What is Sleep Apnea?
Sleep apnea describes instances when people stop breathing, for a few seconds at a time, when asleep.
This potentially serious condition is more common in men than women. It is more prevalent in hispanics, blacks and native americans in the US than it is among whites. (1)
There are many factors that contribute to this condition, including, age, genetics, an unhealthy lifestyle and race and ethnicity. (2)
There are three different kinds of sleep apnea: obstructive, central and mixed.
Obstructive Sleep Apnea
The most prevalent one is called obstructive sleep apnea. It happens when the muscles in the throat and the back of the mouth relax when asleep.
These muscles help support the tonsils, walls of the throat, the soft palate and the tongue. When they relax the airway narrows and can close when breathing in and out. As a result not enough air is taken in which might lower the level of oxygen in the blood.
When the brain registers the inability to breathe adequately, it wakes you up briefly to enable the airway to be reopened. These episodes last only seconds but can occur between five and thirty times every hour. It is so brief that an individual will have no recollection of the occurrence. (3)
Central Sleep Apnea
This less common type of sleep apnea happens when the brain forgets to send signals to the muscles that support breathing. Consequently the body does not make any effort to breathe momentarily. (4)
Mixed or Complex Sleep Apnea
As the name suggests, this sleep apnea is a combination of both obstructive and central sleep apnea. It often comes to light when people are treated for obstructive sleep apnea but still have episodes of breathing interruption. (5)
The signs and symptoms of the differing types of apnea are often the same. These include:
When you sleep, the throat and jaw muscles relax and the tongue falls back towards the throat. The airway narrows and as a result becomes partially blocked. As breaths are taken in and out the the walls of the throat vibrate.
These vibrations make the characteristic sound of snoring. The narrower the gap in the airway, the more intense the vibrations and the louder the snore becomes.
This symptom is prevalent in obstructive sleep apnea, often accompanied by a snorting noise. (6)
Gasping for Air
When the breathing pattern is interrupted during sleep people might be seen or awakened gasping for air. This might be more common in central sleep apnea. (7)
Throughout periods of sleep breathing can be reduced or absent. This is generally witnessed by someone else and the person suffering from apnea will be unaware it’s happening. (8)
Sleepiness and Fatigue
As a result of many episodes of interrupted sleep people might feel excessively tired and fatigued during waking hours. This could be the case even when an individual thinks they are spending enough time in bed.
The need to take a nap during the day might be hard to resist, and you could be irritable and cranky. (9)
Lack of quality sleep can have a domino effect on the ability to function effectively during the day. The effort taken to pay attention and concentrate on everyday tasks might be difficult.
Short-term memory, motor skills and vigilance can also be affected. (10)
Sleep apnea can lead to erectile dysfunction and might decrease libido. (12)
Between 12 and 18 percent of middle aged people who suffer from sleep apnea report waking in the morning with a headache.
The exact cause of these headaches remains unknown at this time. (13)
Waking with a mouth feeling dry and parched is a classic symptom of obstructive sleep apnea. This is likely due to sleeping with the mouth open. (14)
The symptoms associated with this condition can vary between men women and children.
Women with sleep apnea more often experience headaches, depression, fatigue, insomnia, anxiety and sleep disruption.
Children can suffer from bedwetting, hyperactivity, learning difficulties and poor performance at school. If they suffer from asthma, this can be exacerbated. (15)
This condition has three stages which are classified as mild, moderate or severe. They are assessed according to the number of apnea episodes experienced in a one hour period while asleep.
To obtain this diagnosis a person will take part in a sleep study. There are two ways this study can be done.
Home Sleep Apnea Study
A machine which monitors breathing during sleep is provided for use at home.
The sensors used are also able to measure blood oxygen levels, heart rate and provide other information. This provides a sleep specialist with the information required to detect sleep apnea. (16)
This requires an overnight stay in a sleep center. A machine with various sensors is attached to the body while sleeping. It monitors breathing, heartbeat and brain waves among other things which are then analysed by a sleep specialist. (17)
The measurements taken during an assessment will classify sleep apnea as follows:
This is indicated by less than 15 apnea episodes per hour throughout a period of sleep.
A number of apnea episodes between 15 and 29 per hour is classed as moderate.
Experiencing 30 or more apnea episodes an hour throughout a period of sleep is considered severe sleep apnea. (18)
The first recommendation from a doctor in addressing sleep apnea might be lifestyle changes.
Suggestions can include following a heart healthy diet and limiting the intake of alcohol, particularly before bedtime. Maintaining a healthy weight, and losing some if you are obese, will also help.
Taking part in a regular exercise regime and not smoking are further lifestyle changes which can be made. It’s also important to try and get the right amount of sleep your body needs.
In addition to lifestyle changes there are other treatment options available. These include:
The most commonly recommended treatment for sleep apnea is the use of a breathing device. One such machine is a continuous positive airway pressure (CPAP) device.
A CPAP has a mask that fits over the mouth and nose or just the nose, with straps to hold it in place. A tube connects the mask to a monitor which delivers air to keep the airways open while asleep.
Mouthpieces which are worn at night aim to open the airway and prevent apnea. There are two types of oral devices.
The first is called a mandibular repositioning mouthpiece, which repositions the jaw. Resembling a sports guard, it fits over the teeth and slides the lower jaw forward. In doing so it opens the upper airway and allows normal breathing.
The second type of oral device is a tongue retaining mouthpiece which holds the tongue in place. By keeping the tongue from dropping towards the throat the upper airway is kept clear.
These devices are most effective when apnea is mild, or happens when you sleep on your back. A specialized dentist can custom fit devices for a perfect fit.
One device which can be surgically implanted senses patterns of breathing. It then delivers stimulation to key muscles which open the airway during sleep.
Another surgical implant is a nerve stimulator. This device stimulates the nerve which controls movement in the tongue. In doing so it helps keep the tongue positioned so the upper airway is opened.
This therapy aims to strengthen the muscles which control the tongue, lips, soft palate, side walls of the throat and the face. This can in turn lead to better positioning of the tongue.
If sleep apnea is severe and doesn’t respond to non invasive treatment, surgery might be considered. This could also be the case, for example, if tonsils are enlarged.
Surgeries which might be done are: a tonsillectomy to remove tonsils, or maxillary advancement which repositions the jaws to enlarge the upper airway. A tracheostomy is another option, whereby a tube is placed into the airway from the front of the neck. (19)
What is sleep apnea? Sleep apnea is a condition where people stop breathing for a few seconds at a time when asleep.
What are the signs of sleep apnea? Signs of sleep apnea include snoring, daytime tiredness, impaired sexual function, frequent urination at night, morning headaches and dry mouth. Observances of episodes of missed breaths during the night is the main indication of this condition.
How do you develop sleep apnea? Risk factors for this condition include age, genetics, an unhealthy lifestyle and race and ethnicity.
How are you diagnosed for sleep apnea? Following a medical examination and taking family and medical history, a sleep study might be required.
What is the best treatment for sleep apnea? Lifestyle changes can help relieve sleep apnea. Other treatments include use of breathing devices or oral mouthpieces. Surgery might be considered to either insert an implant or open the upper airway.
Is sleep apnea considered a disability? This condition is considered a disability however there are caveats regarding claiming benefits. (21)
Is there a cure or sleep apnea? There are many treatments which are successful in treating this condition.
Is sleep apnea life threatening? Sleep apnea can lead to other conditions which can be life threatening.
Sleep apnea involves the frequent cessation of breathing for a few seconds while sleeping. It can leave people feeling tired and affect their quality of life.
The good news is there are treatments which help manage this condition. Making long term lifestyle changes might be the only thing needed.