Sleep Apnea: Symptoms, Causes, Risk factors, Treatment & Prevention

 

Breathing repeatedly stops and starts when you have sleep apnea, a potentially serious sleep disorder. You may have sleep apnea if you snore loudly and still feel exhausted after a full night's sleep.

When you have sleep apnea, your breathing stops while you're asleep. Your brain wakes you up enough to breathe to protect you, but this keeps you from getting a good night's sleep. Serious complications may arise from this condition over time. It is, however, manageable. A medical professional can assist you in improving your quality of sleep.

Also Read: Heart attack: Symptoms, Causes, Treatment & Prevention

What is sleep apnea? 

 A disorder called sleep apnea causes you to stop breathing while you're asleep. This occurs when your airway becomes blocked (obstructive sleep apnea) or when your brain is unable to regulate your breathing normally (central sleep apnea).

A survival reflex triggered by low oxygen levels wakes you enough to start breathing again. Your sleep cycle is disrupted by that reflex, which also keeps you alive. This keeps you from sleeping soundly. Additionally, it can cause cardiac stress that, if left untreated, could be fatal.

To help you control your symptoms to prevent complications, a healthcare professional can develop a treatment plan.

What types of sleep apnea are there?

Sleep apnea comes in three types:

• Obstructive sleep apnea(OSA). In this condition, the surrounding tissue presses against your windpipe as the muscles in your throat relax while you sleep. This stops the flow of air.

• Central sleep apnea(CSA). Your brain doesn't send signals to keep breathing-related muscles active while you sleep if you have this condition.

• Complex or mixed sleep apnea. Type combination of elements of central and obstructive sleep apnea.

Symptoms:

It can be challenging to distinguish between obstructive and central sleep apnea because of their similar symptoms. The following are the most typical signs of central and obstructive sleep apnea:

• Loud snoring

• Episodes in which you stop breathing while you're asleep; another person would report these

• Breathing heavily while you're asleep

• Waking up with a dry mouth

• Headache in the morning

• Insomnia is the inability to stay asleep

• Hypersomnia, or excessive daytime sleepiness

• Having trouble focusing when awake

• Irritability

Causes:

When the muscles in the back of the throat relax, sleep apnea of this type occurs.  These muscles support the tonsils, the side walls of the throat, the tongue, the soft palate, and the uvula, a triangular piece of tissue that hangs from the soft palate.

 As you breathe in, your airway narrows or closes as the muscles relax.  Your blood oxygen level may drop as a result of insufficient air intake.  When your brain detects that you are having trouble breathing, it wakes you up for a moment so that you can open your airway again.  Usually, this awakening is so fleeting that you forget it.

You may gasp, choke, or snort.  Throughout the night, this pattern may recur five to thirty times per hour or more. Reaching the deep, peaceful stages of sleep is hampered by this.

Risk factors:

Even children can suffer from sleep apnea. However, some things make you more vulnerable.


Obstructive sleep apnea

The following variables raise the chance of developing this type of sleep apnea:

• Overweight. The risk of OSA is significantly increased by obesity. Your breathing may become obstructed by fat deposits surrounding your upper airway.

• Measurement of the neck. The airways of people with thicker necks may be smaller.

• An airway narrowing. A narrow throat may have been inherited by you. Additionally, especially in children, tonsils or adenoids can enlarge and obstruct the airway.

• Being male. Sleep apnea is two to three times more common in men than in women. However, women who have experienced menopause or are overweight are at a higher risk.

• Being older. Older adults are much more likely to suffer from sleep apnea.

• Family history. Your risk may be increased if you have family members who have sleep apnea.

• Use of tranquilizers, sedatives, or alcohol. These substances can exacerbate obstructive sleep apnea by relaxing the muscles in your throat.

• Smoking. Compared to those who have never smoked, smokers have a threefold higher risk of developing obstructive sleep apnea. Inflammation and fluid retention in the upper airway can both be exacerbated by smoking.

• Congestion of the nose. Obstructive sleep apnea is more likely to develop if you have difficulty breathing through your nose, whether due to allergies or an anatomical issue.

• Medical conditions. Obstructive sleep apnea may be more likely to occur in people with congestive heart failure, high blood pressure, and type 2 diabetes. Risk factors include previous stroke, hormonal imbalances, polycystic ovary syndrome, and long-term lung conditions like asthma.

Central sleep apnea

The following are risk factors for this type of sleep apnea:

• Being older. Central sleep apnea is more common in middle-aged and older adults.

• Being a male. Men are more likely than women to have central sleep apnea.

• Heart disorders. The risk is increased if you have congestive heart failure.

• Utilizing narcotic painkillers. The risk of central sleep apnea is increased by opioid medications, particularly long-acting ones like methadone.

• Stroke. The risk of central sleep apnea is increased after a stroke.

