Snoring/Sleep Apnea

Sleep apnea is a potentially dangerous sleeping disorder that is characterized by periodic interruptions in breathing during sleep. Apnea is defined as the spontaneous cessation of breathing for 10 seconds or more causing a decrease in the flow of air into the lungs. There are two predominant types of sleep apnea: central (CSA) and obstructive (OSA).

Central sleep apnea happens when the brain fails to send proper signals to the respiratory muscles during sleep, thus leading to disrupted and unregulated breathing patterns. In contrast, obstructive sleep apnea happens when airflow to the lungs is obstructed as the throat muscles relax and narrow down during sleep. OSA happens despite the proper transmission of brain signals to the respiratory muscles. OSA is more common than CSA; hence, when referring to sleep apnea, people are generally pertaining to OSA.

Signs and symptoms

The common signs and symptoms of sleep apnea are:

• Loud snoring: Often, individuals are not aware that they snore during sleep. Usually, they find out about their snoring when their loved ones or friends inform them about it.
• Breathing cessation: It is possible for other people to witness the actual cessation of breathing of an individual during sleep.
• Abrupt awakening or frequent awakening at night accompanied by gasping or shortness of breath

The lack of sleep due to sleep apnea can also cause:

• Daytime sleepiness and tiredness: Because apnea disrupts sleep, the individual usually wakes up tired and sleepy.
• Attention and memory problems
• Morning headaches
• Irritability

Studies have shown that untreated sleep apnea can contribute to the development of other medical conditions such as hypertension, heart attack, heart failure, stroke, and even death.

Diagnosis

Sleep apnea is a potentially serious condition that has to be diagnosed and managed immediately. Thus, if an individual snores during sleep or has symptoms suggesting sleep apnea, a medical consult is warranted.

On top of a comprehensive medical history and physical examination, a sleep study or a polysomnography might be requested by the physician if sleep apnea is suspected. Polysomnography is the gold standard for diagnosing sleep apnea. It requires an overnight stay in a sleep lab where the individual will be hooked to monitors that record several parameters such as breathing, lung and brain activity, blood oxygen levels, and arm and leg movements while the person sleeps. The results of the sleep study can indicate if an individual has sleep apnea and if intervention is warranted.

Treatment

Immediate treatment of sleep apnea is important not only to reduce its symptoms but also to prevent the development of co-morbidities that can arise if sleep apnea remains untreated.

A doctor may recommend lifestyle changes to treat sleep apnea if the case is considered mild.

Self-Care

• Sleep apnea happens more often when lying on the back; hence, sleeping on the side can be a way to reduce the occurrence of sleep apnea.
• Obesity is a strong risk factor for sleep apnea, and weight loss has been shown to be an effective way of treating sleep apnea.
• Abstaining from alcohol and from smoking can also help improve sleep apnea.
• Adequate treatment of allergies especially allergic rhinitis and nasal polyps.

If these methods don’t provide relief or if sleep apnea is considered moderate or severe, the doctor make recommend a device to help open a blocked airway, such as:

Medical treatment

• Continuous Positive Airway Pressure or CPAP devices are the cornerstone in the treatment of sleep apnea. A CPAP is face mask that pushes pressurized air into an individual’s airway.  The pressurized air prevents the airways from collapsing thus preventing episodes of apnea. The problem with the CPAP, however, is that some individuals find the mask bothersome and the machine noisy. Therefore, some individuals are not compliant in wearing the mask all night.
• For individuals with mild to moderate sleep apnea, an oral appliance or a mandibular advancement device might be helpful. These custom-fit devices keep the airway open by protruding the jaw outward and preventing the tongue from falling backward and obstructing the airway.
• Surgery may be indicated in severe cases of apnea that do not improve with CPAP or oral appliance. Surgical management of sleep apnea generally consists of removing certain parts of the throat to widen the airway and prevent obstruction. Because surgery has its accompanying risks, it is usually reserved for severe cases of sleep apnea.

Is sleep apnea dangerous?

It can be. Sleep apnea is considered a serious medical condition because of the potential complications associated with it, such as:

• Excessive daytime fatigue. Being unable to get a good night’s sleep can cause daytime drowsiness and fatigue, which can make it difficult to concentrate or even perform day-to-day tasks. People with sleep apnea have a proven increased risk of accidents while driving or in the workplace. It can also cause irritability, mood swings, and behaviour issues.
• Heart problems and high blood pressure. The risk of high blood pressure increases when a person has obstructive sleep apnea. It also increases the risk of heart attack, irregular heartbeat, and stroke.
• Insulin resistance and type 2 diabetes. Those with sleep apnea are more likely to develop insulin resistance and type 2 diabetes.

Sleep apnea also increases the risk of metabolic syndrome, liver problems, and relationship issues.