Sleep Apnea: Everything You Need to Know

What is Sleep Apnea?

Sleep apnea is a prevalent condition observed while a person is asleep, in which breathing repeatedly starts and stops involuntarily. The time period during which breathing stops is referred to as an apneic episode.

Sleep apnea can be categorized into two main types:

1. Obstructive Sleep Apnea

2. Central Sleep Apnea

What Causes Sleep Apnea?

Obstructive Sleep Apnea (OSA) is a characteristic chronic condition that requires continuous monitoring of symptoms and a proper treatment plan.

In normal conditions, the passageway of airflow is from mouth and nose to trachea and eventually to lungs. However, in patients suffering from OSA, the airway becomes too narrow. To compensate for the less air entering the lungs, the diaphragm and chest exert a lot of pressure to open the airway repeatedly.

Hence, air tries to rush itself through the minimal airway space available. This creates the snoring sound, which is one of the main identifying symptoms of sleep apnea. 

Central Sleep Apnea (CSA) is a relatively less common and an acute condition, in which no airway blockage occurs. Instead, there is a lack of signals received by the respiratory system for breathing.

What are the Signs and Symptoms of Sleep Apnea?

As there is a blockage of the airway, less oxygen enters the lungs, which results in inadequate oxygen content being supplied to the body. This creates a lot of physiological and mental disturbances in the body.

Common symptoms include:

1. Feeling of lethargy and sleepiness during daytime (hypersomnia)

2. Difficulty falling asleep (insomnia)

3. Awakening multiple times at night with a feeling of being choked

4. Dry mouth at night

5. Forgetfulness

6. Behavioural issues leading to depression and anxiety

7. Long-term headaches

8. Sexual dysfunction

9. Swelling in the lower legs (edema)

What are the Risk Factors Associated with Sleep Apnea?

Risk factors that aggravate the chances of developing this chronic condition include:

1. Obesity: Fat deposition in the immediate vicinity of the upper airway causes blockage.

2. Neck size: People with thicker necks often have a resulting narrowed airway.

3. Tonsils and adenoids: These conditions, especially in children, also cause the enlargement and tapering of airways.

4. Retrognathia: This is when your upper jaw is larger than your lower jaw.

5. Gender: Being male increases the risk of developing sleep apnea. Women, however, are likely to suffer after menopause.

6. Age: Older people are at a greater risk.

7. Use of intoxicants: Usage of alcohol or sedatives relaxes the throat muscles which results in more frequent blockage.

8. Smoking: Smokers are at a greater risk as compared to non-smokers. This is because smoking increases the inflammation of the airways.

9. Nasal breathing issues: People suffering from allergies or other issues which don’t allow them to breathe properly via the nose are at a higher risk of suffering from OSA.

10. Other ongoing medical conditions: asthma, hypertension, diabetes mellitus type 2, chronic lung disorders, Parkinson’s disease, and other hormonal disorders may also maximise the risk of developing sleep apnea.

Complications Resulting from Sleep Apnea:

While many people may not give this condition its due attention, it potentially increases the risk of a lot of other underlying health issues.

1. Low blood oxygen: The blockage of the airway leads to less oxygen in the blood (hypoxia). This leads to a sudden irregular heartbeat.

2. Cardiovascular problems: Inadequate oxygen saturation in the body resulting from sleep apnea leads to pulmonary hypertension, which further puts a strain on cardiac health, such as coronary artery disease, stroke, and arrhythmias.

3. Type 2 Diabetes Mellitus: There is sufficient evidence suggesting the risk of developing insulin sensitivity and Type 2 diabetes in patients suffering from sleep apnea.

4. Liver disorder: Laboratory tests of patients suffering from sleep apnea show signs of scarring.

5. Post-surgery issues: As patients with sleep apnea are susceptible to breathing problems, it eventually poses a risk after major surgery, especially after sedation.

Diagnosis of Sleep Apnea:

Your doctor will likely ask your sleeping partner about immediate symptoms such as snoring.

Your doctor might put you under overnight evaluation for an accurate diagnosis by carrying out nocturnal polysomnography.

This will carry out EEG, EOM, EMG, EKG, ECG, and pulse oximetry tests. These tests will measure your brain activity, eye movement, muscle activity, heart rate, and oxygen saturation level, respectively.

Treatment to Expect:

Once you are diagnosed with sleep apnea, the first thing is not to worry. It is not a life-threatening disease and a proper medication plan will help you feel at ease.

Almost all treatment plans will be focused on minimising the obstruction of your airways. Some effective treatment plans include:

1. Weight loss. These provide a solid relief from mild sleep apnea.

2. Nasal decongestants. Mild sleep apnea is very effectively managed.

3. Therapies like CPAP and BiPAP. Continuous Positive Airway Pressure (CPAP) aims to provide a constant but greater pressure than the surroundings to keep the opening of the airways. In therapy like Bilevel Positive Airway Pressure (BiPAP), a varied amount of pressure is supplied during inhaling and exhaling.

4. Positional Therapy. Sleeping on the back can deteriorate the symptoms of sleep apnea more. Hence, patients are asked to sleep in other relative positions.

5. Surgery. Procedures like uvulopalatopharyngoplasty (UPPP) and Tracheostomy are used as last pickings by a doctor.

A proper treatment plan with certain lifestyle changes such as avoiding alcohol, no intake of pills, and regular exercise can help you manage your sleep apnea symptoms.

Maybe relaxing your mind, such as reading your favorite book, or a 20-minute meditation, will help you put in deep sleep.