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Sleep Apnea |
What is Sleep Apnea?
Sleep apnea is a sleeping disorder in which a person stops breathing
repeatedly during their sleep, sometimes hundreds of times during the
night, and often for a minute or longer. A sufferer of sleep apnea has
frequent episodes (up to 400-500 per night) in which he or she stops
breathing. Sleep apnea warning signs include
excessive snoring, choking, or gasping during sleep. There are
three different types of sleep apnea; obstructive sleep apnea, central
sleep apnea, and mixed (a combination of the two).
The Greek word "apnea" literally means "without
breath." With each apnea event, the sleeper's brain briefly arouses
in order to resume breathing, causing sleep to be extremely fragmented and
of poor quality. Sleep apnea is a serious,
potentially life-threatening condition that can cause many health problems
if left untreated. Sleep apnea is very common, as common as adult
diabetes, and affects more than twelve million Americans, according to the
National Institute of Health.
Central Sleep Apnea
Central sleep apnea occurs when the airway remains open, but the brain's
nerve signals fail to send the appropriate signals to the breathing
muscles to initiate respirations. CSA occurs during sleep because when a
person is awake, breathing is usually stimulated by other signals,
including conscious awareness of breathing rate.
Obstructive Sleep Apnea
Obstructive sleep apnea is the most common form of sleep apnea. It is
thought that about 1-10% of adults are affected by OSA; only about one
tenth of that number have CSA. OSA is caused by a blockage of the airway,
usually when the soft tissue in the rear of the throat collapses and
closes off during sleep. Obesity, especially obesity in the neck, can
increase the risk of developing OSA, because the fat tissue tends to
narrow the airway. In some people, the airway is blocked by enlarged
tonsils, an enlarged tongue, jaw deformities, or growths in the neck that
compress the airway.
A combination of the two forms is also possible, and is called "mixed
sleep apnea." Mixed sleep apnea episodes usually begin with a reduced
central respiratory drive, followed by obstruction.
Some of the risk factors for sleep apnea include:
- Obesity
- male
- age over forty
- a family history of sleep apnea
- a large neck
- a recessed chin
- abnormalities in the structure of the upper airway
- ethnicity (African-Americans, Pacific Islanders, and Mexicans)
Sleep apnea can affect both males and females
of all ages and weight, as well as children.
Most Common Symptoms: (You should visit your doctor if you have
several of these symptoms)
- Loud Snoring
- Waking up tired and having trouble concentrating or staying awake
during the day
- Waking up with headaches, or dry mouth
- Waking up during the night with a choking sensation
- Perspiring excessively during the night
- a dry mouth upon awakening
- depression
- heartburn
- reduced libido
- insomnia
- frequent trips to the bathroom during the night
- restless sleep, tossing and turning
- rapid weight gain
- chest pulls in during sleep in young children
Untreated, sleep apnea can cause or worsen:
- high blood pressure and other cardiovascular disease (up to 50% of
SA patients have high blood pressure)
- memory problems
- weight gain
- impotency and sexual dysfunction
- migraine headaches
- job impairment and motor vehicle crashes
- hyperactivity in children
- Risk for heart attack and stroke
- sudden infant death syndrome.
- depression and anxiety
- Increase in the number of red blood cells (polycythemia)
- enlarged left ventricle of the heart (cor pulmonale)
- left ventricular failure.
- life-threatening heart arrhythmias, including heartbeat slowing
(bradycardia), and racing (tachycardia)
- Pickwickian syndrome
- right heart failure
- pulmonary hypertension
- chronic daytime low blood oxygen (hypoxemia) and increased blood CO
(hypercapnia).
How do you Know if You have Sleep Apnea?
If you or someone you know has some of the common
symptoms or risk factors for sleep apnea, it is important to see a doctor
for an in-depth examination and diagnosis. Diagnosis of sleep apnea
is not simple because there can be many different reasons for disturbed
sleep. Several tests are available for evaluating a person for sleep
apnea. Some of the most common tests and procedures used to access sleep
apnea are Polysomnography, and the Multiple Sleep Latency Test (MSLT).
Diagnostic tests are usually performed in a sleep center, but new
technology may allow sleep studies to be conducted in the home.
How is Sleep Apnea treated?
The treatment of Sleep Apnea can be very complicated
and not every patient responds as well as others to the various attempted
methods. The common treatments can include surgeries like
Uvulopalatopharyngoplasty (UPPP), and Tracheostomy. Other options include
oxygen administration, Nasal continuous positive airway pressure (CPAP),
and dental appliances that reposition the lower jaw and the tongue.
Medications are generally not effective in the treatment of sleep apnea.
Behavioral changes to help ease mild sleep apnea:
- reducing the causes of sleep apnea, such as: obesity, smoking,
tranquilizers, sleeping pills or alcohol use.
- Sleeping on the back. People who snore should use pillows and other
devices that help them sleep in a side position.
- Adjustable
beds can elevate the head and lessen symptoms
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