Apnea comes from the Greek word ‘without breath’. Sufferers of sleep apnea stop breathing during their sleep. This can happen repeatedly during the night and may last for a minute or longer.
Obstructive sleep apnea (OSA) is a sleep related breathing disorder (SBD). Breathing stops as the upper airway collapses preventing air from reaching the lungs. This usually happens during the lighter REM sleep. Sometimes there is only a partial collapse and this is known as hypopneas. These interruptions to normal breathing disrupt sleep causing fragmentation of REM sleep and a shortening of the deeper stages.
The cause of sleep apnea is unclear and it affects more men than women. During the day the airway is kept open by muscles but during the night these muscles relax causing the airway to collapse. When the brain becomes aware that breathing has stopped messages are sent to awake the sleeper and breathing resumes. The sleeper may not be aware of the interruption but sleep has been disrupted, interfering with REM sleep and shortening the deeper stages. As this may happen up to a hundred times a night, the suffer is unlikely to have sufficient sleep to fulfil their sleep needs
Risk of Being Overweight
Sleep apnea is mainly associated with being overweight, aging and having a thick set neck, with a collar size over 17 inches. Fat on the sides of the upper airway can narrow the airway, causing closure when the supporting muscles relax. Age may also cause muscle loss and an accumulation of fat around the airway, allowing a partial or complete collapse. Male hormones also contribute to changes in the structure of the region.
A receding chin, enlarged tonsils and adenoids – especially in children – may also cause sleep apnea. There may also be a family history of the problem, but this may be due to inherited facial characteristics rather than genetics.
Smoking and Alcohol
Smoking can cause inflammation and narrowing of the airway causing or escalating the problem. Alcohol causes the muscles to relax allowing the airway to collapse. Both should be avoided.
There are also a number of neuromuscular disorders, and conditions such as Downs Syndrome, that relate to the condition. Nasal congestion may also restrict or close the airway.
Symptoms and Diagnosis
Most sufferers notice waking during the night, although they may not be aware that they have stopped breathing. They may be aware of trying to catch their breath or that they have difficulty getting back to sleep. Headaches, a dry mouth and the feeling that sleep has been unsatisfactory may alert the sleeper to the problem.
Partners are likely to be affected by the symptoms, although they also may not be aware of the seriousness of the condition.
Sufferers are likely to suffer from daytime drowsiness. They may even find it hard to stay awake and often report difficulty in concentrating and irritability. This puts sufferers of sleep apnea at risk at work and at home. There are also long term risks to health, with an increased risk of cardiovascular disease.
The health risks associated with sleep apnea means that sufferers should seek professional help. Diagnosis includes looking at respiration and blood-oxygen levels. Doctors may refer sufferers to a sleep laboratory for assessment.
Self Help for Sleep Apnea
There are a number of ways of treating sleep apnea. These include:
- Losing weight
- Avoiding alcohol and smoking
- Adapting sleeping position
Sleep apnea affects sufferers and their families. Daytime drowsiness, and health and safety risks, means that anyone who suspects they have the condition should visit their doctor for diagnosis. There are a number of actions that sufferers can take to help the condition, and medical aids that will ensure improved breathing during the night.
These include prosthetic dental appliances that are worn in the mouth overnight which can help breathing. Surgery may also be prescribed in severe cases.
Continuous Positive Airway Pressure
Continuous positive airway pressure (CPAP) is used in many cases to keep the airway open and maintain breathing. This involves using a mask which is fitted to the face and worn during sleep. The pump delivers a continuous supply of oxygen under pressure, which keeps the airway open and prevents the upper airway from collapsing.
CPAP is effective in maintaining breathing during the night allowing the sufferer to stay asleep. The daytime symptoms such as daytime sleepiness and loss of concentration usually disappear. CPAP is a long term treatment and not particularly attractive for the user or their partner, but sleep apnea is a serious condition and the daytime affects outweigh the disadvantages of the treatment.
Suffers may benefit from learning breathing techniques and should take naps during the day if they are suffering from fatigue. Learning relaxation techniques will help with any feelings of anxiety. Adopting healthy habits such as a nutritious diet and avoiding alcohol will help with weight loss which is a major contributor to sleep apnea.