Sleep Apnea

Snoring may not be considered a serious matter in American society. It is most often used as a comedic tool to stir up laughs in movies, but snoring can be a sign of a very dangerous sleep disorder.

Sleep apnea is a sleep disorder that may be fatal to sufferers, and heavy snoring is the most obvious symptom of the condition. Sleep apnea is characterized by a pause or stop in breathing, which can happen hundreds of times a night for up to a minute each time. Sleep apnea can even cause heart attacks or strokes during the night among other mild to severe problems.

The most common type of sleep apnea is Obstructive Sleep Apnea (OSA), in which soft tissue at the back of the throat collapses and obstructs the airway. The lack of oxygen eventually rouses the sleeper, enough to open the airway, but the cycle repeats itself as the sufferer continues into deeper sleep.

The most common symptoms of sleep apnea are:

Loud snoring
Choking or gasping during sleep
Feeling sleepy during the day

Most people who suffer from sleep apnea may not even be aware of any symptoms or signs because they are asleep while all of this is happening. Even though the body has to jerk itself awake to keep breathing during and apnea episode, it is rare that the patient will remember waking.
For this reason, the majority of people who suffer from sleep apnea are undiagnosed, therefore untreated. Untreated sleep apnea has been linked to such problems as fatigue, high blood pressure, stroke and a decline in cognitive functions.

The National Heart, Lung and Blood Institute’s Diseases and Conditions Index state that sleep apnea is more common in men. One out of 25 middle-aged men and 1 out of 50 middle-aged women have sleep apnea that causes them to be very sleepy and/or exhausted during the day. Sleep apnea is also more common in African Americans, Hispanics, and Pacific Islanders. If someone in your family has sleep apnea, you are more likely to develop sleep apnea than someone without a family history of the condition.

Risk factors for developing sleep apnea are numerous and widespread ranging from physical characteristics to lifestyle behaviors. It seems that just about anyone can get Sleep Apnea and the high number of risk factors explains why so many people develop the condition.

Physical Characteristics

Being overweight or obese
Having a large neck –17 inches or greater in men or at least 16 inches in women
Lower part of the face is longer
Brachycephaly (a birth defect in which the head tends to be shorter and wider than average)
A narrow upper jaw
A receding chin
An overbite
A larger tongue
The soft palate and the walls of the throat around it collapse easily
Stiff and/or large soft palate
Large adenoids
Not having tonsils removed

Lifestyle Behaviors

Smoking- heavy smokers (those who smoke more than two packs a day) are 40 times more likely to develop apnea than nonsmokers
Alcohol- Alcohol may help you get to sleep, but disrupts the sleep pattern and can create apnea symptoms

Medical Conditions Related to Sleep Apnea

Diabetes
Sinus problems
Allergies
Gastroesophageal Reflux Disease (GERD)
Polycystic Ovary Syndrome (PCOS)
Chronic Problems in the Upper Airways such as Asthma, Allergies, Respiratory Tract disorders, Chronic Bronchitis

Sleeping Positions

Body position during sleep can affect the number and severity of OSA episodes throughout the night. Twice as many apneas occur when a person lies face downward than when sleeping on his or her side. Gravity is the most likely culprit, which causes the throat to narrow when a person is sleeping on his or her back.

Obesity

Obesity, especially fat in the abdominal region, is a serious risk factor for sleep apnea even in children and adolescents. Doctors and researchers focused on sleep disorders and apnea are unsure of which causes, which, in other words does obesity or sleep apnea, come first? The answer is that no one knows which causes the other but that they have a relationship in which sleep apnea can contribute to obesity and vice versa. Many people with sleep-related breathing disorder, especially women and small children, are not obese. Weight does play a big role as a risk factor for sleep apnea and apnea episodes because extra weight around the neck makes it more difficult for air to pass through the airway.

The Heart and Circulation

Sleep apnea has a negative connection with heart diseases and circulatory disease. Although research is still being performed to find out the exact connection between apnea and these conditions, some findings already prove the theory that the affects are serious.

Obesity, smoking and alcohol abuse are all known risk factors for hypertension and heart disease, but are also associated with sleep apnea. Persons with sleep apnea have a greater risk of heart problems than those without.
When breathing stops during an apnea episode, carbon dioxide levels in the blood increase and the oxygen level drops. This may trigger a cascade of physical and chemical events that can then increase risk for heart conditions.
Apnea causes decreased levels of nitric oxide, which is a potent substance that causes blood vessels to be elastic and expand with ease. Nitric oxide plays a vital role in the control of blood pressure in the body and is part of good heart health.

