Risk Factors And The Treatment Of Sleep Apnea That You Should Know

Sleep apnea is a condition in which you stop breathing several times while you sleep. Your brain will wake you up just enough so that you can breathe, but this will disrupt your ability to have a good night’s sleep. This can have serious long-term consequences. However, if patients stick to their treatment plans, they can typically keep this illness under control.

Sleep apnea explained

Sleep apnea is a serious medical condition that happens when you stop breathing while you sleep. The Greek phrase for “breathless” is where we get our word “apnea.” Sleep apnea occurs when you repeatedly wake up because your breathing has stopped. This can happen if your brain is unable to properly regulate your breathing while sleeping (CSA-central sleep apnea) or if your airway becomes blocked while sleeping (OBS-obstructive sleep apnea).

Oxygen deprivation triggers a survival instinct that causes you to snap out of your slumber long enough to start breathing again. That survival instinct of yours keeps you from getting enough shut-eye. This makes it hard to get a good night’s sleep and has other effects, like putting stress on the heart, which can have serious or even fatal effects.

Sleep apnea can affect a wide variety of people

Infants, children, and the elderly are all at risk for developing sleep apnea. The prevalence of OBS increases in the following settings and demographics:

There is a difference between men and women in how often this disease happens before age 50. This is especially true for men and people who are biologically male at birth (AMAB). After the age of 50, the incidence is the same for both sexes, including those who were assigned female at birth (AFAB).

As one age, their risk of developing this disease increases.
The likelihood of acquiring it is dramatically raised in people who are overweight or obese.
It strikes people of African, Hispanic, and Asian origin disproportionately.
Certain demographics are disproportionately affected by central sleep apnea,

including those who rely on narcotic painkillers.
People aged 60 and up
Those suffering from heart issues including arrhythmia or heart failure.
Treatment-emergent central sleep apnea can develop in certain patients with obstructive sleep apnea or those who use CPAP.
Central apneas can develop in those who are constantly exposed to thin air at high elevations.

What percentage of the population suffers from sleep apnea?

Sleep apnea is not common, but it does affect many people. A significant percentage of the global population—between 5 and 10 percent, according to experts—has it.

What effects does sleep apnea have on my body?

Sleep apnea is easier to understand if you know how most people normally sleep. Multiple stages of sleep occur:

Stage 1. light sleep. A short period of time begins immediately after falling asleep. About 5% of your nighttime slumber is spent doing this.
Stage 2: A deeper sleep state. This phase accounts for 45-50% of total sleep time and is the deepest period (this number goes up as you get older).
This is the slow-wave sleep stage. Twenty-five percent of your total sleep time is spent in this deepest stage (this number goes down with age).
Stage 3. A slow wave of sleep. it’s nearly impossible to wake them up, and if you do, they’ll likely experience “sleep inertia,” a mental condition characterized by delayed reaction times and clouded thinking, for a while. In this state, parasomnias such as sleepwalking and sleeptalking can occur.
REM sleep: The rapid eye movement sleep stage is abbreviated as REM. In this phase, you’re most likely to daydream. Visual evidence of eye movement during rapid eye movement (REM) sleep has been reported.

Stage 1 is the initial phase of sleep, followed by Stages 2 and 3 in rapid succession. After going through these phases repeatedly, you will enter REM sleep and begin dreaming. When the first REM cycle ends, a new one begins, and you return to Stage 1 or Stage 2 of sleep. The average interval between cycles is around 90 to 110 minutes. During a typical night, people go through four or five cycles at most (assuming they get a full eight hours of sleep).

The effects of sleep apnea on the normal sleep-wake cycle

Your brain is always taking a look at your body and making changes based on what it sees. When you stop breathing, whether, from apnea or hypopnea, your blood oxygen levels can drop.

To put it simply, apnea is a condition in which breathing ceases or almost ceases during sleep. It combines the Greek words for “not” and “breathing,” “a” and “apnea,” respectively. A combination of these words signifies “gasping for air.”

The term “hypopnea” is derived from the Greek words for “low” and “breath.” Low or under is implied by the Greek prefix hypo-. Under-breathing is derived from the same roots as “low,” meaning that the person isn’t taking in enough air to keep their blood at a healthy oxygen level.

When your brain senses that there is less oxygen in your blood, whether from apnea or hypopnea, it triggers a failsafe-like reflex that wakes you up enough to start breathing again. As soon as you start breathing normally again, your brain will try to get you back to sleep.

These awakenings will become more frequent as your sleep apnea worsens. The apnea-hypopnea index measures how many times in an hour a person has episodes of shallow or paused breathing. The severity of sleep apnea is mostly determined by the AHI.

