Sleep Apnea

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People suffering from sleep apnea stop breathing for seconds or minutes at a time during the night. Arrested breathing results in restless sleep, frequent awakenings, headaches, loud snoring, and memory deficiency. Either due to malfunctioning muscles or a misfiring brain, the throat doesn't open in time with expanding lungs, so the blood fails to acquire sufficient oxygen.


Two kinds of sleep apnea work by different means yet create the same effect. In the obstructive variety, your throat shuts when it usually remains open to let air through. At first, shallow or short breaths still squeeze through, but then the throat shrinks completely closed. Your body senses that your throat, tongue, or uvula must be preventing breaths. When oxygen isn't getting absorbed, your brain sends an emergency signal for you to wake up so you can clear the air passage.


The brain is the culprit in the second sort of sleep apnea -- central sleep apnea. The brain stops reliably regulating your automatic muscle movements, such as lung expansion and heartbeat, which occur even when other muscles are paralyzed during deep sleep. Neurons don't properly carry messages to trigger the "breath" directive in the throat and lungs so you stop breathing regularly.


From the Greek, "apnea," meaning, "needing breath," this condition is alarmingly common. Sleep apnea especially affects those who are over 50 years of age, male, and overweight. Chronically under-treated, sleep apnea often goes undiagnosed. People assume they aren't getting the best night's sleep, not realizing that they aren't breathing enough.


Sleep apnea makes you tired and irritable where you have trouble remembering or concentrating. Someone who sleeps near you can tell you if they hear coughing or snoring. Since sleep apnea can eventually lead to high blood pressure and increased risk of stroke, we should all confirm that we are getting enough oxygen during the night.


Sleep apnea signs and symptoms

It can be tough to identify sleep apnea on your own, since the most prominent symptoms only occur when you’re asleep. But you can get around this difficulty by asking your spouse to observe your sleep habits or recording yourself during sleep.



Other common signs and symptoms of sleep apnea include:



Signs and symptoms of sleep apnea in children

While obstructive sleep apnea can be common in children, it’s not always easy to recognize. In addition to continuous loud snoring, children with sleep apnea may adopt strange sleeping positions and suffer from bedwetting, excessive perspiration at night, or night terrors. Children with sleep apnea may also exhibit changes in their daytime behavior, such as:



If you suspect your child may have sleep apnea, consult a pediatrician who specializes in sleep disorders. Once obstructive sleep apnea is diagnosed, surgery to remove the child’s tonsils or adenoids usually corrects the problem.


See a doctor immediately if you suspect sleep apnea

Sleep apnea can be a potentially serious disorder, so if you spot the warning signs, see a doctor right away. An official diagnosis of sleep apnea may require seeing a sleep specialist and a home-based sleep test using a portable monitor or an overnight stay at a sleep clinic.


Sleep Apnea test

Your answers to this quiz will help you decide whether you may suffer from sleep apnea:



If you have one or more of these symptoms you are at higher risk for having obstructive sleep apnea. Source: American Sleep Apnea Association


How to Stop Snoring

Even if you don’t have sleep apnea, a snoring problem can get in the way of your spouse's rest and affect your own sleep quality and health. The good news? There are plenty of tips and treatments that can help. If you’re still unsure whether your snoring is normal or something more serious, the following strategies can help you decipher the symptoms:




Treatments and Cures

For milder cases of sleep apnea, your doctor may recommend lifestyle changes, such as losing weight or quitting smoking. If these measures don't improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments are available. Certain devices can help open up a blocked airway. In other cases, surgery may be necessary.


Treatments for obstructive sleep apnea may include:


Therapies

Continuous positive airway pressure (CPAP)

If you have moderate to severe sleep apnea, you may benefit from a machine that delivers air pressure through a mask placed over your nose while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air, and is just enough to keep your upper airway passages open, preventing apnea and snoring.


