What is sleep apnea?

Sleep apnea or obstructive sleep apnea (OSA) is a very common sleep-related breathing disorder and is caused by the repeated collapse of the upper airway while we sleep. 

This condition occurs when the muscles that support soft tissues in the throat, like the tongue, relax: which causes the airway to narrow down or close, momentarily stopping a person from breathing while they’re asleep. 

Under normal circumstances, air will flow seamlessly through the mouth and nose into the lungs during sleep, but for those who have sleep apnea, the normal flow of air is continuously interrupted during the night. A period of time when breathing stops completely is known as apnea, and sleep 

apnea is most common among older men but can affect just about anyone, including children. Menopausal women are as vulnerable as older men. 

Snoring is the most common of all sleep apnea symptoms, especially if the snoring is not continuous; it is caused by airflow trying to get through the narrowed airway space.

This doesn’t mean that everyone who snores faces a potentially serious problem, nor will they necessarily have sleep apnea. 

What does untreated sleep apnea cause? 

If left untreated, sleep apnea can cause serious health complications like heart disease, high blood pressure, stroke, diabetes, hypertension, and abnormal heart rhythm. 

Sleep apnea treatment requires a proper diagnosis and intervention to prevent further complications.

What symptoms can sleep apnea cause? 

Most individuals who have sleep apnea experience daytime sleepiness as their quality of sleep is poor. They complain of feeling drowsy during the day and even a lack of clarity in the morning after waking up. 

Daytime drowsiness puts people at risk of crashes and accidents.

It is the people who share beds with people with sleep apnea will actually report the symptoms associated with the disease. Loud snoring interrupted by gasping, choking, snorting, and interruptions in breathing while sleeping is major symptoms. 

People with sleep apnea can also experience headaches during the morning, drowsiness, forgetfulness, grumpiness, and may repeatedly find themselves waking up at night. 

Less common symptoms are hyperactive children, getting poor grades at school or underperforming at work for no apparent reason, worsening depression, and even loss of interest in sex.

Causes of sleep apnea:

Sleep apnea can be a consequence of certain medical conditions such as 

  • Endocrine conditions like thyroid and polycystic ovarian syndrome 
  • Obesity hypoventilation syndrome; a type of breathing disorder found in obese people
  • Chronic lung diseases like asthma, pulmonary fibrosis, and chronic obstructive pulmonary disease 
  • Kidney or heart failure, which can cause fluid to accumulate in the neck and obstruct the upper airway
  • Neuromuscular conditions like a stroke can interfere with brain signals sent to the chest muscles and airway.
  • Pregnant women also experience sleep apnea. 

Risk factors

There is more risk for sleep apnea if any physical features of an individual end up narrowing the upper airway. Being obese, having large tonsils, men who have a collar size of 17 inches or more and women with a collar size of 16 inches or more, smoking, a narrow airway, a large tongue, and a family history of sleep apnea can put people at risk

Diagnosing sleep apnea 

Any sleep apnea diagnosis will begin with medical history assessment and physical examination. Your doctor will ask about your history of daytime sleepiness and snoring, examine your head and neck to look for any physical factors that may be behind the sleep apnea. Your doctor may ask you to fill out a questionnaire about daytime drowsiness, sleep habits, and quality of sleep.

A number of tests are available for diagnosing sleep apnea, like a Polysomnography (PSG) in which patients sleep overnight in a hospital while connected to monitoring devices that record physiologic variables. These patterns during sleep could indicate sleep apnea breathing as well as many other sleep disorders.

EEG and EOM tests follow brain waves and eye movements which tell doctors about the timing of the different phases of sleep.

In an EMG, two electrodes pick up the electrical activity generated during muscle movements to check for muscle relaxation during sleep.

A single-lead ECG and a pulse oximeter can also help to diagnose sleep apnea.

Sleep Apnea Treatment 

The aim of treatment for sleep apnea is to ensure airflow isn’t obstructed during sleep. Treatment can include weight management and exercise, weight loss decreases the severity of OSA. 

A continuous positive airway pressure (CPAP) can be administered through a face mask worn at night, keeping the airways open at night. While a BPAP or bilevel positive airway pressure (BPAP) is used if CPAP therapy is not effective.

Surgical treatment is most effective for people who have sleep apnea due to a severe but surgically correctable, upper airway. Surgical treatment for OSA provides long-term benefits.

Talk with your doctor if you’re having consistent problems sleeping or feeling drowsy during the day. Sleep apnea can be treated with lifestyle changes and other therapies.

with Dr. Akshay Budhraja


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