Unlocking the Night: Understanding Sleep Apnea and Finding Solutions
My late father was known to be loud snorer in our family. He was a college president before he retired. Years later after he passed away, one of his secretaries told me during meetings he chaired, he would sometimes fall as sleep for a few seconds. Looking back, now suspect he must have had undiagnosed sleep apnea. During that time no body new anything about sleep apnea. He was US army veteran and it was only in 1996 when they considered it a disabilty.
Even today sleep apnea is still a major and under-recognised public health concern. The failure to recognize clinically significant Obstructive Sleep Apnea Syndrom (OSAS) is particularly unfortunate for many reasons. First, the condition carries significant amout of illnesses and death, and is associated with an increased risk of heart attacks and strokes, in addition to a significant risk of automobile accidents and injury in the workplace as a consequence of excessive sleepiness. Secondly, the condition is very treatable, and severe forms of OSAS can respond dramatically well to the continued home use of nocturnal nasal continuous positive airway pressure (CPAP) therapy.
Do you have sleep apnea or know of someone who has it? How do you know if you have sleep apnea? Apnea is defined as a disorder that causes you to stop breathing briefly, often while you’re asleep.
Symptoms of Possible Sleep Apnea
Do you have these problems?
Sleepiness or lack of energy during the day
- Forgetfulness, mood changes, and a decreased sex drive
- Sleepiness while driving
- Waking up with a very sore or dry throat
- Loud snoring
- Occasionally waking up with a choking or gasping sensation
- Morning headaches
- Restless sleep
- Recurrent awakenings or insomnia
- Sleepiness or lack of energy during the day
If you have these symptoms you may have sleep apnea.
Sleep apnea is characterized by repetitive episodes during sleep where there is repetitive pauses of breathing for an abnormal period during sleep. These pauses can last from a few seconds to minutes and can occur multiple times throughout the night.
Types of Sleep Apnea
There are three main types of sleep apnea:
- Obstructive sleep apnea (OSA): This is the most common type, occurring when the muscles in the throat relax too much during sleep, causing the airway to become blocked or narrowed.
- Central sleep apnea (CSA): This occurs when the brain fails to send the proper signals to the muscles that control breathing, leading to interrupted breathing patterns during sleep.
- Complex sleep apnea syndrome: This is a combination of obstructive sleep apnea and central sleep apnea.
These episodes result in giving the body large amount of stress. It may cause day time fatigue or sleepiness, irritability, mode changes, inability to focus and memory problems.
Health Problems Associated with Sleep Apnea
There is associated increased risk for obesity, diabetes, high blood pressure, heart attack, stroke, dementia and premature death. These are reasons to diagnose and treat the problem early on before complications develop.
Sleep apnea may run in families because certain disorders that maybe inherited may predispose one to have sleep apnea. These disorders are:
- breathing problems due defect in signals from the brain
- due to floppy upper airway tissue
- family history of obesity
- irregular sleeping pattern
- certain ethic groups people of African decent
“Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results.
Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung and nerve specialists and ear, nose, and throat specialists. Other types of doctors also can be sleep specialists.
Medical and Family Histories
If you think you have a sleep problem, consider keeping a sleep diary for 1 to 2 weeks. Bring the diary with you to your next medical appointment.
Write down when you go to sleep, wake up, and take naps. Also write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel at various times during the day. This information can help your doctor figure out whether you have a sleep disorder.
You can find a sample sleep diary in the National Heart, Lung, and Blood Institute’s “Your Guide to Healthy Sleep.”
At your appointment, your doctor will ask you questions about how you sleep and how you function during the day.
Your doctor also will want to know how loudly and often you snore or make gasping or choking sounds during sleep. Often you’re not aware of such symptoms and must ask a family member or bed partner to report them.
Let your doctor know if anyone in your family has been diagnosed with sleep apnea or has had symptoms of the disorder.
Many people aren’t aware of their symptoms and aren’t diagnosed.
If you’re a parent of a child who may have sleep apnea, tell your child’s doctor about your child’s signs and symptoms.
Physical Exam
Your doctor will check your mouth, nose, and throat for extra or large tissues. Children who have sleep apnea might have enlarged tonsils. Doctors may need only a physical exam and medical history to diagnose sleep apnea in children.
Adults who have sleep apnea may have an enlarged uvula (U-vu-luh) or soft palate. The uvula is the tissue that hangs from the middle of the back of your mouth. The soft palate is the roof of your mouth in the back of your throat.
Sleep Studies
Sleep studies are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is. Sleep studies are the most accurate tests for diagnosing sleep apnea.
There are different kinds of sleep studies. If your doctor thinks you have sleep apnea, he or she may recommend a polysomnogram (poly-SOM-no-gram; also called a PSG) or a home-based portable monitor.
A PSG is the most common sleep study for diagnosing sleep apnea. This study records brain activity, eye movements, heart rate, and blood pressure.
A PSG also records the amount of oxygen in your blood (oxygen saturation), air movement through your nose while you breathe, snoring, and chest movements. The chest movements show whether you’re making an effort to breathe.
PSGs often are done at sleep centers or sleep labs. The test is painless. You’ll go to sleep as usual, except you’ll have sensors attached to your scalp, face, chest, limbs, and a finger. The staff at the sleep center will use the sensors to check on you throughout the night.
A sleep specialist will review the results of your PSG to see whether you have sleep apnea and how severe it is. He or she will use the results to plan your treatment.
Your doctor also may use a PSG to find the best setting for you on a CPAP (continuous positive airway pressure) machine. CPAP is the most common treatment for sleep apnea. A CPAP machine uses mild air pressure to keep your airway open while you sleep.
If your doctor thinks that you have sleep apnea, he or she may schedule a split-night sleep study. During the first half of the night, your sleep will be checked without a CPAP machine. This will show whether you have sleep apnea and how severe it is.
If the PSG shows that you have sleep apnea, you’ll use a CPAP machine during the second half of the split-night study. The staff at the sleep center will adjust the flow of air from the CPAP machine to find the setting that works best for you.
Home-Based Portable Monitor
Your doctor may recommend a home-based sleep test with a portable monitor. The portable monitor will record some of the same information as a PSG. For example, it may record:
- The amount of oxygen in your blood
- Air movement through your nose while you breathe
- Your heart rate
- Chest movements that show whether you’re making an effort to breathe
A sleep specialist may use the results from a home-based sleep test to help diagnose sleep apnea. He or she also may use the results to decide whether you need a full PSG study in a sleep center.”
Sleep apnea treatments is depends on the under lying cause of the problem. It may be lifestyle changes, such as losing weight or changing sleep positions, to CPAP therapy, to ever surgery to correct the specific problem.
Treating Sleep Apnea at Home
You may be able to treat mild cases of sleep apnea by lifestyle changes, for example:
- Losing weight.
- Avoiding alcohol and sleeping pills.
- Changing sleep positions to improve breathing.
- Stopping smoking. Because smoking increases the swelling in the lining of the upper airway, which may worsen both snoring and apnea.
- Avoiding sleeping on your back.
- The use oral appliances
- “Continuous positive airway pressure therapy (CPAP ) uses a machine to help a person who has obstructive sleep apnea (OSA) breathe more easily during sleep. A CPAP machine increases air pressure in your throat so that your airway doesn’t collapse when you breathe in.” This is usually prescribed by a pulmonologist physician specialist.
If you suspect you or some you know has sleep apnea it is important to consult with a healthcare professional for proper diagnosis and treatment before any permanent side effects set in.
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