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Sleep Apnea

Sleep Apnea

Sleep Apnea

Sleep apnea is a common sleep disorder that involves repeated breathing interruptions during sleep. These interruptions may occur hundreds of times each night, and may be the result of structural abnormalities or brain malfunctions. During normal breathing, air passes through the nose, past the flexible structures in the back of the throat, including the soft palate, uvula and tongue. When a person is awake, the muscles hold this airway open. When they are asleep, these muscles relax and the airway usually stays open. Sleep apnea occurs when the upper airway and airflow are blocked, causing the oxygen levels to drop in both in the brain and the blood, resulting in shallow breathing or breathing pauses during sleep.

What Causes Sleep Apnea?

Sleep apnea occurs as a result of a partial or fully blocked airway passage in the throat. Certain factors may put certain people at risk for developing sleep apnea, which include:

  • Enlarged tonsils or adenoids
  • Obesity
  • Cardiovascular problems
  • Smoking
  • Family history
  • Nasal congestion
  • Throat and tongue muscles that are more relaxed than normal

Adults over the age of 60 may be more at risk of developing sleep apnea because the aging process may limit the brain’s ability to keep the throat muscles stiff during sleep. Heavy use of alcohol or sedatives may also contribute to sleep apnea because these substances may relax the muscles of the throat.

Types of Sleep Apnea:

Obstructive Sleep Apnea
Obstructive sleep apnea is the most common form of sleep disorded breathing. Obstructive sleep apnea can occur when the soft tissues in the back of their throat — the tongue, tonsils, sidewalls of the throat — sag or slide backwards and block the airway. This can lead to episodes where a patient does not get enough oxygen or stops breathing. The brain senses that breathing has stopped and it awakens the person, making them take in air, often with a snorting sound. The interruption is so brief the person usually doesn’t remember this in the morning, and it can happen dozens, or even hundreds, of times each night.
Central Sleep Apnea
In patients with central sleep apnea the airway remains open but the brain does not send signals to the muscles involved in breathing. Patients with heart-related conditions may suffer from central sleep apnea.
Mixed Sleep Apnea
Mixed sleep apnea combines aspects of the obstructive and central types of apnea. A common warning sign of mixed sleep apnea is snoring, especially interspersed with gasps or lack of breathing.
Patients who are overweight, have high blood pressure, are older, smoke or have a family history of sleep apnea may have an increased risk of developing obstructive sleep apnea, while those with heart disease or a stroke are at an increased risk for central sleep apnea.

What are the Symptoms of Sleep Apnea?

Sleep apnea really has two sets of symptoms — those that occur while the disruption is happening at night and those that occur as a result of the disrupted sleep, usually the next day.
These symptoms are common with sleep apnea:

  • Awakening with shortness of breath
  • Episodes of breathing cessation witnessed by another person
  • Loud snoring
  • Abrupt awakenings from sleep, often with snorting sounds
  • Waking up with a headache in the morning
  • Excessive daytime sleepiness
  • Waking up with a dry mouth or sore throat
  • Difficulty staying asleep
  • Attention problems
  • Irritability

What Negative Effects Can Sleep Apnea Have On the Body?

Many people discount the seriousness of sleep apnea, thinking it’s just a little snoring. That’s a risky line of thinking. Untreated sleep apnea can lead to a number of very serious health concerns:

  • High blood pressure — Because you wake up over and over during the night, this process places stress on your body, activating your hormone systems. This raises your blood pressure.
  • Heart disease — People with obstructive sleep apnea are more likely to have heart attacks, strokes, and atrial fibrillation.
  • Type 2 diabetes — Sleep apnea is common in people with type 2 diabetes. This is because when your body is tired it has trouble effectively processing insulin.
  • Weight gain — Sleep apnea can make your body release more of the hormone ghrelin, which makes you crave carbs and sweets.
  • Adult asthma — Adult asthma and sleep apnea combined tend to cause the patient to suffer from more asthma attacks.
  • Car accidents — People with sleep apnea are up to five times more likely than normal sleepers to have traffic accidents, and to even fall asleep at the wheel.

How is Sleep Apnea Diagnosed?

Your doctor at Coastal ENT will evaluate your symptoms and you’ll be asked to provide a sleep history/sleep diary. You’ll need help from a spouse or partner for this.
From there, evaluation will likely include overnight monitoring at a sleep center, or possibly a home sleep test will suffice. These are the two typical tests used to detect sleep apnea:

  • Nocturnal polysomnography — At a sleep center, you are attached to equipment that monitors your heart, lung, and brain activity. It also records breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
  • Home sleep tests — Testing may be able to be done at home by using portable monitoring devices. These devices provide simplified testing, usually of your heart rate, blood oxygen level, airflow, and breathing patterns.