Complications:

Complications of OSA can include:

• Fatigue during the day. Typically, restorative sleep is impossible due to sleep apnea's frequent awakenings, which increase the likelihood of severe daytime drowsiness, fatigue, and irritability. You may find it difficult to focus and end up nodding off while working, watching TV, or even while operating a motor vehicle. Individuals who suffer from sleep apnea are more likely to be involved in workplace and auto accidents. Additionally, you may experience mood swings, depression, or irritability. Sleep apnea in children and adolescents can cause behavioral issues or poor academic performance.

• Elevated blood pressure or heart problems. OSA causes abrupt drops in blood oxygen levels, which raise blood pressure and put stress on the heart. You are more likely to develop hypertension, or high blood pressure, if you have OSA. Additionally, OSA may raise your risk of atrial fibrillation, recurrent heart attacks, strokes, and irregular heartbeats. Multiple episodes of low blood oxygen (hypoxia or hypoxemia) in people with heart disease can cause an irregular heartbeat that can result in sudden death.

• Diabetes type 2. Insulin resistance and type 2 diabetes are more likely to develop in people with sleep apnea.

• Metabolic syndrome. This condition is associated with an increased risk of heart disease and manifests as high blood pressure, abnormal cholesterol, high blood sugar, and an enlarged waist circumference.

• Medication and surgical complications. General anesthesia and some medications can also cause obstructive sleep apnea. Due to their propensity for breathing issues, particularly when sedated and lying on their backs, people with sleep apnea may be at higher risk of experiencing complications following major surgery. Inform your physician about your sleep apnea and current treatment before undergoing surgery.

• Problems with the liver. Individuals who suffer from sleep apnea are more likely to experience abnormal liver function test results and to have nonalcoholic fatty liver disease, which is characterized by scarring in the liver.

• Partners who don't get enough sleep. Anyone sleeping close by may find it difficult to get a good night's sleep if they hear loud snoring. To sleep, a partner frequently needs to move to a different room or even a different floor of the house.

CSA complications may include:

• Fatigue. Sleep apnea prevents normal, restorative sleep by causing frequent awakenings. Individuals who suffer from central sleep apnea frequently experience severe fatigue, drowsiness during the day, and irritability. You may have trouble focusing and end up nodding off while working, watching TV, or even while operating a motor vehicle.

• Cardiovascular problems. Heart health may suffer as a result of central sleep apnea's abrupt drops in blood oxygen levels. These recurrent episodes of low blood oxygen, also referred to as hypoxia or hypoxemia, worsen the prognosis and raise the risk of irregular heart rhythms if there is underlying heart disease.

How is the diagnosis of sleep apnea made?

Your symptoms and medical history will be questioned by a healthcare professional to diagnose sleep apnea. They will suggest testing to confirm a diagnosis if they have any suspicions about the condition.


Which tests are used to identify sleep apnea?

The following are the most popular tests for sleep apnea:

• Polysomnogram. Wearing sensors that track your heart rate, breathing, blood oxygen levels, brain waves, and other parameters is part of this overnight test.

• Testing for sleep apnea at home. This sleep study is conducted at home without the use of brain wave monitoring. This test has certain drawbacks, such as the inability to identify central sleep apnea.

• You may be able to assist a medical professional in diagnosing sleep apnea if you believe you or a loved one has it. Videos and audio recordings of you or this person sleeping, particularly ones that show breathing, can provide important evidence that a provider needs to expedite the diagnostic process. Another way to demonstrate air movement is to place a piece of tissue in front of a loved one's face so that the movement can be captured on video.

Treatment:

How does one treat sleep apnea?

 Various treatment options will be suggested by a healthcare provider depending on the severity and type of sleep apnea.  These could consist of:

•  Using a breathing apparatus, such as a machine that provides continuous positive airway pressure (CPAP).

•  Taking care of any underlying conditions that contribute to or raise your risk of developing sleep apnea.

•  Avoid placing pressure on your airways by sleeping in a different position than on your back.

•  Using a mouthpiece or other oral appliance to maintain an open airway.

•  Keeping your tongue and upper airway muscles from obstructing your airway while you sleep by using a neuromuscular electrical stimulation (NMES) device.

•  Taking  medication.

•  Having surgery.

Surgery for sleep apnea

Sleep-related airway blockages may be avoided with the help of surgeries on your mouth, throat, and nose. Among these surgeries are:

• Surgery on the jaw. Your jaw can be moved during different procedures to prevent soft tissue from pressing back against your airway.

• Nasal surgery. Septoplasty is a common type of nasal surgery. By doing this, the soft tissue in your nose is straightened, which facilitates airflow through your nasal passages.

Prevention:

 Not every cause of sleep apnea can be avoided.  However, you can lower your risk by doing the following:

•  Reaching and keeping a healthy weight for yourself

•  Consuming wholesome foods and engaging in regular exercise

•  Maintaining proper sleep hygiene (such as establishing a consistent bedtime and turning off electronics)

•  Taking care of any current health conditions, such as Type 2 diabetes, high blood pressure, and high cholesterol

•  Getting a checkup with your doctor at least once a year

•  Avoiding smoking and consuming alcoholic beverages

References:

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