Sleep Apnea :- Types, Central and Obstructive and mixed, Risk Factor, Symptoms, Cause, Test, Diagnosis, Prevention, Treatment of Sleep Apnea

Sleep apnea is a serious, potentially life-threatening condition that is far more common than generally understood. Sleep apnea is a breathing disorder characterized by brief interruptions of breathing during sleep. In sleep apnea, your breathing stops or gets very shallow while you are sleeping. Each pause in breathing typically lasts 10 to 20 seconds or more. These pauses can occur 20 to 30 times or more an hour.

Sleep apnea usually is caused by a partial or complete blockage of the breathing airway in your nose or throat. The blockage can be caused by large tonsils, a large tongue or by excess tissue in the airway, which is more common among people who are overweight. A sleeping person normally breathes continuously and uninterruptedly throughout the night. A person with sleep apnea, however, has frequent episodes (up to 400-500 per night) in which he or she stops breathing. This interruption of breathing is called "apnea."

Types of Sleep Apnea

There are two types of sleep apnea:

Central sleep apnea-Central sleep apnea, which is less common, occurs when the brain fails to send the appropriate signals to the breathing muscles to initiate respirations.

Obstructive sleep apnea-Obstructive sleep apnea is far more common and occurs when air cannot flow into or out of the person's nose or mouth although efforts to breathe continue.

Mixed sleep apnea: When individuals experience a combination of the two other types of sleep apnea, Obstructive Sleep Apnea and Central Sleep Apnea, they have mixed sleep apnea.

Risk Factors of Sleep Apnea

Risk factors include being male, a family history of sleep apnea

A large neck, a recessed chin, abnormalities in the structure of the upper airway overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children.

Sleep Apnea Symptoms

Loud Snoring

Waking up tired and having trouble concentrating or staying awake during the day

Waking up with headaches, or dry mouth

Waking up during the night with a choking sensation

Perspiring excessively during the night

A dry mouth upon awakening

Depression

Heartburn

Reduced libido

Insomnia

Frequent trips to the bathroom during the night

Restless sleep, tossing and turning

Rapid weight gain

Chest pulls in during sleep in young children

Frequent cessation of breathing (apnea) during sleep. Your sleep partner may notice repeated silences from your side of the bed.

Gasping, or gagging during sleep to get air into the lungs

Waking up sweating during the night

Daytime sleepiness, including falling asleep at inappropriate times, such as during driving or at work

Lethargy

Memory loss and learning difficulties

Short attention span

Personality changes

Cause of Sleep Apnea

Sleep apnea happens when enough air cannot move into your lungs while you are sleeping. Certain mechanical and structural problems in the airway cause the interruptions in breathing during sleep. In some people, apnea occurs when the throat muscles and tongue relax during sleep and partially block the opening of the airway. When the muscles of the soft palate at the base of the tongue and the uvula relax and sag, the airway becomes blocked, making breathing labored and noisy and even stopping it altogether. Sleep apnea also can occur in obese people when an excess amount of tissue in the airway causes it to be narrowed. With a narrowed airway, the person continues his or her efforts to breathe, but air cannot easily flow into or out of the nose or mouth. Ingestion of alcohol and sleeping pills increases the frequency and duration of breathing pauses in people with sleep apnea.

Other causes include:

Severe heartburn or acid reflux is another cause of sleep apnea

Nasal congestion, nasal blockages, and nasal irritants such as household dust and dander can inhibit breathing through the nose and force breathing through the throat, which may also be blocked resulting in the cause of sleep apnea.

Immune-system abnormalities can also cause sleep apnea

Sleep Apnea Test / Diagnosis

Your doctor can diagnose sleep apnea. He or she may ask you if you feel tired or sleepy during the day. Your doctor may also want to know about your bedtime habits and how well you sleep. Your doctor may ask you to go to a sleep center for a sleep study. Tests done at the sleep center may reveal which kind of sleep apnea you have. You may need to take some equipment home with you to do a sleep study there. Diagnosis can only be confirmed by a sleep study, during which a person's breathing patterns and sleep stages are monitored throughout an entire night. A daytime study of brief naps can measure the degree of daytime sleepiness and indicate the severity of the disorder.

Some of the tests include:

Polysomnography is a test that records a variety of body functions during sleep such as brain activity, eye movement, muscle activity, breathing and heart rate, how much air moves in and out of your lungs while you are sleeping

The percentage of oxygen in your blood these tests are used both to diagnose sleep apnea and to determine its severity.

The Multiple Sleep Latency Test (MSLT) measures the speed of falling asleep. In this test, patients are given several opportunities to fall asleep during the course of a day when they would normally be awake. For each opportunity, time to fall asleep is measured. People without sleep problems usually take an average of 10 to 20 minutes to fall asleep. Individuals who fall asleep in less than 5 minutes are likely to require some treatment for sleep disorders. The MSLT may be useful to measure the degree of excessive daytime sleepiness and to rule out other types of sleep disorders.

Prevention of Sleep Apnea

You can treat obstructive sleep apnea (OSA) at home if you have mild sleep apnea (5 or fewer apnea episodes per hour). Home treatment for sleep apnea includes:

You can help to reduce sleep apnea symptoms by avoiding alcohol and sedatives. These relax the muscles in the back of your throat, making it harder for you to breathe.

If you smoke, quit smoking.

If you are overweight, lose weight.

Sleep on your side instead of on your back.

Sleep Apnea Treatment

Treatment for sleep apnea includes lifestyle changes, continuous positive airway pressure (CPAP) (to prevent the airway from closing during sleep), and surgery. The goals of treatment are to relieve symptoms such as snoring and excessive daytime sleepiness and prevent other problems, such as high blood pressure.

Continuous positive airway pressure (CPAP) is the most common treatment for sleep apnea. For this treatment, you wear a mask over your nose during sleep. The mask blows air into your throat at a pressure level that is right for you. The increased airway pressure keeps the throat open while you sleep. The air pressure is adjusted so that it is just enough to stop the airways from briefly getting too small during sleep.

A mouthpiece (oral appliance) may be helpful in some people with mild sleep apnea. Some doctors may also recommend this if you snore loudly but do not have sleep apnea

Surgery may be done to remove the tonsils and adenoids if they are blocking the airway. This surgery is especially helpful for children.

Uvulopalatopharyngoplasty (UPPP) is a surgery that removes the tonsils, uvula (the tissue that hangs from the middle of the back of the roof of the mouth), and part of your soft palate (the roof of your mouth in the back of your throat). This surgery is only effective for some people with sleep apnea.

Laser-assisted (LAUP) is a surgery that can stop snoring but is probably not helpful in treating sleep apnea.

Tracheostomy is a surgery used in severe sleep apnea. This surgery is very successful but is needed only in patients not responding to all other possible treatments

Other possible surgeries for some people with sleep apnea include:

Rebuilding the lower jaw

Surgery on the nose

Surgery to treat obesity

CALL THE DOCTOR

Call your doctor if:

You are excessively sleepy during waking hours, if you snore a lot

Your bed partner notices that your breathing stops sometimes when you sleep.