Sleep Apnea :
WHAT YOU NEED TO KNOW
We hear a lot about obstructive sleep apnea ( OSA ) from both local and national news sources . Some 20 million people suffer with OSA and only 10 % are diagnosed . More than 50 % of those over 64 have a sleep problem . What is OSA , the causes , effects and how is it treated ? I will try to answer these questions so if you or a loved one are aware of the symptoms you can take action .
There are two types of sleep apnea : central and obstructive . Central is less common , occurs when the brain fails to send the appropriate signal to the breathing muscles to initiate respirations . Obstructive is more common and occurs when air cannot flow into or out of the person ’ s nose or mouth although efforts to breathe continue . In a given night , the number of involuntary breathing pauses or “ apnea events ” may be as high as 20 to 30 or more an hour . These pauses are usually accompanied by snoring between apnea events , although not everyone who snores has this condition .
During these “ events ” the person in unable to breathe in oxygen and to exhale carbon dioxide , resulting in low levels of oxygen and increased levels of CO2 . The brain senses this imbalance and triggers the upper airway muscles to open ; usually a loud snort or gasp will occur . These arousals restart breathing but prevent the patient from getting deep restorative sleep ( Stage 4 or REM ).
Contributing risk factors for sleep disorders including being overweight , race , gender , smoking , alcohol consumption , high blood pressure , under-active thyroid or some physical abnormality in the nose , throat or upper airway . Sleep apnea seems to run in some families , possible genetic basis .
SIGNS AND SYMPTOMS OF SLEEP APNEA Loud disruptive snoring cessation of breathing during sleep , waking up gasping , morning headaches , grogginess , dry mouth , frequent nighttime urination , moodiness and irritability . This pretty much is how I feel after staying out late and my grandkids wake me up early .
Left untreated OSA can lead to serious health conditions , including physical , emotional consequences and an increase in accidents . The effects are excessive daytime sleepiness , poor concentration , irritability , possible depression , memory difficulties and increase stroke or heart attack risk . Long term is the strain untreated OSA places on the body along with the “ link ” to other medical conditions ; CHF , nocturnal arrhythmias , Type II diabetes , hypertension and stroke .
As one who has OSA , I understand the ways that I coped to deal with my being sleepy during the day , not realizing how tired I was in the morning . It was my wife and my involvement with various respiratory manufacturers that led me to visit my doctor . I had a complete physical , answered several questions and was referred to a sleep physician specialist . I along with my wife completed a detailed questionnaire and after another meeting , it was agreed that I should have an overnight sleep study . This is a painless overnight exam that monitors one ’ s sleep ; electrodes and sensors record all brain activity , eye movements and breathing functions . This will help determine the type and frequency of the sleep disorder that may be occurring nightly .
HOW IS SLEEP APNEA TREATED ? In cases of mild sleep apnea , certain lifestyle changes can sometimes achieve positive results . Exercise and proper sleep habits , oral appliances , avoiding alcohol and sleeping pills ( make throat muscles relax ) or sleep on your side . The most common and successful method is through continuous positive airway pressure ( CPAP ) device . In this procedure , a mask is worn at night over the nose or mouth and the air pressure will keep the airway open while you ’ re asleep . The pressure setting is based on the sleep study . From experience , the mask fitting is crucial to achieving success and compliance . The goal of the provider is to work with the patient to determine the best interface that will allow the patient and their bedmate to sleep comfortably . Once this is determined , follow up , encouragement and support is needed from the health team and spouse to stay compliant with the treatment .
48 • MAY / JUNE 2021