Sleep Apnea

It is estimated that up to 70 million Americans suffer from some type of sleep disorder.  Lack of sleep and sleep disorders have become a national concern as studies have linked sleep disorders with a multitude of health problems.  Sleep apnea, for example, is associated with numerous disease states including cardiovascular disease, depression, obesity, Type 2 diabetes, hypertension and stroke.  Treating sleep disorders can reduce the chances of developing some of these serious diseases and can even reduce some of the symptoms associated with them.

What is Sleep Apnea?

The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.

Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.

Sleep apnea is the cessation of breathing or slowed breathing during sleep for 10 seconds or longer. Sleep apnea is classified as mild, moderate or severe, based on the number of times per hour breathing stops (apnea) or slows (hypopnea).

What are the different types of apnea?

The three main types of sleep apnea are:
Obstructive Sleep Apnea (OSA) is a life-threatening and life-altering condition that causes a person to stop breathing repeatedly during sleep. As a result, the body doesn't get enough oxygen.

The upper airway repeatedly collapses, causing cessation of breathing (apnea) or inadequate breathing (hypopnea) and sleep fragmentation.

The lack of sleep effects your alertness and ability to function throughout the day. OSA takes a toll on your quality of life. Your bed partner's sleep may also be disrupted by your snoring, pauses in breathing and restless sleep.

What causes the airway to collapse during sleep?

Several factors that can contribute to airway collapse are:

  • Extra tissue in the back of the throat, such as large tonsils or uvula
  • A decrease in the tone of the muscles holding the airway open
  • Nasal obstruction
  • Certain jaw or facial structures or attributes, such as a recessed chin.
Normal Breathing 
Airway is open 
Air flows freely to lungs 
OSA
Airway collapses
Blocked air flow  

CPAP
Airway splinted open
 Air flows freely to lungs

Central sleep apnea (CSA) is a disorder in which your breathing repeatedly stops and starts during sleep due to lack of respiratory effort. Unlike obstructive sleep apnea, in which you can't breathe normally because of upper airway obstruction, central sleep apnea occurs when your brain doesn't send proper signals to the muscles that control your breathing. Central sleep apnea is less common, accounting for less than 5 percent of sleep apneas.
Central sleep apnea may occur as a result of other conditions, such as heart failure and stroke. Sleeping at a high altitude also may cause central sleep apnea.  
Mixed sleep apnea (MSA) as its name would suggest, mixed sleep apnea is a combination of the first two types of this disorder. It is not uncommon for the primary cause to be central sleep apnea, with obstructive sleep apnea as a secondary consequence. In this case, central sleep apnea causes the initial failure to breathe but, as your brain reacts to the problem and signals you restart your breathing, this creates a blockage, resulting in obstructive sleep apnea syndrome.

What Causes Obstructive Sleep Apnea?

When you're awake, throat muscles help keep your airway stiff and open so air can flow into your lungs. When you sleep, these muscles are more relaxed. Normally, the relaxed throat muscles don't stop your airway from staying open to allow air into your lungs.
But if you have obstructive sleep apnea, your airways can be blocked or narrowed during sleep because:

  • Your throat muscles and tongue relax more than normal.
  • Your tongue and tonsils (tissue masses in the back of your mouth) are large compared to the opening into your windpipe.
  • Being overweight. The extra soft fat tissue can thicken the wall of the windpipe. This causes the inside opening to narrow and makes it harder to keep open. Although thin people can have sleep apnea to.
  • The shape of your head and neck (bony structure) may cause a smaller airway size in the mouth and throat area.
  • The aging process limits the ability of brain signals to keep your throat muscles stiff during sleep. This makes it more likely that the airway will narrow or collapse.

Not enough air flows into your lungs when your airways are fully or partly blocked during sleep. This can cause loud snoring and a drop in your blood oxygen levels.
When the oxygen drops to dangerous levels, it triggers your brain to disturb your sleep. This helps tighten the upper airway muscles and open your windpipe. Normal breaths then start again, often with a loud snort or choking sound.
The frequent drops in oxygen levels and reduced sleep quality trigger the release of stress hormones. These compounds raise your heart rate and increase your risk for high blood pressure, heart attack, stroke, and irregular heartbeats. The hormones also raise the risk for or worsen heart failure.
Untreated sleep apnea also can lead to changes in how your body uses energy. These changes increase your risk for obesity and diabetes.

Who Is At Risk for Sleep Apnea?