Although CPAP is a preferred method of treating sleep apnea, some people find it cumbersome or uncomfortable. With some practice, most people learn to adjust the tension of the straps to obtain a comfortable and secure fit. You may need to try more than one type of mask to find one that's comfortable. Some people benefit from also using a humidifier along with their CPAP system.


Don't just stop using the CPAP machine if you experience problems. Check with your doctor to see what modifications can be made to make you more comfortable. Additionally, contact your doctor if you are still snoring despite treatment or begin snoring again. If your weight changes, the pressure settings may need to be adjusted.


Adjustable airway pressure devices

If CPAP continues to be a problem for you, you may be able to use a different type of airway pressure device that automatically adjusts the pressure while you're sleeping. For example, units that supply bilevel positive airway pressure (BPAP) are available. These provide more pressure when you inhale and less when you exhale.


Oral appliances

Another option is wearing an oral appliance designed to keep your throat open. CPAP is more effective than oral appliances, but oral appliances may be easier for you to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.


A number of devices are available from your dentist. You may need to try different devices before finding one that works for you. Once you find the right fit, you'll still need to follow up with your dentist at least every six months during the first year and then at least once a year after that to ensure that the fit is still good and to reassess your signs and symptoms.


Surgery

The goal of surgery for sleep apnea is to remove excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea. Surgical options may include:


Uvulopalatopharyngoplasty (UPPP)

During this procedure, your doctor removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well. This type of surgery may be successful in stopping throat structures from vibrating and causing snoring. However, it may be less successful in treating sleep apnea because tissue farther down your throat may still block your air passage. UPPP usually is performed in a hospital and requires a general anesthetic.


Maxillomandibular advancement

In this procedure, your jaw is moved forward from the remainder of your face bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely. This procedure may require the cooperation of an oral surgeon and an orthodontist, and at times may be combined with another procedure to improve the likelihood of success.


Tracheostomy

You may need this form of surgery if other treatments have failed and you have severe, life-threatening sleep apnea. In this procedure, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe. You keep the opening covered during the day. But at night you uncover it to allow air to pass in and out of your lungs, bypassing the blocked air passage in your throat.


Removing tissues in the back of your throat with a laser (laser-assisted uvulopalatoplasty) or with radiofrequency energy (radiofrequency ablation) are procedures that doctors sometimes use to treat snoring. Although sometimes these procedures are combined with others, they aren't usually recommended as sole treatments for obstructive sleep apnea.


Other types of surgery may help reduce snoring and contribute to the treatment of sleep apnea by clearing or enlarging air passages:



Treatments for central and complex sleep apnea may include:


Therapies

Treatment for associated medical problems

Possible causes of central sleep apnea include heart or neuromuscular disorders, and treating those conditions may help. For example, optimizing therapy for heart failure may eliminate central sleep apnea.


Supplemental oxygen

Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs.


Continuous positive airway pressure (CPAP).

This method, also used in obstructive sleep apnea, involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway to keep it from collapsing. CPAP may eliminate snoring and prevent sleep apnea. As with obstructive sleep apnea, it's important that you use the device as directed. If your mask is uncomfortable or the pressure feels too strong, talk with your doctor so that adjustments can be made.


Bilevel positive airway pressure (BPAP)

Unlike CPAP, which supplies steady, constant pressure to your upper airway as you breathe in and out, BPAP builds to a higher pressure when you inhale and decreases to a lower pressure when you exhale. The goal of this treatment is to assist the weak breathing pattern of central sleep apnea. Some BPAP devices can be set to automatically deliver a breath if the device detects you haven't taken one after so many seconds.


Adaptive servo-ventilation (ASV)

This more recently approved airflow device learns your normal breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to normalize your breathing pattern and prevent pauses in your breathing. ASV appears to be more successful than CPAP at treating central sleep apnea in some people.


Natural cures for sleep apnea

Here are some other natural treatments that could work if you have only a mild case of sleep apnea.