Sleep Apnea: What Are the Causes, Symptoms, and Treatment?
Sleep apnea is a very common but serious sleeping disorder, wherein your breathing gets briefly interrupted while you sleep. Breathing might stop or become very shallow with pauses while you are sleeping. It can last from a few seconds to several minutes and usually recurs through the night. Since it often disturbs a person's sleep, he or she might experience fatigue and tiredness during the day. It can also lead to a lack of concentration and even makes you fall asleep. Being sleep deprived for a long time can result in many problems such as slow reflexes, increased risk of accidents, and depression.
What are the types of sleep apnea?
There are two types of sleep apnea. While these types share similar symptoms, the risk factors associated with them, their treatments, and causes vary significantly. These types of sleep apnea are:
- Obstructive sleep apnea (OSA) - is the most common type of sleep apnea, which accounts for as much as 80 percent of sleep apnea cases. It occurs due to a blockage in the air passage. The blockage is a result of the muscles in the throat relaxing, which causes the narrowing of the airway and even closing the passage. This blockage causes disrupted sleep and awakening. It can be easily treated by the use of a continuous positive airway pressure therapy (CPAP) machine, which helps the patient to breathe normally by blowing pressurized air down the air passage.
- Central sleep apnea (CSA) - is a much rarer disease. It accounts for about 20 percent of diagnosed sleep apnea cases. It occurs due to the failure of the brain to send a signal to the body to breathe or due to the instability of the respiratory control center. Central sleep apnea can often be associated with other serious disorders such as kidney failure or heart failure. It can be treated by using a non-invasive ventilator called the adaptive servo-ventilation (ASV) machine.
What are the risk factors for sleep apnea?
Sleep apnea can affect anyone at any stage of life including children. However, there are certain factors that might increase an individual's risk of developing the disease more than others. The risk factors include:
- Being obese - Obesity can cause a lot of health problems for a person, sleep apnea being one of them. The fat deposits around the upper airway tend to obstruct the smooth passage of air.
- Narrow airways - The enlargement of tonsils or adenoids can close the airway. Sometimes, a person can naturally inherit a narrow air passage. Having a narrow airway can lead to sleep apnea by obstructing one's breathing process.
- Nasal congestion - There is twice as much possibility of a person developing obstructive sleep apnea who chronically suffers from a nasal congestion. Since nasal congestion blocks the air passage, it hinders a person's breathing, leading to a disrupted sleep and partial awakening.
- Being male - Men are twice as likely to develop sleep apnea compared to women.
Other factors that increase the risk of developing this sleeping disorder include:
- a family history of sleep apnea
- high blood pressure
- age over 40
- a large neck size (17 inches or greater in men and 16 inches or greater in women)
- gastroesophageal reflux disease (GERD)
- nasal obstruction
What causes sleep apnea?
Obstructive sleep apnea occurs when the muscles in the back of your throat relax more than normal, obstructing the path of air to go down the air passage. This obstructed breathing leads to a buildup of carbon dioxide in the body and a reduction in blood oxygen levels. This impaired breathing causes sleep disturbances by waking you up to let the air passage become normal again. Central sleep apnea can occur due to some causes that disturb the brainstem functions. It can occur due to a congestive heart failure or stroke, severe obesity, consumption of certain drugs, or when you are exposed to high altitudes, making your breathing irregular. A complex sleep apnea occurs when a person develops a combination of the obstructive and central sleep apnea.
Sleep Apnea Symptoms
The most common symptom of sleep apnea is snoring. However, it does not necessarily mean that when people snore, they already have the sleeping disorder. When snoring is followed by breathing pauses and gasping sounds, it can be a sign of sleep apnea. Below is a list of the symptoms that may be helpful in diagnosing the disorder:
- loud snoring (mostly in obstructive sleep apnea)
- pauses in breathing
- morning headaches
- excessive sleepiness at daytime or fatigue
- mood changes and decreased sexual desire
- lack of focus
- abrupt awakening followed by a shortness of the breath (indicating CSA)
Sleep Apnea Treatment
Your doctor will go through your symptoms, which often involve overnight monitoring to check for breathing patterns and other body functions while you are sleeping. Nocturnal polysomnography is a test for the diagnosis of sleep apnea, where the doctor monitors a person's heart, lung, brain activities, blood oxygen levels, breathing patterns, as well as arm and leg movements.
Your doctor may also provide you with simple tests, which you can bring home to diagnose the problem. These tests usually involve measuring your heart rate, blood oxygen level, and breathing patterns. In case any abnormality is seen in the results, your doctor shall carry on with the treatment process.
The therapies for treating sleep apnea include:
- Continuous positive airway pressure (CPAP) - A moderate obstructive sleep apnea can be treated with the help of a mask placed on your nose, which helps in keeping the air passage open and prevents snoring and apnea. Although CPAP is the most common way of treating moderate levels of the disorder, you might also try the expiratory positive airway pressure (EPAP) and other airway pressure devices including bilevel positive airway pressure (BiPAP) and auto-CPAP.
- Surgery - When the use of the device is not working well, surgery can be done to enlarge the airway through the nose or throat. The surgical options include the removal of tissues from the top of the throat and rear of the mouth. The aim here is to remove the structures that lead to vibration along the air passage, causing the obstruction of breathing. Other surgeries include the repositioning of jaw forward from the remainder of the facial bones.
- Supplemental oxygen - People suffering from central sleep apnea can be treated by delivering supplemental oxygen to their lungs, which will help them breathe.