Causes of sleep apnea and information on snoring related to apneic breathing problems.
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What is Sleep Apnea?
Sleep apnea is a condition characterized by episodes in which breathing stops during sleep. These episodes of stopped breathing usually last for 10 seconds or more, sometimes more than 300 times a night. This condition is potentially life threatening causing significant social and emotional problems, and hampering day to day living. People with sleep apnea will awaken partially as they struggle to breathe, but in the morning will be unaware of any sleep disturbances ever occurring.
There are two main types of sleep apnea – obstructive sleep apnea and central sleep apnea.
Obstructive sleep apnea: is the most common type of sleep apnea and is caused by the relaxation of soft tissue in the back of the throat that obstructs the airway passage. When you try to breathe, there isn’t sufficient air as a result of the blockage. The blockage may be due to your windpipe being blocked by your tongue, tonsils, uvula or the fatty tissue in your throat.
Central sleep apnea: is a rare type of sleep apnea that is associated with the function of the central nervous system. It occurs when the area of the brain that controls your breathing does not send the correct signals to the breathing muscles. This means that there is no effort to breathe at all for brief periods. With central apnea, snoring does not usually occur.
It is estimated that sleep apnea affects more than 12 million Americans. It is more common in men (over 40 years old) than women, and in people who are overweight or obese.
Additional medical problems associated with untreated sleep apnea include hypertension, coronary artery disease, myocardial infarction, stroke, psychiatric problems, impotence, cognitive dysfunction, memory loss, and death.
Diagnosing Sleep Apnea
The diagnosis of sleep apnea is based on a complete medical history and symptoms of the individual. Your physician may also ask you a series of questions pertaining to sleep quality, daytime sleepiness and bedtime habits. A thorough physical examination of the mouth, neck and throat (oropharanyx) is performed to detect for any abnormalities.
Certain tests may also be performed and they include:
- Polysomnography test that records a variety of body functions during sleep such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiration effort, air flow, and blood oxygen levels. It is used both to diagnose sleep apnea and to determine its severity
- The Multiple Sleep Latency Test (MSLT) measures the speed of falling asleep
- ECG to show arrhythmias during sleep
- Arterial blood gases to show low oxygen or elevated carbon dioxide
- Echocardiogram to evaluate the function of the heart
- Thyroid function studies
Usually people suffering from sleep apnea will have a combination of obstructive sleep apnea and central sleep apnea. The person who has obstructive sleep apnea does not remember the episodes of apnea during the night. It is generally, family members, particularly spouses who witness the periods of apnea.
- Excessive daytime sleepiness
- Loud snoring
- Periods of silence (not breathing) followed by gasps
- Restless sleep
- Falling asleep during the day and at inappropriate times
- Morning headaches
- Trouble concentrating and limited attention
- Recent weight gain
- Low Libido
- Memory loss
- Poor judgment
- Mood or behavior changes
Additional symptoms that may be associated with this disorder include:
- Hyperactivity, especially in children
- Automatic behavior (performing actions by rote)
- High blood pressure
- Leg swelling (if severe)
What Causes Sleep Apnea?
Sleep apnea occurs when air struggles to pass into your lungs while you are sleeping. Under normal conditions, the upper part of your throat muscles keeps this passage open to allow air to flow into your lungs. During sleep, these muscles usually relax but the passage stays open enough to allow air to flow through.
Some people, however, have a narrower passage and during sleep, relaxation of these muscles causes the passage to close. As a result, air cannot pass through into the lungs and loud snoring and labored breathing occurs. When the airway is obstructed completely, air fails to reach the lungs.
Help for Sleep Apnea
Depending on the medical history of an individual and the severity of the disorder, there are a variety of treatment options available. A few simple lifestyle changes can also make a huge difference. Firstly, eating a balanced diet and exercising regularly is very important as they both promote healthier sleeping patterns.
Learning to manage your weight and losing weight may relieve the symptoms of sleep apnea in some people. Avoiding alcohol and medications such as sedatives and muscle relaxants as well as quitting smoking will help to control sleep apnea. Pillows and devices specifically designed to prevent people from sleeping from their backs may also be of benefit to some.
For more extreme cases of sleep apnea, continuous positive airway pressure (CPAP) is one of the most popular methods prescribed. It is a form of mechanical breathing assistance that involves the use of a mask worn over the nose or nose and mouth at night that blows pressurized air through the airway to keep it open.
In addition, surgical procedures may be performed to remove enlarged tonsils or adenoids (tonsillectomy) or excess tissue at the back of the throat (uvulopalatopharyngoplasty or UPPP).
Tips to help you cope with sleep apnea
- There are some helpful guidelines that can be followed to manage sleep apnea more effectively:
- Establish and maintain regular bedtime and wake-up time patterns
- Eat a healthy balanced diet packed with fresh fruit and vegetables
- Exercise regularly by walking, jogging, swimming or going to gym
- Determine how much sleep you need to feel constantly awake and recharged - this can be done by keeping a sleep journal
- Improve your sleeping position by lying on your side
- Practice relaxation techniques such as meditation, yoga or visualization to reduce stress and anxiety
- Spend time outdoors after waking as this regulates the body’s biological clock
- Create a comfortable, tranquil and relaxing sleeping environment
- Maintain a healthy weight as being overweight or obese also affects sleeping patterns
- Avoid stimulants such as caffeine, sedatives, alcohol and nicotine that may interfere with the sleep cycle
- Avoid eating heavy meals and drinking large amounts before bedtime
- Join a support group and have access to family, marriage and occupational counseling