Other Adverse Affects of Sleep Apnea

Pulmonary hypertension
Kidney failure
Stroke
Heart attack
High blood pressure
Premature death
Restless sleep
Insomnia
Depression
Impotence, sexual dysfunction, reduced libido
Peripheral nerve damage (i.e. tingling, pain of numbness in the hands and feet)
Seizures, epilepsy and other nervous system disorders
Irregular menstrual periods
Eye disorders including glaucoma, conjunctivitis, dry eye and other infections and irritations
Headaches

Children’s Sleep Apnea

Sleep is vital to the growth process, and is especially important for young children who are still developing physically and mentally.

Approximately 3 to 12 percent of children snore, while obstructive sleep apnea syndrome affects 1 to 10 percent of children. The majority of these children have mild symptoms, and many outgrow the condition. Consequences of untreated obstructive sleep apnea in children include failure to thrive, enuresis, attention-deficit disorder, behavior problems, poor academic performance and cardiopulmonary disease.

Treatment

Dependant on whether you have mild or severe sleep apnea, treatments vary. For those with mild sleep apnea, some simple lifestyle changes and smart choices can help suppress the symptoms and even control the condition altogether.

Avoid alcohol, smoking, and medications that make you sleepy; they will make it harder for your throat to stay open while you sleep.
Losing weight if you are overweight and basically maintaining a healthy, active lifestyle is also helpful. Even a little weight loss can improve your symptoms because it can reduce the amount of fat around the throat, making your airway wider. This makes it easier for air to flow into your lungs.
Sleep on your side instead of your back. Sleeping on your side may help keep your throat open. Many snoring patients find sleeping on their side to greatly reduce snoring.

For more severe cases of sleep apnea, surgery may be recommended. The type of surgery depends on what it hindering your breathing. Removal of the adenoids and tonsils, if they are blocking the airway, is helpful, especially in children.

Other surgeries recommended for some sleep apnea patients (all with consultation and diagnosis from a qualified physician) include:

Uvulopalatopharyngoplasty (UPPP), removal of the tonsils, uvula (the tissue that hangs from the middle of the back of the roof of the mouth), and part of your soft palate (roof of your mouth in the back of your throat). This surgery is only effective for some people with sleep apnea.
Laser-assisted uvulopalatoplasty (LAUP) can ameliorate snoring, but is not a very effective treatment for sleep apnea.

There is another procedure available for those with sleep apnea, and this dental surgery is FDA approved. The Pillar Procedure is, essentially, palate implants and is the only FDA-cleared implantable device treatment for OSA. The results of a one-year study of Restore Medical’s Pillar palatal implants found that more than 80 percent of the participants demonstrated a reduction in their apnea.

The procedure is moderately invasive and is appropriate for patients with mild-to-moderate OSA and snoring. The Pillar Procedure involves placing three tiny woven implants into the soft palate, which makes the palate stiffen. This stiffened palate helps to reduce or prevent blockages of the airway. In most individuals this procedure effectively treats apnea and substantially reduces severe snoring. Plus the procedure is permanent and will continue to ameliorate sleep apnea symptoms. CPAP, while effective, is a therapy that is ongoing for the duration of the patient’s life and may prove to be a nuisance and a hassle.

Dental appliances are recommended by some doctors and they work by repositioning the jaw. However, one serious side effect is that they can cause TMJ and are uncomfortable for many users. TMJ stands for the temporomandibular joint and several facial pain and jaw disorders are referred to as TMJ.

CPAP is comparable to life support; it keeps you breathing at night by forcing air into the breathing passage that in turn keeps you alive, but the problem of apnea itself, as a disorder, is not fixed because it hasn’t gone away. It is merely a treatment that must be used every night. Many patients find the CPAP machine uncomfortable and tend to think that it makes the wearer unattractive.

Conclusion

Finding the root cause of the apnea, whether it is weight, allergies, sinus problems or any other factor is the best way to begin alleviating symptoms of apnea. Finding the cause of the apnea episodes and treating that will help to begin fixing the condition.

If you believe you, your partner, or a family member may have sleep apnea, the best course of action to take is to consult a physician. With testing and research into family and personal health background, diagnosis and treatment can be the answer and cure to this sleep affliction. And while there are many ways to treat apnea symptoms, finding the right method for you is the most important way to getting your sleep, health and life back on track.