Sleep apnea is an annoying respiratory disorder that occurs during sleep. It casts a shadow over the quality of sleep and mood during the day. Sometimes it is mild, other times it intensifies over time, posing a health risk. Regardless of the severity and cause, sleep apnea should not be underestimated. Since sleep apnea sufferers repeatedly experience shallow or temporary respiratory arrest during sleep, the condition can cause severe hypoxia if left untreated. In most cases, the cause of sleep apnea is anatomical changes in the upper respiratory tract. What else is worth knowing about sleep apnea? How to protect yourself from exacerbation of the condition and how to reduce symptoms?
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What is sleep apnea?
Sleep apneasyndrome (OSA – obstructive sleep apnea) is a condition whose main symptom is breathing disorders during sleep, which translates into hypoxia of organs and tissues, resulting in disruption of the functioning of the entire system. The main symptom indicative of apnea is snoring, which goes hand in hand with restless sleep.
During sleep, a person suffering from sleep apnea experiences numerous episodes of temporary stoppage of breathing or restriction of airflow (breathing becomes very shallow for a few moments, and as a result, the patient inhales far too little air into the lungs than he needs). Although the pauses in breathing are not long, usually lasting about 10 seconds, they are nevertheless a health risk.
As a result of stopping breathing, people struggling with sleep apnea experience a drop in saturation, which means that the oxygen content of the rainbow bloodoxygen content is reduced (with such respiratory arrests, a 2-4% reduction in saturation is observed compared to the saturation during wakefulness). As a result of inadequate oxygenation of the blood, the work of the heart and cardiovascular system deteriorates, and brain performance also decreases. The quality of sleep decreases, and the regeneration processes of cells and tissues do not proceed efficiently enough. The entire body begins to function less well both during sleep and during the day, during normal activity.
To make matters worse, sleep apnea and the oxygen deficiency in the body that occurs as a result of it can also be the cause of dangerous complications such as heart attack, stroke, hypertension and diabetes, so this problem should not be taken lightly by us.
What are the types of sleep apnea?
There are 2 main types of sleep apnea:
- Obstructive sleep apnea (peripheral sleep apnea) – the most common type of sleep apnea, accounting for more than 90% of all cases. The cause of the problem is reduced tension in the muscles of the throat and tongue, which affects the partial closure of the lumen of the respiratory system at the level of the throat and interferes with the free flow of air. This in turn translates into temporary respiratory arrest or shallow breathing. The upper airway can also be obstructed due to a crooked nasal septum or anatomical defects.
- Central sleep apnea – is a disorder of the central nervous system (resulting, for example, from brain tumors). It involves a decrease in the activity of the respiratory center, resulting in a stoppage of respiratory movements of the chest and inhibition of airflow.
There is also the so-called mixed sleep apnea, which is a fusion of the two main types of apnea. In this case, the ailment is caused by both a disruption of the breathing center in the brain and a relaxation of the muscles of the soft palate.
Sleep apnea – causes
Obstructive sleep apnea often affects people who are overweight or obese, especially when excessive amounts of fat tissue are located in the neck area (fat tissue exerts pressure on the walls of the throat, so that its capacity is reduced and air cannot flow freely).
Male gender and obesity are considered the biggest risk factors for obstructive sleep apnea. Factors that increase the risk of this ailment are also smoking and excessive alcohol consumption. If overweight and stimulants are the main cause of apnea, and its symptoms are mild, in many cases it is enough to reduce weight and change lifestyle to get rid of the ailment. However, in more severe forms of sleep apnea, and even more so when sleep apnea coexists with other conditions (such as chronic obstructive pulmonary disease or diabetes), it is important to be under the constant care of a doctor.
In people struggling with obstructive sleep apnea, the respiratory muscles are too relaxed and flaccid, making the airway less passable and disrupting the process of oxygenating the blood and the entire body.
The most common causes of sleep apnea and factors that increase the risk of the disease are:
- overweight and obesity,
- alcohol abuse,
- smoking cigarettes,
- eating too much food before bedtime,
- weakening of the throat muscles,
- curvature of the nasal septum,
- chronic rhinitis,
- overgrowth of tissue after infections,
- polyps in the nose,
- hypertrophy of the palatal tonsils,
- taking sleeping and sedative medications,
- certain chronic diseases (e.g., hypertension, hypothyroidism, acromegaly, circulatory insufficiency),
- specific anatomical structure that promotes airway obstruction (e.g., thick and short neck, receded mandible, too small mandible, too long uvula).
Sleep apnea in children
The widest group struggling with sleep apnea are men over 40 years of age. In women, the condition occurs much less frequently, and if it does, it occurs after the age of 50. In young people and children, sleep apnea is rare. The occurrence of sleep apnea in children can be caused by obesity or enlargement of the pharyngeal or palatine tonsils. The cause can also be a congenital defect, as part of which there was a deformation of the facial skull (such as Down syndrome).
