The Sleep Apnea Guide

Information About One of the Most Common Sleep Disorders 

Sleep apnea, a potentially serious sleep disorder in which breathing stops and starts repeatedly while sleeping, is experienced by roughly 25% of men and 10% of women. Sleep apnea can affect people of all ages but is more likely to occur in those over the age of 50. Left untreated or undiagnosed, sleep apnea can lead to serious health problems, such as heart trouble, chronic fatigue, and cognitive impairment. In addition to immediate health concerns, long term sleep apnea can also cause chronic daytime sleepiness and impact a person’s ability to function normally while awake.

Symptoms and Causes

The signs and symptoms of sleep apnea vary, depending on if it is obstructive or central sleep apnea. Obstructive sleep apnea is the type that occurs when your throat muscles relax intermittently and block your airway while sleeping. Because of this physical obstruction, the most common sign of obstructive sleep apnea is snoring.

Central Sleep Apnea differs significantly, as it is related to how the brain transmits or interprets signals for breathing properly. In cases of central sleep apnea, the brain fails to signal muscles used in breathing to contract, meaning that the body simply fails to breathe. As a result of this improper signaling, the most common symptom of this type of apnea is an abrupt awakening and shortness of breath as well difficulty with falling asleep.

Overall, both have many symptoms that overlap such as:

  • Snoring
  • Excessive sleepiness (such as throughout the daytime)
  • Episodes of stopped breathing
  • Abrupt awakening accompanied by gasping or choking
  • Morning Headache
  • Insomnia
  • Irritability
  • Difficulty paying attention or loss of focus

While there are many different causes for sleep apnea, some key causes and conditions to look out for include being overweight, use of alcohol, smoking, or being predisposed due to underlying health conditions such as high blood pressure, previous incidents of stroke, diabetes, or even Parkinson’s. Again, due to the differences in how the two types of apnea occur, there are key differences in what causes them.

Obstructive sleep apnea is primarily caused by physical conditions which allow your breathing passages to be blocked, and can be affected by other factors, such as obesity, age, congestion, as well as poor health habits like smoking or drinking. These factors can impact how the breathing muscles relax or contract, creating air blockage.

Central Sleep Apnea is generally caused by central nervous system issues, where the signaling process of the brain in controlling breathing muscles is not working properly. Other underlying medical conditions, such as heart failure, kidney disease, or prior stroke can also be to blame. 

Bottle of Alcohol and glass clip art

Use of alcohol and smoking can cause sleep apnea.

 

Risk Factors

One of the key risk factors for Obstructive sleep apnea is simply being male. Men are two to three times more likely to have sleep apnea than women. Aside from this, smoking significantly increases the risk of developing this type of apnea, putting smokers at three times more likely to have obstructive apnea. As noted above, obesity also greatly increases the risk, as fat deposits around your upper airway can obstruct your breathing. Many of these risk factors also coincide with medical conditions such as heart failure, high blood pressure, hormone disorders, prior stroke and lung disease.

For Central sleep apnea, the risk factors a much less extensive, but once again, being male puts you at higher risk for developing this type of apnea. Heart disorders, old age, previous incidents of stroke, and use of pain medications can also be factors associated with central sleep apnea. Most causes of central sleep apnea are seen as anything that can cause interference with the brains signaling mechanisms to the breathing muscles while sleeping. Some other suspected causes for this type of apnea can also be described as poor health factors. This can range from poor breathing habits, drug use, stress, or anything that disrupts the central nervous system.

    Around roughly 25% of men and 10% women have sleep apnea.

    Complications

    Due to the seriousness of sleep apnea, some major complications that can occur when dealing with it include daytime fatigue, high blood pressure and heart problems, diabetes, as well as sleep deprived partners. These complications can put not only the individual dealing with apnea at risk for other conditions, but also extend to a partner. A partner can be woken up by abrupt gasping, have their own sleep impacted by loud snoring, or simply become stressed due to concern over their partners apnea. These kinds of complication can lead to sleep deprivation serious which can lead to, loss of productivity, or even injury and accidents during the daytime. 

    Prevention and Treatment

    Due to the differences in the two types of apnea, prevention and treatment differ. For obstructive sleep apnea, the most direct form of prevention or treatment is to address conditions such as being overweight and consumption of substances that predispose oneself to apnea. Avoiding alcohol, smoking, as well as sedatives is recommended. For more severe cases that cannot be treated by habit or lifestyle changes, a Continuous Positive Airway Pressure (CPAP) machine may be a final resort. A CPAP machine effectively forces air past physical blockage and enables normal breathing. For causes that are related to the physical blockage of breathing passages, surgery can be used as an alternative to allow proper airflow and less restriction of breathing.

    For Central sleep apnea, as the causes can be substantially different compared to obstructive sleep apnea, the treatment and prevention will vary. A CPAP machine can be used, similar to treating obstructive apnea, to enable correct breathing. Other treatment options for this type of apnea include adjusting sleep position, Adaptive Servo Ventilation (ASV), or a Bilevel Positive Airway Pressure (BiPAP) machine. ASV is a newer technology that is used to treat central sleep apnea. As opposed to more passive systems of air pressure adjustment, this method responds based on the detection of pauses during sleep and algorithmically adjusting air pressure. BiPAP is slightly more complex than CPAP, as it has more pressure settings, however, this method is not as adaptative as ASV. Adjusting sleep position is another relatively simple treatment but can be an underlying cause that is causing this form of apnea in an individual.

    Lastly, other uncommon treatment and prevention options could be grouped into the “Iceberg Analogy”. This approach for treatment assumes that there are multiple underlying factors, such as posture, breathing habits, diet, stress, and other co-factors which cause central apnea to occur. One of the primary considerations of this approach is that by adjusting breathing habits, such as through breathing exercises, the mechanisms and signals the brain uses to determine breathing patterns can return to normal by undoing blood chemistry imbalances. Using this in conjunction with reducing stress, improving posture as well diet, it can lead to positive results in treating this type of apnea by allowing the signaling mechanism the brain uses in sleep breathing to work without interference. Otherwise, if the underlying cause is due to conditions of heart failure, kidney failure, stroke, etc., treatment will rely on correcting these conditions first.

    Other sleep conditions, such as insomnia may be potentially ignored for long periods of time without significantly impacting long term health, but sleep apnea should be treated immediately if symptoms begin reoccuring. While lifestyle changes and healthy habits can help or even cure apnea, some cases of apnea may require more advanced treatment from a doctor.

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