Having an AHI between 5 and 15 indicates mild sleep apnea. That’s between five and fifteen apnea or hypopnea episodes every hour. However, at this stage, healthcare providers also take symptoms into account. They might not think it’s serious enough to treat if you don’t have any other symptoms.

Between 15 and 29 episodes per hour characterize those with mild sleep apnea. That equates to anywhere from 120 to 239 times throughout sleep when a person stops breathing or wakes up.

People with severe sleep apnea often wake up 30 times or more per hour. This indicates that over the course of a full night’s sleep, they experience 240 or more episodes in which they either cease breathing or awaken.

Occupying events are transient and can disrupt sleep at any point. Most of the time, they happen during the deeper stages of sleep, like stages 1 and 2 and REM. Because of this, people with apnea might not know they have a problem until they start to feel bad. Stages 1 and 2 of sleep are the most likely times for central events to occur, although they can happen at any time.

When does sleep apnea show up?

Some of the signs of sleep apnea are more obvious than others. Among the symptoms are:

Having a severe case of sleepiness upon awakening is very common in the case of OBS. People who have this issue often say that they feel very tired even after a full night’s sleep.

having trouble staying awake during the day. It can make it hard to focus, which can lead to accidents while driving, at work, or doing any number of other things.

Snoring. This is a typical symptom of sleep apnea (but it doesn’t always occur). It may or may not be accompanied by loud snoring.
When one’s disposition shifts, things happen. Sleep apnea is characterized by a host of negative emotions.
Modifications to normal brain operation. Memory loss, inability to focus and other cognitive difficulties are examples.
Irregular awakenings in the wee hours of the morning. People often don’t recall waking up or why they woke up, which could make it more difficult to detect this symptom. Most people who do this say they woke up for another reason, like heartburn or the need to use the restroom.
Sleep pauses that can be seen by others. It’s possible that these symptoms will be noticed by a loved one while you’re sleeping.
Breathing irregularities. CSA is associated with a unique breathing rhythm called Cheyne-Stokes breathing (CSB). Rapid, shallow, and finally nonexistent respiration are all symptoms of chronic shallow breathing. Sometimes they’ll go a few seconds without breathing, and then they’ll start breathing again, just to repeat the sequence again.
Insomnia.
Restless sleeping and perspiring at night.
Dysfunction in the sex organ.
A sense of being suffocated or short of air upon awakening.
Problems focusing on tasks because of a throbbing head.
Children’s snoring and sleep apnea

There are a few distinct causes of sleep apnea in kids. In children it is characterized by the following symptoms:

Inattention, restlessness, or poor academic performance are all symptoms of hyperactivity. Anxiety, restlessness, and a general lack of focus are all signs that this may be the case (ADHD).

Too loud snoring.
Bedwetting.
Restless limbs when sleeping, involving the arms or legs.
Taking up strange sleeping positions or laying with the neck propped up.
Acid reflux (heartburn) or excessive perspiring during sleep.

Causes of Sleep apnea

Some evidence suggests that sleep apnea runs in families and is often caused by a certain set of circumstances. The most common types of sleep apnea all show up in different ways and are caused by different sets of underlying factors. Types include:

Sleep apnea with obstruction (OSA).
Central sleep disorder (CSA).
Both Complicated and Mixed.

Sleep apnea with obstruction (OSA)

This is the most typical variation. When you sleep, the muscles in your head and neck relax, which can cause the tissue around your windpipe to press on it. This is called obstructive sleep apnea. That prevents airflow across the structure.

The central sleep disorder

There is an issue in the brain that causes this type of sleep apnea. In a normal state, your brain controls your breathing at all times, even while you’re asleep. To put it simply, central sleep apnea occurs when the brain stops sending signals to the body’s breathing-related muscles.

Many different factors, such as:

Stroke or heart failure.
Having too little oxygen in the blood (hypoxia) due to being at a high altitude.
disruption of the nervous system, particularly in the brainstem (which regulates respiration) or the spinal cord.
Start with continuous positive airway pressure therapy (CPAP) for OSA. This condition usually goes away with regular use of CPAP.
Disorders of the nervous system, such as amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s illness).

Apnea of Sleep Disordered Breathing, Complex Type

Mixed or complex sleep apnea is another subtype. The emphasis in this configuration is on both peripheral and center activities.

How the issue of Sleep Apnea is diagnosed?

Sleep apnea is diagnosed by questioning the patient about their symptoms and medical history. Based on your answers and symptoms, they may think you have sleep apnea and suggest that you get a sleep study.

What diagnostic procedures will be utilized to determine if sleep apnea is present?

