Sleep apnea can be a serious medical condition. If you snore loudly, wake up gasping for air during the night, or feel drowsy during the day, you may have sleep apnea. This article examines risk factors, symptoms, and treatments of sleep apnea.
Do you experience sleepiness during the daytime? When you wake up in the morning, do you feel tired? Have you been told you snore loudly? If you answer yes to these questions, you may have seep apnea (Greek word meaning “without breath”) which can be life threatening.
Symptoms of Sleep Apnea
Excessive daytime tiredness: falling asleep at inappropriate times (while driving or at work)
Very loud snoring
Periods of not breathing
Abrupt awakenings
Gasping or choking for breath
Awakenings with a dry mouth or sore throat
Morning headaches
Awakening and not feeling rested
Weight gain
Irritability
Poor judgment
Lethargy
Memory loss
Lack of concentration
Episodes of sleep apnea are considered a serious health situation. Those with sleep apnea snore very loudly and may choke and gasp for breath. The sleep cycle goes from deep sleep to light sleep many times during the night. The oxygen levels in the blood briefly drop repeatedly. Is it any wonder a person with sleep apnea does not feel rested.
Over 18 million people in the United States have sleep apnea and more men are diagnosed than women. There are two forms of apnea: Obstructive sleep apneas (OSA) is more common and occurs when throat muscles relax; Central sleep Apnea (CSA) is when the brain fails to send signals to muscles that control breathing.
OSA occurs when the muscles in the back of the throat relax and block the airway. These are the uvula, soft palate, tonsils and tongue. When the airway is narrowed or blocked, air cannot get to the lungs and the oxygen levels in the blood are lowered. The brain senses this and tries to awaken you to breathe. Usually, you wake up and take one or two deep breaths followed by a gasping, snorting sound. This is repeated many times. The awakening is so brief that most do not remember it at all.
In CSA, the person is awakened due to the low levels of oxygen and the high levels of carbon monoxide in the blood. You may awake with shortness of breath and generally will remember it the next morning.
Risk Factors
Snore loudly
Overweight
Enlarged tonsils or adenoids
A naturally narrow throat
Being male—twice as likely as female
Being older—2 to 3 times as likely than in younger
Have high blood pressure
Decrease in size of airway may be caused by congestion due to hay fever
Family history of apnea
Use of alcohol, sedatives, or tranquilizers
Complications
Serious complications can occur with sleep apnea. Your breathing becomes increasingly shallow or stops for 10-20 seconds. These pauses occur frequently during the night. When your sleep is disturbed, you can be quite sleepy the next day. If untreated, asleep apnea can lead to increased risk of coronary heart disease. Drops in oxygen levels during sleep increase the blood pressure. Over half of those with apnea have high blood pressure which brings an increased risk for stroke.
Another complication is excessive sleepiness during the day which can increase difficulty in concentrating. People may fall asleep at work or worse, while driving. People with apnea are five times more likely to have an accident according to the National Institute of Neurological Disorders and Stroke.
And of course, the bed partner is deprived of a good rest as loud snoring can be at 100 decibels. The sound of a chain saw or pneumatic drill is equal to 100 decibels. So it is not surprising that the bed partner cannot sleep. Usually, it is the spouse or family who first notices the apnea.
When to Consult a Physician
Most people do not think that snoring is a serious medical condition. You may not have all of the symptoms but if you experience particularly loud snoring, intermittent pauses in breathing during sleep, or extreme daytime sleepiness, you should be assessed by a physician.
Diagnosis
The doctor will evaluate you based on your symptoms and usually send you to a sleep disorder clinic where you will be monitored overnight. Tests performed may include:
Nocturnal polysomnography is a test in which you are hooked up to a machine that monitors heart, lung and brain activity, breathing patterns, and blood oxygen levels.
Oximetry is a screening method in which a small cuff is worn on the finger to measure blood oxygen levels. This may be done at home.
Electroencephalogram monitors brain activity.
You may also be evaluated by an Ear, Nose, and Throat (ENT) physician to examine you for throat blockages.
Treatment
Numerous treatments are available for sleep apnea including devices and surgery.
The most common device is Continuous Positive Airway Pressure (CPAP). This is a machine that pushes oxygen into the airway through a mask worn while sleeping. This provides adequate air pressure to keep your air passage open which prevents apnea.
Dental devices: Certain devices can be worn to open the throat by bringing the jaw forward.
As with any device, you may have to try various ones to find one that is both workable and comfortable for you.
Surgery
There are several forms of surgery that can be done to alleviate the problem of sleep apnea. Two that are performed in the doctor’s office are less invasive and less painful. However, these are not recommended for moderate to severe sleep apnea. The invasive surgical procedure involves about a month of recovery, sore throat and soft food. Clearing the throat passage way through surgery by removing tonsils and adenoids may additionally alleviate the problem.
Uvulopaltopharyngoplasty is the most common type of surgery used to treat sleep apnea. This is done under general aesthetic in the hospital and requires removal of tissue at the back and top of the throat as well as tonsils and adenoids. This surgery eliminates those tissues that would vibrate and cause snoring.
With laser assisted uvulopalatoplasty (LAUP) that is performed in the doctor’s office, shortening of the uvula is done to open the airway passage.
Radiofrequency ablation (RFA) can be performed in the doctor’s office and uses radio frequency energy to remove tissue from the uvula, soft palate and tongue which opens the airway.
Lifestyle Changes for Sleep Apnea
Loosing excess weight may relieve the narrowing of the air passage.
Avoid alcohol, sedatives, and tranquilizers which relax the musculature in the back of the throat.
Sleep on your side or stomach as sleeping on your back causes the tongue to rest on the back of the throat and block the air passage. You can try sewing a tennis ball to the back of nightclothes to prevent you from lying on your back.
Keep nasal passages open by using a decongestant or antihistamine.
Quit smoking as this causes inflammation and swelling of the tissue.
With treatment designed at reinstating regular nighttime breathing and relieving symptoms such as thunderous snoring and daytime drowsiness, associated medical problems of high blood pressure and risk of stroke and heart attack are reduced. If you are told by family members that you stop breathing, gasp and snorke for breath, get evaluated for sleep apnea.