| What
Is Sleep Apnea?
Sleep
Apnea Treatments:
Sleep Apnea Symptoms
Sleep Apnea Tests/diagnosis
For Patients - Important Information
About Sleep Anea
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What Is Sleep Apnea
Sleep apnea is a common disorder in which you have one or
more pauses in breathing or shallow breaths while you sleep.
Breathing
pauses can last from a few seconds to minutes. They often
occur 5 to 30 times or more an hour. Typically, normal breathing
then starts again, sometimes with a loud snort or choking
sound.
Sleep
apnea usually is a chronic (ongoing) condition that disrupts
your sleep 3 or more nights each week. You often move out
of deep sleep and into light sleep when your breathing pauses
or becomes shallow.
This results
in poor sleep quality that makes you tired during the day.
Sleep apnea is one of the leading causes of excessive daytime
sleepiness.
Types of Sleep Apnea
Sleep
apnea often goes undiagnosed. Doctors usually
can't detect the condition during routine office visits. Also,
there are no blood tests for the condition.
Most people
who have sleep apnea don't know they have it because it only
occurs during sleep. A family member and/or bed partner may
first notice the signs of sleep apnea.
Obstructive
Sleep Apnea - The most common type of sleep apnea.
Obstructive Sleep Apnea most often means that the airway has
collapsed or is blocked during sleep. The blockage may cause
shallow breathing or breathing pauses.
When you
try to breathe, any air that squeezes past the blockage can
cause loud snoring. Obstructive sleep apnea happens
more often in people who are overweight, but it can affect
anyone.
Central
Sleep Apnea is a less common type of sleep apnea.
It happens when the area of your brain that controls your
breathing doesn't send the correct signals to your breathing
muscles. You make no effort to breathe for brief periods.
Central
sleep apnea often occurs with obstructive sleep apnea,
but it can occur alone. Snoring doesn't
typically happen with central sleep apnea.
Untreated
Sleep Apnea Can increase The Risk For:
- high
blood pressure,
-
heart attack,
- stroke,
- obesity,
- diabetes
- Increase
the risk for or worsen heart failure
- Make
irregular heartbeats more likely
-
Increase the chance of having work-related or driving accidents
Sleep
Apnea Treatments: Learn More About Proven, Safe, Effective
and Natural Treatments for Sleep Apnea Click Here
Causes/Risk
Factors:
What
Causes Sleep Apnea?
When you're
awake, throat muscles help keep your airway stiff and open
so air can flow into your lungs.
When you
sleep, these muscles are more relaxed. Normally, the relaxed
throat muscles don't stop your airway from staying open to
allow air into your lungs.
But if
you have obstructive sleep apnea, your airways can be blocked
or narrowed during sleep because:
- Your
throat muscles and tongue relax more than normal.
- Your
tongue and tonsils (tissue masses in the back of your mouth)
are large compared to the opening into your windpipe.
- You're
overweight.
The extra soft fat tissue can thicken the wall
of the windpipe. This causes the inside opening to narrow
and makes it harder to keep open.
- The
shape of your head and neck (bony structure) may cause a
smaller airway size in the mouth and throat area.
- The
aging process limits the ability of brain signals to keep
your throat muscles stiff during sleep. This makes it more
likely that the airway will narrow or collapse.
Not enough
air flows into your lungs when your airways are fully or partly
blocked during sleep. This can cause loud snoring and a drop
in your blood oxygen levels.
When the
oxygen drops to dangerous levels, it triggers your brain to
disturb your sleep. This helps tighten the upper airway muscles
and open your windpipe. Normal breaths then start again, often
with a loud snort or choking sound.
The
frequent drops in oxygen levels and reduced sleep quality
trigger the release of stress hormones.
These compounds raise your heart rate and increase your risk
for high blood pressure, heart attack, stroke, and irregular
heartbeats. The hormones also raise the risk for or worsen
heart failure.
Untreated
sleep apnea also can lead to changes in how your body uses
energy. These changes increase your risk for obesity and diabetes.
Symptoms:
Do You Suffer From Any Of These?
The
most common symptoms of obstructive sleep apnea (OSA) that
you may notice include:
- Excessive
daytime sleepiness, which is falling asleep when
you normally should not, such as while you are eating, talking,
or driving.
- Waking
with an unrefreshed feeling after sleep, having problems
with memory and concentration, feeling tired, and experiencing
personality changes.
- Morning
or night headaches. About half of all people with
sleep apnea report headaches. Heartburn or a sour taste
in the mouth at night.
- Swelling
of the legs if you are obese.
- Getting
up during the night to urinate
(nocturia).
- Sweating
and chest pain while you are sleeping.
Symptoms
of Sleep Apnea That Others May Notice Include:
- Episodes
of not breathing (apnea), which may occur as few as 5 times
an hour (mild apnea) to more than 50 times an hour (severe
apnea). How many episodes you have determines how severe
your sleep apnea is.
- Loud
snoring. Almost all people who have sleep apnea snore, but
not all people who snore have sleep apnea.
- Restless
tossing and turning during sleep.
- Nighttime
choking or gasping spells.
Older
adults may normally have periods when they stop breathing
during sleep, making it hard to know whether they have sleep
apnea. Short lapses in breathing during sleep usually do not
cause a large drop in the blood oxygen level.
Sleep Apnea Symptoms In Children
In
children, symptoms of sleep apnea depend on how old the child
is:
- In
children younger than 5, symptoms include snoring, mouth
breathing, sweating, restlessness, and waking up a lot.
- In
children 5 years and older, symptoms include snoring, bed
wetting, doing poorly in school, and not growing as quickly
as they should for their age.
These children may also have behavior problems and a short
attention span.
Children
who have sleep apnea nearly always snore. But they
may not appear to be excessively sleepy during the day (a
key symptom in adults).
