Sleep Apnea and Snoring
Obstructive Sleep Apnea is a common sleep disorder in which your breathing temporarily stops during sleep as a result of blockage in the upper airways. As the body struggles to breathe, it often creates very loud snoring noises while gasping for air. These sleep interruptions lead to frequent awakenings that most people may be unaware of resulting in fatigue. Sleep apnea is a serious and potentially life threatening sleep disorder. According to the Mayo Clinic, about 90 million Americans suffer from snoring and as many as half of those may be suffering from Obstructive Sleep Apnea (OSA).
It is important to see a doctor right away!
Sleep Apnea Warning: Sleep Apnea and heart disease are highly correlated. The more severe the sleep apnea, the higher the risk for high blood pressure, heart attack, and stroke.
Sleep apnea in children can cause hyperactivity, poor school performance, and hostile behavior. Children who have sleep apnea also may breathe through the mouth instead of the nose.
Signs and Common Symptoms of Obstructive Sleep Apnea include:
- Loud, chronic snoring
- Frequent pauses in breathing during sleep
- Choking or gasping following the pauses in breathing
- Decreased productivity
- Lack of energy
- Not being able to concentrate, memory and learning problems
- Exhaustion during the day
- Irritability and depression
- Feeling restless and unrefreshed after waking up
- Feeling sleepy during the day
- Waking up with shortness of breath, chest pains, nasal congestion, or a dry throat
- Chronic headaches, upon waking up or throughout the day
- High blood pressure
- Higher risk of diabetes
- Higher risk of heart attack
- Higher risk of brain damage and stoke
The four types of Sleep Apnea are:
- Obstructive Sleep Apnea (OSA) - This is the most common form of sleep apnea and occurs when the throat closes and the airway becomes blocked as the individual inhales during sleep. During sleep the soft tissue of the throat expands and relaxes. When it relaxes too much, the back of the tongue may obstruct air flow in the upper respiratory tract. Low oxygen and choking force the patient to wake up and take a deep breath. Men between the ages 30 to 50 are the main group affected by OSA. Many people will experience some form of mild OSA during their lives. It is chronic or severe OSA that requires medical attention.
- Central sleep apnea - Central sleep apnea, or Cheyne-Stokes respiration, is a relatively rare form of sleep apnea that occurs when the region of the brain responsible for controlling the breathing muscles temporarily fails. Central sleep apnea differs from OSA in that the patient's pauses in breathing are due to a lack of effort to breathe.
- Mixed apnea - Mixed apnea is a combination of OSA and central sleep apnea. Chronic OSA can sometimes cause central sleep apnea. Although the exact cause is still unknown, obesity, cardiovascular, and respiratory conditions can contribute to mixed sleep apnea.
- Complex sleep apnea - Complex sleep apnea is a form of mixed sleep apnea. With this unusual condition, a patient still experiences sleep apnea even when the physical obstruction to breathing is removed.
Factors that Influence Sleep Apnea
Obstructive Sleep Apnea is caused when soft tissue in the airway relaxes. Usually, OSA occurs because of changes in muscle tone, an increase in the soft tissue due to obesity, and structure issues with the skull and face. Obese people are at a great risk for OSA because they carry more muscle and tissue mass. Over 50 percent of people with Down's syndrome also suffer from OSA. Nasal congestion and alcohol consumption can also contribute to OSA. In children, enlarged adenoids and tonsils are the most common causes of Obstructive Sleep Apnea. OSA can also occur as a part of the aging process. The brain's efficiency in transmitting signals that maintain rigidity to the throat muscles decreases with age.
Central sleep apnea (CSA) is rare in healthy individuals. CSA often accompanies a medical condition such as Parkinson's disease, advanced arthritis, and encephalitis that can trigger central sleep apnea.
The Importance of Sleep Apnea Treatment
Complications from sleep apnea can include inattentiveness at work, tiredness, risk of accidents, mood swings, high blood pressure and erectile dysfunction. Sleep apnea also increases the risk of congestive heart failure and stroke. Children affected by sleep apnea can be hyperactive, high strung, aggressive, and prone to bed-wetting. They may have also unusual sleeping positions. Overall, a person suffering from sleep apnea experiences deterioration in the quality of life.
Diagnosing Sleep Apnea
To properly diagnose sleep apnea, a dentist or physician will have diagnostic sleep testing performed for the patient, especially if one is suffering from conditions such as high blood pressure, heart failure, and epilepsy. Physical examination for adults includes measuring for a wide neck, looking for enlarged tonsils, and assessing upper body obesity. In evaluating children, doctors check for enlarged adenoids and determine if the child has attention deficit issues.
Doctors use the patient's medical and sleep history in diagnosing sleep apnea. Symptoms such as drowsiness, headaches, heartburn, and patient medications can influence the diagnosis. A sleep study, where the patient is monitored in a sleep lab, can also help determine an individual has sleep apnea. When testing rules out sleep apnea, then the patient must be evaluated for other potential sleep disorders.
Treating Sleep Apnea
After a diagnosis of sleep apnea, Dr. Vermani will review treatment surgical and non-surgical options. Non-surgical treatments include medications, behavioral changes, dental appliances, and use of a Continuous Positive Airway Pressure (CPAP).
- Medication - Nasal steroid sprays may effectively control sleep apnea caused by nasal airway obstruction. Hypothyroidism treatment helps manage sleep apnea caused by the thyroid condition.
- Behavioral changes - In milder cases, lifestyle and behavior changes are often the only treatment required. Exercising to reduce weight and avoiding sleep positions that lead to increased snoring have been shown as effective treatments.
- Oral Appliance Therapy - Mild to moderate sleep apnea and snoring can be controlled by using dental appliances that hold the palate up and keep the airway free.
- Continuous positive airway pressure (CPAP) - CPAP machines use air pressure to ensure that the soft palate does not sag during sleep. The pressurized air is delivered to the patient through a face mask. As the person breathes, gentle air pressure keeps the air passage open and prevents sleep apnea.