Sleep Apnea
 Symptoms, Causes, Diagnosis, and Treatment
Sleep apnea, a disruption of breathing while asleep, is a particularly tricky sleep disorder - 90% of people who have sleep apnea don't know that they have it! Although episodes of choking or gasping for air might occur hundreds of times throughout the night, you may not have any recollection of struggling for breath.
Usually it is the bed partner who first notices that the person is struggling to breathe. If left untreated, this common disorder can be life-threatening.
Signs and symptoms of sleep apnea
Warning signs and symptoms of sleep apnea include:
- Frequent cessation of breathing (apnea) during sleep. Your sleep partner may notice repeated silences from your side of the bed.
- Choking or gasping during sleep to get air into the lungs
- Loud snoring
- Sudden awakenings to restart breathing
- Waking up in a sweat during the night
- Feeling unrefreshed in the morning after a night’s sleep
- Headaches, sore throat, or dry mouth in the mornings after waking up
- Daytime sleepiness, including falling asleep at inappropriate times, such as during driving or at work
Types of sleep apnea
There are three types of sleep apnea: obstructive, central, and mixed.
Obstructive Sleep Apnea (OSA)
OSA is the most common type of sleep apnea. It is caused by a breathing obstruction, which stops the air flow in the nose and mouth. The rest of this article discusses, in length, the causes, symptoms and treatments for OSA.
Central Sleep Apnea (CSA)
Central sleep apnea is a far rarer type of sleep apnea, which occurs when the brain signal that instructs the body to breathe is delayed. This central nervous system disorder can be caused by disease or injury involving the brainstem, such as a stroke, a brain tumor, a viral brain infection, or a chronic respiratory disease. People with CSA seldom snore, which makes it even harder to diagnose as they do not fit the “normal” profile of a sleep apnea sufferer. However, while the causes of the breathing cessation are different in CSA and OSA, the symptoms and results are much the same – a deprivation of oxygen and poor sleep due to repeated awakenings at night. The treatments for CSA include specific medications that stimulate the need to breathe and administration of oxygen.
Mixed sleep apnea
Mixed sleep apnea is a combination of the two other types of sleep apnea, Obstructive Sleep Apnea and Central Sleep Apnea. A person with mixed sleep apnea will often snore, but finds that treatments which only help obstructions in the airways do not completely stop apnea episodes. Treatment usually includes a combination of the treatments used for OSA and CSA.
Causes and risk factors of obstructive sleep apnea
When you have obstructive sleep apnea, your throat collapses during sleep, blocking the airway and preventing air from getting to the lungs. Generally, your throat muscles keep the throat and airway open.
Risk factors of sleep apnea:
- Shape of head and neck may create a smaller than normal airway.
- Large tonsils or adenoids or other anatomical differences. (A deviated septum, enlarged tongue, or receding chin can also create difficulties breathing during sleep)
- Being overweight or obese (although almost 50% of people with sleep apnea are not obese)
- Throat muscles and tongue relax more than normal during sleep. (This can be due to alcohol or sedative use before bedtime, but not necessarily)
- Snoring - Snoring can cause the soft palate to lengthen, which in turn can obstruct the airway.
- Smoking or exposure to secondhand smoke
- Nasal congestion, nasal blockages, and nasal irritants
- Family history of sleep apnea - No specific genetic marker for sleep apnea has been discovered, but obstructive sleep apnea seems to run in families. This may be a result of anatomic abnormalities that run in the family
- Other disorders and syndromes - Hypothyroidism, acromegaly, amyloidosis, vocal cord paralysis, post-polio syndrome, neuromuscular disorders, Marfan's syndrome, and Down Syndrome
- Other physical conditions, such as immune system abnormalities, severe heartburn or acid reflux and high blood pressure. It isn’t clear whether the conditions are the cause or the result of 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.
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