The only symptom of sleep apnea in some children may be that
they do not grow as quickly as they should for their age.
Although
rare, in children sleep apnea can cause developmental delays
and can cause the right side of the heart to get bigger (cor
pulmonale).
Other
conditions with symptoms similar to sleep apnea include an
underactive thyroid (hypothyroidism) and other sleep disorders,
such as suddenly falling asleep (narcolepsy) or an intense
urge to move the legs (restless legs syndrome).
Treatments
For Sleep Apnea:
Self-help treatment for sleep apnea
- Minor
sleep apnea is responsive to self-help remedies, or “behavioral
treatments.”
Some of the following self-help treatments for sleep apnea
may work for you.
- Lose
weight. Overweight individuals who lose even 10% of their
weight can reduce sleep apnea during the night and dramatically
improve the quality of their sleep.
- Eliminate
the use of alcohol, tobacco, and sedatives such as sleeping
pills. Avoiding the use of alcohol, tobacco, and sleeping
pills can reduce the likelihood of airway closure during
the night.
- Sleep
on your side. People who experience sleep apnea only when
they sleep on their backs can benefit from special pillows
or folk remedies that encourage side-sleeping, such as the
“tennis ball trick” (putting a tennis ball under
you to make back-sleeping uncomfortable).
- Regularize
your sleep hours. Irregular sleep hours can throw off your
sleep cycles and lead to breathing problems during the most
important sleep stages.
Stabilizing bedtime hours and eliminating disturbances to
your sleep can reduce sleep apnea.
Treatment
for sleep apnea
Continuous
Positive Airway Pressure (CPAP)
Positive
airway pressure, the most widely recommended treatment for
moderate to severe obstructive sleep apnea, entails wearing
a mask-like device while you sleep that supplies pressurized
air, which helps prevent the airway from collapsing.
The most
common of these devices is called CPAP (Continuous Positive
Airway Pressure), which provides constant air pressure regardless
of whether you are breathing in or out.
While
CPAP works very well in preventing apnea symptoms, many people
find the apparatus uncomfortable and difficult to use. Luckily,
recent advancements to CPAP technology have made these once
cumbersome devices much lighter and quieter. Newer styles
provide options, so that users can find one that works best
for them.
Recent
refinements include options such as “bilevel PAP”,
which switches from higher to lower air pressure during the
exhalation, making breathing easier for some, and “AutoPAP”,
which uses an internal regulator that adjusts pressure rather
than remaining at one fixed setting.
CPAP
can be cost-prohibitive – the devices can cost
up to $1000 or more - but they are usually effective when
used correctly.
Unfortunately,
many people don’t receive proper coaching and guidance
for using these breathing devices, and give up on them quickly.
The following
tips may help you use CPAP more comfortably and successfully:
- *
Don’t “self-medicate” with CPAP. Your
doctor should help you in obtaining the device, and will
probably suggest a night at a sleep lab where experts can
adjust air pressure for your individual needs. The mask
needs to fit correctly and be used in specific ways, and
your doctor can help achieve optimal results.
- Irritation
can be soothed. Some find that the mask irritates the skin
or nose. There are special skin moisturizers for CPAP users,
and nasal pillows can be worn in the nostrils to relieve
pressure on the nose.
- Find
out if you’re a mouth breather. For those who breathe
through the mouth rather than the nose at night, a full-face
mask will work better that the normal CPAP, which just covers
the nose.
- Take
your time. Adjusting to the CPAP takes time. Try wearing
it for just a few hours per night, and increase the time
incrementally every night.
- Talk
to your doctor about specific issues, as most problems can
be addressed. For example, some find the constant air pressure
makes it difficult to breathe.
Rather than giving up on CPAP, you doctor can switch you
to a bilevel device, which lowers air pressure when you
exhale. This treatment is effective enough to give it your
best shot – keep trying until you adjust to wearing
the device.
Dental
appliances, oral devices, and lower jaw adjustment devices
Most dental
devices are acrylic and fit inside your mouth, much like an
athletic mouth guard or orthodontic appliance. Some others
fit around your head and chin to adjust the position of your
lower jaw. Two common oral devices are the Mandibular Repositioning
Device and the Tongue Retaining Device. These devices open
your airway by bringing your lower jaw or your tongue forward
during sleep.
While
oral devices are less cumbersome than CPAP and relatively
simple to use, they are only effective for mild to moderate
sleep apnea. There are also a number of troubling side effects
from using this type of treatment – soreness; damage
to/permanent change in position of the jaw, teeth, and mouth;
saliva build-up; and nausea. It is vitally important to get
fitted for these devices by a dentist that specializes in
sleep apnea, and continue to see the dentist on a regular
basis to monitor for any dental problems that may occur.
Surgery as treatment
Certain
types of surgery can increases the size of your airway by
surgically removing tissues. The surgeon may remove tonsils,
adenoids, or excess tissue at the back of the throat or inside
the nose. Or, the surgeon may reconstruct the jaw to enlarge
the upper airway.
Surgery
may be an effective option for some, and can even provide
permanent relief from symptoms. However, any surgery carries
risks of surgical complications and infections, and in some
rare cases, symptoms have worsened after surgery. If you have
exhausted other apnea treatment options, or find the non-surgical
treatments intolerable, you may want to discuss surgical options
with your doctor or sleep specialist.
Find a Sleep Apnea Specialist
For treatment
of sleep apnea, see a doctor specializing in sleep problems.
Sleep centers are clinics with such specialists. The American
Academy of Sleep Medicine provides a Sleep Center Locater.
For dental
devices, The American Academy of Dental Sleep Medicine provides
“find a dentist” who specializes in dental sleep
medicine.
Tests/diagnosis
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