Sleep apnea is a common and often dangerous breathing disorder that occurs while an individual is sleeping. The upper airway can become blocked, which then reduces or completely stops the steady flow of air. The result is that breathing may stop altogether for as little as a few seconds or as long as a minute. The long-term result of these episodes is lower-quality sleep due to an inadequate amount of oxygen.
If left unchecked, sleep apnea can lead to a host of additional medical issues, many of them serious. Because sleep apnea is so prevalent in the population, it is imperative to know the types, symptoms, diagnoses, and treatments.
Due to the difficulty in recognizing whether or not you may have sleep apnea - as you are asleep when symptoms present themselves - many people go undiagnosed and, therefore, untreated. Sleep apnea is most widely seen in men, but can affect all adults and children.
There are three types of sleep apnea.
This type occurs due to a physical blockage at the back of the throat that closes the airway. This blockage usually occurs when the throat muscle relaxes during sleep. Of the three types, OSA is the most common form of sleep apnea. It can affect people of any age, though it is most prevalent among people in their late 50s.
This type occurs when the brain stops sending signals that regulate breathing patterns to the muscles that control breathing. This miscommunication leads to shallower and/or slower breathing, and on occasion, a temporary cessation of breathing. CSA affects less than 1% of people.
This type occurs when an individual suffers from both Obstructive Sleep Apnea and Central Sleep Apnea.
Undiagnosed sleep apnea can lead to a variety of dangerous complications including heart attack, diabetes, cancer, glaucoma, and cognitive disorders. It’s important to be able to recognize the signs and symptoms of this disorder and understand the causes to be proactive with your health.
As sleep apnea directly affects and impedes breathing during sleep, one of the most common signs can be frequent and loud snoring. Snoring usually indicates that the free flow of oxygen in the airway is impaired. Additionally, you may experience periods of excessively shallow breathing, or cessation of breathing altogether.
These are known as apnea events. These breathing issues may cause sudden gasping for air in the middle of the night as the body strains to recover oxygen.
Because not everyone has the opportunity to track what is happening as they sleep, it is important to know the waking symptoms of sleep apnea. The symptoms include general fatigue throughout the day, a decrease in motor skills, memory, and attention, dry mouth and/or headaches when waking, decreased libido, and waking up often during the night to go to the bathroom.
Symptoms for women and children may differ slightly from men. Women are more likely to suffer from headaches and fatigue, depression and anxiety, and sleep disruption and insomnia. Children may experience bedwetting, hyperactivity, exacerbated asthma, and learning issues.
Many factors may bring on sleep apnea, from underlying medical conditions to physical composition. Other factors include:
Obesity: a very common cause of OSA, as obese individuals may have fat deposits in the neck area that are involved in the blockage of the airway.
Large tonsils: may block the airway as the throat muscles relax.
Endocrine conditions, such as hypothyroidism, acromegaly, and polycystic ovary syndrome: may contribute to sleep apnea, as these conditions influence weight. Hypothyroidism can also affect the part of the brain that controls the nerves and muscles of the throat, further complicating the condition.
Neuromuscular disorders, such as stroke or amyotrophic lateral sclerosis: may compound sleep apnea, as these disorders interfere with the brain’s communication with the muscles of the chest and airway.
Heart and/or kidney failure: can cause sleep apnea due to the build-up of fluids in the neck.
Genetic syndromes that affect the structure of the face: facial bones may interfere with breathing or cause the tongue to sit poorly in the throat during sleep.
The use of sedatives, including drugs and alcohol, as well as cigarette smoking.
Sleeping on one’s back and nasal congestion.
If left unchecked, sleep apnea can lead to a variety of complications, such as:
Asthma, a long-term chronic condition that affects the lungs,
Atrial fibrillation—an irregular heart rhythm—as well as heart disease,
Chronic kidney disease,
Metabolic disorders and pregnancy complications
Additionally, because of the effects that apnea has in the waking hours, including increased fatigue and decreased attention span, sleep apnea can lead to both behavioural and cognitive disorders.
Doctors may use several factors to establish a diagnosis of sleep apnea. Medical history is examined to determine if you might have any pre-existing conditions that would bring on sleep apnea, or present any of the risk factors, including age or lifestyle. Doctors may also look at a family history of sleep apnea, any other sleep disorder, or any of the additional complications that may suggest undiagnosed sleep apnea somewhere on the family tree.
Next, the doctor conducts a physical examination to look at the throat, tongue, jaw, and other physiological determinants that may suggest a diagnosis of sleep apnea. Obesity, a narrowed airway, and a large neck circumference are all considered physical factors in diagnosis. During the physical examination, the doctor may also look at heart and lung function, as well as neurological function.
After that, the doctor might prescribe a sleep study and refer you to a sleep specialist. The specialist studies you while you’re sleeping with sensors attached to your body. Sleep studies may be done at home, or at a facility. The feedback will include a breakdown of apnea events through the night, a record of activity in the muscles that control breathing, a record of blood oxygen levels throughout sleep, and a record of brain and heart activity.
Using all that information, the doctor can establish if you are suffering from sleep apnea, and if so, how severe it may be. Five to fourteen apnea events per hour are considered mild, while fifteen to twenty-nine events per hour are considered moderate, and thirty or more events per hour severe.
Lastly, the doctor will rule out any further medical conditions, or factors such as additional medications, such as opioids, or endocrine issues. Additionally, excessive and recent travel at altitudes above 6,000 feet can trigger sleep apnea symptoms.
At-home sleep apnea tests are available and are easy and cost-effective, and allow you to track breathing and oxygen levels throughout the night. While sleep study centers can offer a more in-depth overview of sleep-related issues, at-home testing is an alternative to start the diagnosis process.
Once a diagnosis of sleep apnea is confirmed, there are a few key ways to treat it:
These would include weight loss, increased physical activity, and cessation of smoking and alcohol consumption.
CPAP machines, or Continuous Positive Airway Pressure machines, send humidified air into the nose, creating pressure that keeps the throat open while the individual is asleep. Studies have shown that regular use of a CPAP machine reduces blood pressure and improves wakefulness.
This may be suggested if you don’t respond well to lifestyle changes or breathing devices. Surgeries may include a tonsillectomy to remove tonsils that are blocking the airway, surgery to move the upper and/or lower jaw to expand the airway, or a tracheostomy, in which a surgeon makes a hole in the front of the neck to insert a breathing tube and facilitate breathing.
It is important to seek a medical diagnosis sooner rather than later. Finding the right doctor and the right plan of action can lead to increased health and quality of life during both waking and sleeping hours. Contact us at Maple Dental Health to find out if you require treatment.