It's estimated that more than 12 million American adults have obstructive sleep apnea. More than half of the people who have this condition are overweight.
Sleep apnea is more common in men. One out of 25 middle-aged men and 1 out of 50 middle-aged women has sleep apnea.
Sleep apnea becomes more common as you get older. At least 1 out of 10 people over the age of 65 has sleep apnea. Women are much more likely to develop sleep apnea after menopause.
African Americans, Hispanics, and Pacific Islanders are more likely to develop sleep apnea than Caucasians.
If someone in your family has sleep apnea, you're more likely to develop it.
People who have small airways in their noses, throats, or mouths also are more likely to have sleep apnea. Smaller airways may be due to the shape of these structures or allergies or other medical conditions that cause congestion in these areas.
Small children often have enlarged tonsil tissues in the throat. This can make them prone to developing sleep apnea.

What Are the Signs and Symptoms of Sleep Apnea?

One of the most common signs of obstructive sleep apnea is loud and chronic (ongoing) snoring. Pauses may occur in the snoring. Choking or gasping may follow the pauses.
The snoring usually is loudest when you sleep on your back; it may be less noisy when you turn on your side. Snoring may not happen every night. Over time, the snoring may happen more often and get louder.
You're asleep when the snoring or gasping occurs. You will likely not know that you're having problems breathing or be able to judge how severe the problem is. Your family members or bed partner will often notice these problems before you do.
Not everyone who snores has sleep apnea.
Another common sign of sleep apnea is fighting sleepiness during the day, at work, or while driving. You may find yourself rapidly falling asleep during the quiet moments of the day when you're not active.

Other Signs and Symptoms

Others signs and symptoms of sleep apnea may include:

  • Morning headaches
  • Memory or learning problems and not being able to concentrate
  • Feeling irritable, depressed, or having mood swings or personality changes
  • Urination at night
  • A dry throat when you wake up

In children, sleep apnea can cause hyperactivity, poor school performance, and aggressiveness. Children who have sleep apnea also may have unusual sleeping positions, bedwetting, and may breathe through their mouths instead of their noses during the day.

How Is Sleep Apnea Diagnosed?

Doctors diagnose sleep apnea based on your medical and family histories, a physical exam, and results from sleep studies. Usually, your primary care doctor evaluates your symptoms first. He or she then decides whether you need to see a sleep specialist.

These specialists are doctors who diagnose and treat people with sleep problems. Such doctors include lung, nerve, or ear, nose, and throat specialists. Other types of doctors also can be sleep specialists.

Narcolepsy

Narcolepsy is a disabling sleep disorder that mixes the nervous system's messages about when to sleep and when to be awake. Narcolepsy usually starts during the teen years or early adulthood and continues throughout life.
Narcolepsy may cause:

  • Sudden sleep attacks, which may occur at any time during any type of activity, such as eating dinner, driving the car, or carrying on a conversation. These sleep attacks can occur several times a day and may last from a few minutes to several hours.
  • Sudden, brief periods of muscle weakness while a person is awake (cataplexy). The weakness may affect specific muscle groups or may affect the entire body. These periods of muscle weakness are often brought on by strong emotional reactions, such as laughing or crying.
  • Hallucinations just before a sleep attack.
  • Brief loss of the ability to move when a person is falling asleep or just waking up (sleep paralysis).

Insomnia

Insomnia is an inability to sleep well. A person with insomnia may have difficulty falling asleep or staying asleep, or may wake up earlier than desired, resulting in symptoms such as daytime fatigue, irritability, and poor memory. Short-term (temporary) insomnia lasting from a day to a month is very common. An occasional restless night may be caused by a period of emotional distress or sleeping in an unfamiliar bed. Ongoing (chronic) insomnia lasts a month or more and can cause significant distress. Chronic insomnia can be caused by many other conditions, such as depression, chronic pain, medications, poor sleep habits, or even worrying about sleeping.

Periodic Limb Movement (PLM)

Periodic limb movement disorder is continuous or wild movements of the feet, arms, or legs during sleep. These movements can last for up to 10 seconds and may repeat after 5 to 90 seconds and can interfere with sleep and cause excessive daytime sleepiness. Periodic limb movement disorder is typically treated with medicines that prevent the movements or help with sleep during the movements. Periodic limb movement disorder is more common in older adults than in younger people.

 

Sleep Center of Central Minnesota
13495 Elder Dr. Suite 120
Baxter, MN 56425
Phone: 218-454-0225
Fax: 218-454-0214