Obstructive Sleep Apnea
WHAT IS OBSTRUCTIVE SLEEP APNEA?
Obstructive sleep apnea is a medical condition in which a person has repeated,
brief, temporary breathing pauses (apneas) during sleep. Lack of breathing
causes a decrease in oxygen and an increase in carbon dioxide (CO2) in the
body. These changes signal the brain that breathing has stopped; the brain then
signals the body to briefly awaken and restart breathing. Thus, these obstructions
result in frequent brief arousals from sleep. Although the actual number of
minutes of arousal during the night may be small, these repeated, brief
disruptions in sleep could lead to significant daytime symptoms. A comparable
image would be that of being poked by someone 15–30 times a night. However,
individuals are usually unaware of waking up, and bed partners often describe
very restless sleep but usually do not say that the person wakes up completely.
WHAT CAUSES OBSTRUCTIVE SLEEP APNEA?
In many, sleep apnea is caused by excessive tissue in the back of their throat.
This would include a prominent soft palate, a large uvula and/or large
tonsils/adenoids, which can block the airway. Sleep apnea is also more common
in people who are overweight, although many sufferers may be underweight.
Children with sleep apnea may have poor growth because of disruption in
nighttime secretion of growth hormone. Others who are at high risk for sleep
apnea include those with a narrow facial bone structure, a history of cleft palate,
and Down syndrome. Persons with allergies, asthma, reflux, or frequent sinus
infections may also be at risk for obstructive sleep apnea. Smoking, alcohol and
any type of sedative medications further increase one’s risks.
WHAT ARE THE SYMPTOMS OF OBSTRUCTIVE SLEEP APNEA?
• Breathing pauses during sleep or difficulty breathing during sleep
• Mouth breathing
• Noisy breathing
• Restless sleep
• Sweating during sleep
• Morning headaches
• Difficulty waking in the morning
• Nasal voice
Those with obstructive sleep apnea may also have daytime symptoms as a result
of the sleep disruption. They may be sleepy during the day, taking unplanned
naps or falling asleep at inappropriate situations, such as at work, at a party or
while driving. In addition, poor work performance may be noted. People with
sleep apnea may also be moody, irritable, or cranky. They may feel or act
depressed and lose their motivation to do things they should typically enjoy doing
(fishing, ballgames, shopping, gardening, etc).
MEDICAL PROBLEMS CAUSED BY SLEEP APNEA
Significant and severe medical problems can develop as a result of untreated
sleep apnea. The risks of developing hypertension, heart disease and strokes all
increase two, three and fourfold respectively from sleep apnea. Diabetes can
develop and be more difficult to control. Fat storage and obesity are increased as
a direct result from the sleep loss caused by sleep apnea. The chances of death
or severe injury to one’s self or to others is greatly increased with the risk of
injury at work or from a car accident.
HOW IS OBSTRUCTIVE SLEEP APNEA DIAGNOSED?
Many with symptoms of obstructive sleep apnea require an overnight sleep study
to confirm the diagnosis. The overnight sleep study, which is done in a
specialized sleep laboratory, monitors breathing, heart rate, oxygen levels and
HOW IS OBSTRUCTIVE SLEEP APNEA TREATED?
Most with sleep apnea require a treatment called continuous positive airway
pressure (CPAP), which is a portable breathing machine used at night. Despite
the frightful appearance and the unpleasant thought of using a device to sleep
with, the vast majority of people needing CPAP find themselves successfully
using it every night with a remarkable change in their sleep and their lives. For
some, removal of tonsils and adenoids, if enlarged, and some of the other
prominent tissues in the back of their throat takes care of the problem. An ear,
nose, and throat specialist makes the evaluation for such surgery. An oral
mouthpiece designed strictly for sleep apnea works for some select patients
when they wear it at night. People who are overweight should be counseled
about nutrition and exercise. Those with allergies or asthma may be treated with
medication. Nasal sprays or sleeping in positions in which the person does not
snore may also be recommended.