Sleep Apnea
What is sleep apnea?
Sleep apnea is
a serious, potentially life-threatening condition. It is far more common than
generally understood. Sleep apnea occurs in all age groups and both genders. It
is more common in men, although it may be under diagnosed in women and young
African-Americans. It is estimated that as many as 18 million Americans have
sleep apnea.
Sleep apnea is
a breathing disorder characterized by brief interruptions of breathing during
sleep. There are two types of sleep apnea:
·
Central sleep apnea occurs when the brain fails to send the appropriate signals
to the muscles to start breathing. Central sleep apnea is less common than
obstructive sleep apnea.
·
Obstructive sleep apnea occurs when air can’t flow into or out of the nose or mouth
although efforts to breathe continue.
Sleep apnea is
characterized by a number of involuntary breathing pauses or "apneic
events" during a single night's sleep. There may be as many as 20 to
30 or more events per hour. These events are usually accompanied by snoring
between apnea episodes. But, not everyone who snores has sleep apnea. Sleep
apnea may also be characterized by choking sensations. The frequent
interruptions of deep, restorative sleep often lead to early morning headaches
and excessive daytime sleepiness.
During the
apneic event, you can’t breathe in oxygen or exhale carbon dioxide. This
results in low levels of oxygen and increased levels of carbon dioxide in the
blood. This alerts the brain to resume breathing and cause an arousal. With
each arousal, a signal is sent from the brain to the upper airway muscles to
open the airway. Breathing is resumed, often with a loud snort or gasp.
Frequent arousals, although necessary for breathing to restart, prevent
restorative, deep sleep.
Early
recognition and treatment of sleep apnea is important, as it may be associated
with:
·
Irregular heartbeat
·
High blood pressure
·
Heart attack
·
Stroke
·
Daytime sleepiness
·
Increased risk of motor
vehicle accidents
What are the causes of sleep
apnea?
Certain
mechanical and structural problems in the airway cause the interruptions in
breathing during sleep. Apnea occurs:
·
When the throat muscles and
tongue relax during sleep and partially block the opening of the airway.
·
When the muscles of the soft
palate at the base of the tongue and the uvula relax and sag, the airway
becomes blocked, making breathing labored and noisy and even stopping it
altogether.
·
In obese people when an
excess amount of tissue in the airway causes it to be narrowed.
·
With a narrowed airway, the
person continues his or her efforts to breathe, but air can’t easily flow into
or out of the nose or mouth.
Who is at risk for sleep apnea?
Sleep apnea
seems to run in some families, suggesting a possible genetic basis. People most
likely to have or develop sleep apnea include those who:
·
Snore loudly
·
Are overweight
·
Have high blood pressure
·
Have some physical
abnormality in the nose, throat, or other parts of the upper airway
Use of alcohol
and sleeping pills increases the frequency and duration of breathing pauses in
people with sleep apnea.
What are the symptoms of sleep
apnea?
In either form of sleep apnea, your breathing
pauses a number of times during sleep. These are called apneic events.
There may be as many as 20 to 30 or more events per hour. Between events,
you may snore. But, not
everyone who snores has sleep apnea. Sleep apnea may also cause a choking sensation. When breathing starts, you may make a loud
snort or gasp. These frequent breaks in deep, restorative sleep often lead to headaches andexcessive daytime sleepiness.
Other symptoms include dry mouth or sore throat and problems
paying attention.
How is sleep apnea diagnosed?
Diagnosis of
sleep apnea is not simple because there can be many different causes. Primary
care doctors, pulmonologists, neurologists, or other doctors with specialty
training in sleep disorders may be involved in making a diagnosis and starting
treatment. Several tests are available for evaluating sleep apnea, including:
·
Polysomnography. This test records a variety of body functions during
sleep, such as the electrical activity of the brain, eye movement, muscle
activity, heart rate, respiratory effort, air flow, and blood oxygen levels.
·
Multiple Sleep Latency Test (MSLT). This test measures the speed of falling asleep. People
without sleep problems usually take an average of 10 to 20 minutes to fall
asleep. People who fall asleep in less than 5 minutes are likely to
require some type of treatment for sleep disorders.
Diagnostic
tests usually are done in a sleep center, but new technology may allow some
sleep studies to be done in your home.
How is sleep apnea treated?
Specific
treatment will be determined by your doctor based on:
·
Your age, overall health, and
medical history
·
Severity of the disease
·
Your tolerance for specific
medications, procedures, or therapies
·
Expectations for the course
of the disease
·
Your opinion or preference
Medications
are generally not effective in the treatment of sleep apnea. Therapy may
include the following:
·
Giving oxygen may safely help
some people, but does not end sleep apnea or prevent daytime sleepiness. Its
role in the treatment of sleep apnea is controversial.
·
Behavioral changes are an
important part of a treatment program, and in mild cases of sleep apnea,
behavioral therapy may be all that is needed. You may be advised to:
·
Avoid the use of alcohol.
·
Avoid the use of tobacco.
·
Avoid the use of sleeping
pills.
·
Lose weight if overweight
(even a 10% weight loss can reduce the number of apneic events for most
people).
·
Use pillows and other devices
to help sleep in a side position.
·
Physical or mechanical
therapy options are also available. Nasal continuous positive airway pressure
(CPAP) is a procedure in which you wear a mask over the nose during sleep, and
pressure from an air blower forces air through the nasal passages. Dental
appliances that reposition the lower jaw and the tongue have been helpful to
some people with mild sleep apnea, or who snore but do not have apnea.
·
Some people with sleep apnea
may need surgery. Examples of these procedures include:
·
Surgical procedures to remove
adenoids and tonsils, nasal polyps, or other growths or tissue in the airway,
or to correct structural deformities may be done.
·
Uvulopalatopharyngoplasty
(UPPP) is a procedure used to remove excess tissue at the back of the
throat (tonsils, uvula, and part of the soft palate).
·
Surgical reconstruction for
deformities of the lower jaw may benefit some people.
·
Surgical procedures to treat
obesity are sometimes recommended for a person with sleep apnea who is obese.
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উত্তরমুছুনOral Appliance Therapy St Paul
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