Obstructive Sleep Apnea

What Causes Sleep Apnea?

It is like sucking on a wet straw. The harder you pull, the more it collapses. Muscles are relaxed more during sleep, therefore, in people with narrow upper airways this relaxation can close off the air flow. This may occur in the lower part of the throat or tongue falling back. Remember the snorer does not realize this, as he/she is asleep. People with sleep apnea do not breathe properly during sleep and do not get enough oxygen in their circulation and have poor quality of sleep. This may contribute to the following complications:

Symptoms of Obstructive Sleep Apnea:

Complications of Obstructive Sleep Apnea (OSA):

Treatment Alternatives For Obstructive Sleep Apnea:

Continuous Positive Airway Pressure (CPAP)

Dental Appliances

What is Sleep Apnea?

Sleep apnea is a serious, potentially life-threating condition that is far more common than generally understood. First described in 1965, sleep apnea is a breathing disorder characterized by brief interruptions of breathing during sleep. It owes it's name to Greek word, apnea, meaning "want of breath". There are two types of sleep apnea, which is less common, occurs when the brain fails to send the appropriate signals to the breathing muscles to initiate respirations. Obrstructive sleep apnea is far more common abd occurs when air cannot flow into or out of the person's nose. Or mouth although efforts to breathe continue.

In a given night, the number of involuntary breathing pauses or "apneic events" may be as high as 20 to 30 or more per hour. These breathing pauses are almost always accompained by snoring between apnea episodes, although not everyone snores has this condition. Sleep apnea can aslo be characterized by choking sensations. The frequent interruptions of deep, restoratives sleep often to lead to early morning headaches and excessive daytime sleepiness.

Early recognition and treatment of sleep apnea is important because it may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke.

Who Gets Sleep Apnea?

Sleep apnea occurs in all age groups and both sexes but is more common in men (it may be under diagnosed in women) and possibly young African Americans. It has been estimated that as many as 18 million Americans have sleep apnea. Four percent of middle-aged men and two percent of women have sleep apnea along with excessive day time sleepiness. People most likely to have or develop sleep apnea include those who snore loudly and also are overweight, or have high blood pressure, or have some physical abnormality in the nose, throat, or other parts of the upper airway. Sleep apnea seems to run in families, suggesting as possible genetic basis.

What Causes Sleep Apnea?

Certain mechanical and structural problems in the airway cause the interruptions in the breathing during sleep. In some people, apnea occurs when the throat muscles and tongue relax during sleep and partially block the opening of the airway. When the muscles of the soft palate at the base of tongue and the uvula (the small fleshy tissue hanging from the center of the back of the throat) relax and sag, the airway becomes blocked, making breathing labored and noisy and even stopping it all together. Sleep apnea can also occur in obese people when an excess amount of tissue is in the airway causes it to be narrowed. With a narrowed airway the person continues his or her efforts to breathe, but air cannot easily flow into or out of the nose or mouth. Unknown to the person, this result in heavy snoring, periods of no breathing, and frequent arousals (causing abrupt changes from deep sleep to light sleep). Indigestion of alcohol and sleeping pills increases the frequency and duration of breathing pauses in people with sleep apnea.

What Are The Effects of Sleep Apnea?

Because of the serious disturbances in the normal sleep patterns, people with sleep apnea often feel very sleepy during the day and their concentration and daytime performance suffer. The consequences of sleep apnea range from annoying to life threatening. They include depression, irritability, sexual dysfunction, learning and memory diffuclties, and falling asleep while at work, on the phone, or driving. It has been estimated that up to 50% of sleep apnea patients have high blood pressure. Although it is not known with certainty if there is a cause and effect relationship, it appears that sleep apnea contributes to high blood pressure. Risk for heart attack and stroke may also increase in those with sleep apnea. In addition, sleep apnea is sometimes implicated in sudden infant death syndrome.

When Should Sleep Apnea Be Suspected?

For many sleep apnea patients, their spouses are the first ones to suspect that something is wrong, usually from their heavy snoring and apparent struggle to breathe. Coworkers or friends of the sleep apnea victim may notice that the individual falls asleep during the day at inappropriate times (such as while driving a car, working, or talking). The patient often does not know he or she has a problem and may not believe it when told. It is important that the person see a doctor for evaluation of the sleep problem.

How Is Sleep Apnea Diagnosed?

In addition to the primary care physician, otolaryngologists, pulmonologists, neurologists, or other physicians with specialty training in sleep disorders may be involved in making a definitive diagnosis and initiating treatment. Diagnosis of sleep apnea is not simple because there can be many different reasons for disturbed sleep. Several tests are necessary tp properly evaluate a person for sleep apnea.