The most widely used diagnostic procedures for sleep apnea are:

examining how you sleep throughout the course of a single night (polysomnogram). This is a sleep study, where you spend the night in a medical facility (often called a “sleep lab”) designed to make you as comfortable as possible while still monitoring your sleep.

As part of this evaluation, sensors will be put on your body to track things like your heart rate, breathing rate, blood oxygen levels, brain waves, and more. This test is often thought to be the most accurate and reliable way to find out if someone has sleep apnea.

Testing for sleep apnea at home A sleep study can be conducted in the comfort of one’s own home with the help of this diagnostic tool. It’s like a sleep study but doesn’t entail recording your brain waves while you sleep. But if your doctor thinks you have severe sleep apnea or any other sleep disorder or health problem, you probably won’t be given this test. When a home sleep test doesn’t show sleep apnea, doctors usually suggest an overnight study to be sure.

Does sleep apnea have a cure, and how is it treated?

Depending on the severity and type of sleep apnea, various treatments may be attempted. Even though none of them are effective at treating sleep apnea, they can help reduce the frequency and severity of episodes.

There are a lot of things you should be doing every day (or every night). That, so long as you keep up with your treatments, can lessen the impact of sleep apnea on your life.

Examples of potential treatments are:

Nonmedical or conservative types.
Machines that apply pressure to the airway and modify the rate of ventilation are available.
Medications and tools for the mouth and teeth (mouthpieces).
Electro-chemical nerve stimulators.
Surgery.
Medications (central sleep apnea only) (central sleep apnea only).

Nonmedical or conservative

Most cases of obstructive sleep apnea can be helped or even cured by using one of these methods. While they don’t eliminate apnea altogether, they can lessen its severity to the point where it no longer causes symptoms or no longer warrants medical attention. Some examples of these are:

Slimming down. In many cases, sleep apnea can be greatly alleviated if a person with obesity or extra weight loses just 10 percent of their body weight.
Sleeping in a variety of positions and using various sleep aids. The prevalence of sleep apnea is increased when one sleeps on their back. Sleeping on your side or stomach instead of your back can alleviate this problem because soft tissue doesn’t press against the windpipe in that posture.
Topical patches, nasal sprays, and the like. These over-the-counter remedies help people breathe better by reducing the nasal obstruction. They can sometimes help with snoring and mild sleep apnea, but not with moderate or severe cases.
Addressing the source of the problem. Central sleep apnea frequently gets better when underlying diseases like heart failure were treated.
Treatment modifies. Central sleep apnea may be improved or perhaps resolved if the patient works with their doctor to reduce or stop taking opioid pain drugs.

Adaptive ventilation and positive airway pressure (PAP)

When you use a positive airway pressure device, the pressure of the air entering your airway is raised to help you breathe. Obstructive, central, and mixed sleep apneas can all be remedied with this technique.

When your windpipe is kept open by a blast of pressured air, you can continue to take deep breaths. These machines force air into a mask placed over your face while you sleep. Masks come in a wide variety of materials, shapes, and sizes, and can hide either the nose or the mouth.

The CPAP machine is the most well-known type of PAP machine. While CPAP machines are the most common, there are others (see our CPAP Machine article for more about the different types of devices, including adaptive servo-ventilation devices). When you inhale with one of these devices, the air pressure in your airway and lungs increases, preventing the surrounding tissue from forcing your airway shut.

Instruments used in the mouth

When the soft tissues in your head or neck, especially in the area around your mouth and jaw, collapse and press down on your windpipe during sleep, you experience obstructive sleep apnea. A specialized mouthpiece can keep your jaw and tongue from pressing on your airway. Dentists and sleep medicine doctors frequently collaborate on its creation.

Stimulants to the Nervous System

The hypoglossal nerve (whose Greek name literally translates to “under the tongue”) is responsible for moving your tongue. With a nerve stimulator implanted near this nerve, you may feel a tiny forward movement of your tongue in conjunction with each breath as you slept. This prevents obstructive sleep apnea, which can occur when the tongue relaxes and presses backward on the airway during sleep.

The nerve in your jaw is stimulated via an electrode that is attached to a device that is surgically inserted under the skin of your chest. When you go to bed, you can activate the stimulator, and when you wake up, you can deactivate it. The mildly painful electrical current is just enough to keep your tongue from relaxing too much.

Central sleep apnea can cause comparable nerve activation. The phrenic nerves are impacted by this form of stimulation. These nerves travel from the spinal cord to the diaphragm, a sheet of muscle that lies just below the lungs and regulates breathing. The phrenic nerve controls the muscles that help you breathe, thus stimulating it will make those muscles contract.