Sleep apnea – diagnosis
An ailment associated with sleep apnea is snoring. Virtually every person who suffers from sleep apnea snores during sleep. But not every person who snores suffers from sleep apnea. For a doctor to make a diagnosis of apnea, he or she must do special tests to see how episodes of respiratory arrest are distributed and how the patient’s body behaves during sleep (e.g. brain function, heart rate, eye movements).
Not in every case of occurrence of breathing pauses during sleep can one speak of obstructive sleep apnea. The condition can be diagnosed only when:
- apneic episodes occur more than 5 times during each hour of sleep in symptomatic individuals and more than 15 times in asymptomatic individuals,
- apnea episodes last longer than 10 seconds.
The occurrence of up to 5 apneic episodes per hour of sleep is within normal limits.
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Sleep apnea – symptoms
Symptoms of sleep apnea can be divided into two groups: symptoms at night (we are not able to observe them, most often we are informed about them by our partner or partner) and daytime symptoms.
Since sleep breathing disorders translate into disruption of the body’s recovery processes and deterioration of the work of many organs, the symptoms of the condition are many. Some symptoms accompanying apnea can be mistaken for symptoms of other ailments. Certainly, loud snoring, pauses in breathing, morning headaches and waking up unrested going hand in hand with falling asleep during the day should alert us.
How does sleep apnea most often manifest itself?
Symptoms at night:
- restless sleep,
- fidgeting during sleep,
- loud snoring,
- intermittent, irregular snoring,
- stopping snoring for several seconds ending with a loud grunt and intense intake of air,
- sudden awakenings with a feeling of shortness of breath,
- increased sweating during sleep,
- frequent getting out of bed to urinate.
Daytime symptoms:
- morning headache,
- frequent feeling of fatigue,
- weakness,
- abnormal heart rhythm,
- fatigue and excessive daytime sleepiness,
- irritability, worsening of mood,
- problems with concentration,
- memory disorders,
- distraction, impaired psychomotor performance,
- depressive disorders,
- decreased libido.
Sleep apnea – testing
There are 2 tests used in the diagnosis of sleep apnea – polysomnography and polygraphy. Although the first variant is more accurate, in-depth and extensive, also the second one in most cases allows to diagnose the disease and select an adequate method of treatment. What’s more, the second variant can be performed at the patient’s home, while the first one cannot.
What does a sleep apnea study look like?
Polysomnography is a detailed examination, during which the work of the body during the patient’s sleep is monitored. As part of polysomnography, the following is performed:
- a study of heart function, or electrocardiography (EKG),
- examination of brain function, or electroencephalography (EEG),
- the study of eye movements, or electrooculography (EOG),
- examination of muscle and nerve function, or electromyography (EMG),
- airflow through the nose and mouth,
- snoring,
- blood oxygen content,
- the course of sleep,
- respiratory effort.
Polysomnography is a very similar test to polysomnography, but it does not include EEG, EOG and muscle work testing.
How much does a sleep apnea test cost?
The cost of polysomnography is unfortunately high (about $500). Moreover, this test is relatively difficult to access. In contrast, a polygraph is a cheaper, easier and more accessible test.
Sleep apnea – treatment
Obstructive sleep apnea is a condition that poses a risk of many serious complications, especially from the cardiovascular system (e.g. hypertension, heart failure, stroke). Treatment of sleep apnea will help us avoid the dangerous health consequences of this disease, contribute to the overall improvement of health (among other things. will improve airway patency, increase tissue oxygenation, normalize blood pressure, improve brain function), as well as positively affect the quality of our sleep.
The most effective method of treating sleep apnea is to produce constant positive pressure during sleep. This is done by a special CPAP device consisting of an air pump and a mask to improve breathing. Adjustable airflow ensures optimal oxygenation of the body.
Sleep apnea sufferers are also generally advised by their doctor to reduce weight (if overweight), avoid taking sleeping pills and consuming alcohol before bed, lead a healthy lifestyle and follow a diet.
If you suffer from a crooked nasal septum, you should undergo a simple ENT procedure to straighten it.
Sleep apnea – the consequences of not treating it
Although snoring and apnea often seem like trivial ailments to us, they actually pose a major health risk. The consequences of not treating sleep apnea include:
- increased blood pressure,
- increased risk of strokes and heart attacks,
- increased risk of type 2 diabetes,
- increased risk of heart disease (such as coronary artery disease),
- increased risk of lung disease,
- poorer brain function, impaired psychomotor performance, increased risk of traffic accidents.
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