygen can also trigger seizures. So people with coronary heart disease are at risk of having irregular heartbeat, angina and even myocardial infarction (heart attack).
Complex Sleep Apnea
A person can also have a mix of both types, which is known as complex sleep apnea. It is found that people with severe obstructive sleep apnea has a tendency to later on develop central apnea.
Sleep apnea can affect any person of any age and gender, although there is an increased risk for:
- People who are overweight
- Middle age and older adults
- Males (especially at the age of 40 and above)
- Women with a neck size greater than 16 inches, and males with a neck size larger than 17 inches
- Patients drinking alcohol or taking sedatives that suppress the ability to wake up (this can also cause extended periods of sleep apnea)
Symptoms of Sleep Apnea
Many people who have sleep apnea do not recognise they have it immediately. This can leave the condition untreated. Visit your doctor if you have experienced:
- Loud snoring: some patients know this, or a bed partner can tell
- Low energy and sleepiness during the day: this is the result of lack of sleep caused by the disruption of rest at night
- Feeling drowsy when driving
- Waking up with a headache, or dry or sore throat
- Feeling groggy or unrested when you wake up
- Mood changes and memory impairment (forgetfulness)
Sleep Apnea Treatment
Sleep apnea can be treated several ways. First, a full sleep study will be conducted either in a sleep laboratory or at home. Depending on your diagnosis, you can undergo a surgical or non-surgical treatment.
- Continuous positive airway pressure (CPAP) – using an airtight attachment to the nose, which is connected to a tube and blower that generates pressure, the upper airway is kept open, allowing air to pass through.
- Dental devices or oral appliances – one common type is the mandibular advancement splint, which is used for obstructive sleep apnea. It is a mouthpiece designed to pull the lower jaw forward and open the bite to keep the airway open.
- Surgery – those with obstructive sleep apnea may consider surgery. The type of surgery depends on the requirements and obstructions found in each person. Some of the most common surgeries involve the correction of nasal problems, removal of soft tissues on the throat and uvula, and tongue reduction.
- Lifestyle changes or behavioural therapy – changes in sleeping position, avoiding alcohol and sedatives, weight loss for obese patients, and quitting smoking can help with the treatment of sleep apnea.
If symptoms do not improve, or you are experiencing discomfort with your current treatment or therapy, talk to your physician for other options.