Surgery

Nasal, oral, and tracheal surgeries can reduce or get rid of the need for breathing aids when the nose, mouth, or windpipe is blocked. In adults, however, their effects are typically muted and quite individual. The following procedures fall under this category:

Somnoplasty: Radiofrequency (RF) ablation is used to shrink the fatty tissue that lines your windpipe’s upper regions.
Tonsillectomy/adenoidectomy.: When the tonsils and adenoids are taken out during a tonsillectomy, the space between the mouth and the pharynx (the back of the throat) gets bigger. Since less fatty tissue is there, less of it can get in the way of your airflow and prevent you from getting a good night’s rest. Children with obstructive sleep apnea benefit the most from this surgery.
Uvulopalatopharyngoplasty (UPPP): The uvula is surgically removed during this treatment (the teardrop-shaped soft tissue that hangs at the back of your mouth). Soft tissue removal from the throat and soft palate is also a side effect. These expand the space between the mouth and the throat, allowing more air to flow through.
Jaw Surgery Several surgical techniques can be used to make small changes to the position of the jaw so that the soft palate and uvula don’t block the airway. People who have sleep apnea because of a physical problem, like micrognathia, often benefit a lot from these surgeries.
Nasal Surgery: Septoplasty is a type of nasal surgery in which the soft tissues of the nose are moved to make it easier for air to flow through the nose.

Treatments for CSA

Central sleep apnea can be helped by positive airway pressure, adaptive ventilation, and phrenic nerve stimulators, as well as some drugs. This group includes drugs that make you sleepy (hypnotics), drugs that stimulate the respiratory system, and other substances. However, none of these drugs has been officially accepted or approved for this purpose.

With sleep apnea, what foods and beverages should I avoid?

People with sleep apnea should drink less alcohol and stay away from any substances, recreational or otherwise, that make them feel very sleepy. These factors can amplify the effects of sleep apnea. Talking to your doctor about the medications that could trigger this and how to prevent it is a good first step in managing your health.

Treatment-related complications or adverse effects

There are a number of things, including the treatments themselves, that can cause problems and side effects and make them worse. The best person to ask about reducing or avoiding side effects is your healthcare provider.

Please follow the care/symptom management instructions.

The effects of sleep apnea are far-reaching, and the illness can put you at risk for serious health problems and even death (for more on this, see the prognosis and outlook section). As a result, you should not attempt self-diagnosis or self-treatment. You should see a sleep doctor or have your primary care doctor refer you to one if you suspect you have sleep apnea.

How quickly will my health improve if I begin treatment?

The time to recover or improve after sleep apnea treatment is treatment-specific. Some people will feel better almost right away, while for others, it may take three to six months of nightly treatment to feel the full benefits. If you want to know when you can expect to feel better, your doctor will have that information.

Positive airway pressure devices are the best way to treat sleep apnea, and they can have big effects very quickly. Most newer devices can change themselves to fit your needs. Older ones, especially if your sleep apnea is mild or on the low end of moderate, may need some tweaking to the settings. This is called “titration.”

Although some people may take some time to get used to sleeping with a mask on, most people have little trouble adapting to this change. A positive airway pressure device has been shown to help many people have better sleep instantly.

Sleep apnea’s potentially fatal side effects

Several serious and even fatal complications can arise from sleep apnea. Some examples of these are heart attacks and heart failure. Increased pressure on the heart’s chambers and blood vessels is one of the effects of sleep apnea. The extra pressure puts stress on the heart, and conditions like atrial fibrillation, which is marked by irregular heart rhythms, could damage the heart muscle.

Blood flow disturbances in the upper left chamber of the heart are what make atrial fibrillation such a serious arrhythmia. Because of the disturbance, blood pools and stays there for too long. If blood clots form in the heart, they can break free and go to the brain, where they can cause a stroke.

This person died of a heart attack. In extreme cases, sleep apnea can cause a heart to stop beating due to cardiac arrhythmia. SCD describes what happens when the heart suddenly stops beating.

irregular sleep patterns during the day. A lack of sleep during the day may not seem dangerous, but it might be deadly if you’re doing something you shouldn’t be. Whether at the wheel or in charge of heavy equipment, dozing off can have disastrous results.

How long does sleep Apnea continue?

Sleep apnea is a chronic disorder that lasts a long time. Some people are able to overcome it by changing their diet or getting surgery. It could be a permanent condition for some people.

Disclaimer:

This information is for educational purposes only, and no medical advice should be inferred from it. Before changing your diet or adding supplements, please talk to your doctor.

The author’s views are his or her own. The facts and opinions in the article have been taken from various articles and commentaries available in the online media and Eastside Writers does not take any responsibility or obligation for them.

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