Sleep apnea is a type of sleep disorder where the individual stops breathing for a period of time during their sleep. This pattern of breathing happens multiple times per night, sometimes awakening a person from sleep so that they get interrupted and poor sleep throughout the night. Often the person with the disorder is unaware of it and only their sleep partner can tell by hearing significant snoring throughout the night and can see times when the person stops breathing, which can last up to a minute.
There are two recognized types of sleep apnea:
Obstructive sleep apnea
In obstructive sleep apnea, there is blockage of the upper airway, usually by having the muscles and tissue of the uvula or the back of the throat flop into the airway, blocking the passage of air. This is the more common type of sleep apnea.
Central sleep apnea
This is directly caused by a failure of the brain to send signals to the muscles used in breathing. This can be due to a stroke involving the breathing centers of the brain or other brain abnormality that causes the sleep center to malfunction.
Who is likely to get sleep apnea?
The risk factors for sleep apnea are as follows:
- Being obese
- Being of the male gender.
- Being over the age of 40 (although sleep apnea can happen at any age)
- Having a thick neck greater than 17 inches around in men or 16 inches around for women
- Having a large uvula, large tonsils, a big tongue or a jaw bone too small to fit the tissues in properly
- Having a strong family history of sleep apnea
- Having sinus trouble, a deviated septum or nasal allergies blocking the nasal passages
- Having heartburn, also called gastroesophageal reflux disease.
In sleep apnea, the problem goes further than just stopping airflow to the lungs during sleep. Chronic sleep apnea can lead to the following health problems:
- Sleepiness during the daytime hours
- High blood pressure
- Heart failure
- Heart attacks of arrhythmia of the heart
- ADHD worsening
- Depression and anxiety during the day
- Chronic headaches
- An increased risk of motor vehicle crashes due to sleepiness while driving
How to know if you have sleep apnea?
People with sleep apnea are often very sleepy during the day and can’t keep up in activities involving concentration or focus. They may wake up with a sore throat or a dry throat and are often loud snorers. Some people sleep through their sleep apnea while others wake up gasping, feeling as though they might be choking in their sleep. They may have a very fitful sleep, tossing and turning during the night and may awaken with a morning tension headache. Those with sleep apnea can suffer mood changes along with memory problems and a decreased libido. They may suffer from insomnia due to having to wake up in the night to catch their breath.
How to get tested for sleep apnea?
The best way to know if you have sleep apnea is to be tested at a sleep laboratory. In such a situation, the staff attaches several devices to you to monitor your oxygenation during sleep, to listen to the snoring during sleep, to count absences of breathing and to check your brain waves during sleep in order to monitor the sleep cycle.
During the sleep study, you wear comfortable sleep clothing and simply sleep. If sleep apnea is detected right away during your sleep study, the staff may awaken you and fit you with a CPAP machine, which directs a constant stream of air into your breathing passages so that you don’t stop breathing during the night to see if this helps your sleep and relieves the blockages. The CPAP machine can also help the doctors tell the difference between central sleep apnea and obstructive sleep apnea.
A home testing device is available that you can use to help identify sleep apnea in the comfort of your home. It doesn’t test as many parameters of a full sleep study but it is good for people who live far from a sleep study center or who just can’t fall asleep in such a foreign environment.
Sleep Equipment used during your Sleep Study
As mentioned, you are hooked up to various devices to check the various parameters of your sleep while you are sleeping. This includes the following:
- Scalp electrodes are placed on your scalp to monitor the brain waves while you sleep. There are different brain waves occurring while you sleep that are not the same as when you are awake.
- An oximeter is placed on your finger to monitor the amount of oxygenation going on in your blood during sleep. When you have an episode of sleep apnea, usually the oxygen levels drop, signaling the need to take a deeper breath or wake up in order to bring the oxygen level back up.
- Belts are placed around the abdomen and chest that demonstrate your breathing patterns.
- An electromyogram can be attached to record facial twitching and leg movements. It can also tell if you are grinding your sleep at night. There are different electromyogram patterns depending on whether you are in dream sleep (REM sleep) or non-REM sleep.
- An electrooculogram or EOG can record the eye fluttering pattern that happens during REM sleep.
- An electrocardiogram (ECG) can be monitored for the presence of cardiac arrhythmias during your sleep.
- A special “snore microphone” is placed around your neck to demonstrate whether or not you are snoring at night.
How to treat sleep apnea without the cpap?
There are simple ways of treating sleep apnea without the cpap:
You can lose some weight, which will improve obstruction in your airways.
You can avoid taking sleeping pills or drinking alcohol just before sleep.
Changing your sleeping positions can reduce the risk of obstructing your airway. Sleeping on your back, for example, increases sleep apnea and snoring.
You can stop smoking. Smoking has a way of swelling the upper airway passages, contributing to sleep apnea.
A common treatment for sleep apnea is often to use continuous positive airway pressure (CPAP), a device worn by a person with sleep apnea. There are various kinds of CPAP devices, which involve masks worn to keep air pushing through the blocked airway passages. The positive pressure stops the tissues of the upper airway from collapsing on themselves so you breathe and sleep better at night. The problem with CPAP devices is that they can be uncomfortable to wear and many people stop wearing them after a brief period of time.
Some dental devices can be fitted in your mouth in order to make it easier for air to pass through the airway passages. In serious cases of sleep apnea not corrected by CPAP, surgery can be performed. There are various types of surgery recommended which include surgery to correct a deviated nasal septum, and surgeries which remove the uvula and the thick tissues in the soft palate and throat so air can pass more easily. Some people have surgery which pushes the lower jaw muscles forward so there is more room for air to pass.