Sleep Disorders: Sleep Apnea

Often mis-perceived as a condition limited to the overweight, sleep apnea actually affects men and women of all ages and body types. Suffers of sleep apnea are troubled by disturbed sleep brought on by irregular breathing while they are at rest. This causes them to wake up many times a night (as often as twenty to thirty times every hour). These constant disturbances prevent the body from cycling through the necessary stages of sleep that provide them with the rest they need. This leads to a sense of chronic sleepiness, which in turn can impair judgment, hand-eye coordination, concentration, and can contribute to depression.

In more serious cases, sleep apnea can increase blood pressure and strain the cardiovascular system. About half of people diagnosed with sleep apnea have heart conditions. If there's an underlying heart condition, repeated apnea episodes can trigger potentially lethal cardiac events.

There are two forms of sleep apnea:

Obstructive sleep apnea occurs when the muscles in the back of the throat relax. In regular breathing, as you inhale the throat passage narrows. During inhalation, relaxed muscles in the throat can cause the airway to close entirely, preventing air intake. This in turn lowers oxygen levels in the blood, which triggers a response in the brain to awaken the body to restore breathing. These awakenings are often so brief as not to be noticed by the sufferer who may awaken believing they slept peacefully, despite feeling tired in the morning.

Central sleep apnea is far less common than the obstructive variety. Central sleep apnea occurs when the brain does not send the proper signals that control breathing. This often leads to awakening at night with either a shortness of breath or a headache. People with central sleep apnea are far more likely to recall waking up in the middle of the night.

Risk Factors Associated with Sleep Apnea

There are certain factors that increase your risk of suffering from sleep apnea. For obstructive sleep apnea these include:

  • Being overweight
  • A neck over seventeen inches in circumference.
  • Being male
  • Being over age 65
  • Having a family history of sleep apnea
  • Smoking
  • Use of alcohol, sedatives and tranquilizers

Central sleep apnea has its own set of characteristic risk factors. They are:

  • Being male
  • Heart Disorders - Atrial fibrillation and congestive heart failure are conditions that increase the risk of central sleep apnea.
  • Stroke or Brain Tumor - these can impair the brain's ability to send proper signals to regulate breathing during sleep.
  • Neuromuscular disorders - conditions like Amyotrophic Lateral Sclerosis, spinal cord injuries and Muscular Dystrophy can impair the central nervous system and breathing function.

Diagnosis

Physicians will use a number of methods to diagnose sleep disorders based on your signs and symptoms. These include Nocturnal Polysomnography, which tests your heart rate, leg movement, lung and brain activity, and blood oxygen levels while you are asleep, and Oximetry, which measures oxygen levels in the blood while you sleep. If you have sleep apnea, the doctor will see a dip in oxygen levels during apneas and a rise when you awaken.

If your doctor suspects that you have sleep apnea, he or she will likely recommend you visit a nose and throat doctor to rule out blockages, and a cardiologist or neurologist to look for signs of central sleep apnea.

Treatment

Treatments for obstructive sleep apnea vary. Among the most common is Continuous Positive Airway Pressure (CPAP), in which air is delivered via a mask worn over the nose and mouth during sleep. If a CPAP machine proves uncomfortable to sleeping, some oral devices can be used to help keep the throat open during sleep. There are several surgical procedures aimed at removing excess tissue from the upper airway.

Options for treating central sleep apnea are more limited. Treatment usually consists of a CPAP machine or other oxygen delivery devices while sleeping.

In addition to medical treatment, if you suffer from sleep apnea you can take measures to manage the condition by losing excess weight, avoiding alcohol and nicotine, testing out different sleep positions to see which ones allow you to breathe normally, and keeping your nasal passage open at night using saline solutions (do not use decongestants or antihistamines without first consulting your doctor as these are generally for short-term use only).

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