Tired all day? Accident Prone? Get Checked for Sleep Apnea!
Sleep apnea is a serious and widespread breathing disorder that affects over 12 million Americans, according to the National Institute of Health. It is characterized by abnormal pauses in breathing that occur during sleep. Although we all have some pauses in breathing during sleep, a pause is considered abnormal when it lasts for 10 seconds or longer, or when it recurs more than five times in an hour.
Untreated, sleep apnea can lead to considerable problems -- and sadly, sleep apnea often goes untreated. Because of the low levels of oxygen in their system, victims of sleep apnea often do not achieve quality sleep.
Sleep apnea also often causes its victims to wake periodically throughout the night in order to resume normal breathing. Not only do patients with sleep apnea not remember these waking periods, but because the disorder gradually worsens, they often do not notice the increasing effect it has on their lives. It can leave them feeling tired and groggy during the day. They may also experience problems such as memory loss, and difficulty concentrating, elevated blood pressure, weight gain, and increased accidents.
It is generally agreed that there are three types of sleep apnea, defined according to their distinct causes.
Obstructive sleep apnea (OSA): OSA is the most common type of sleep apnea. While efforts to breathe continue, the airway is blocked by the soft tissues in the back of the palate and the pharynx.
Central sleep apnea: In central sleep apnea, the problem stems not from a blocked air passage, but from the brains failure to signal the muscles involved in respiration.
Mixed sleep apnea: Mixed sleep apnea combines the problems of both obstructive and central sleep apnea.
How do I know if I have sleep apnea?
Because sleep apnea causes its victims to wake up throughout the night, signs of sleep apnea include chronic fatigue, problems with memory and concentration, blood pressure, weight gain, diminished sex drive, inability to achieve an erection, depression, and increased risk of accidents.
What factors may increase my risk of developing sleep apnea?
There are several risk factors for sleep apnea that you should be aware of. The most significant factor in adults is being overweight. This may be due to fat deposits forming in the airway, making it smaller and more difficult to breathe through. Some studies indicate that the airway is shaped differently in overweight individuals.
Another common risk factor is snoring. You may snore without having sleep apnea, but most victims of sleep apnea do snore.
Another risk factor is being male. A study at the University of Wisconsin found that 4 percent of adult men in the U.S. have sleep apnea, while only 2 percent of women are victims.
Sleep apnea tends to be more common among people over the age of 40, although it does occur in children as well. In children, the central risk factor is not being overweight, but having large tonsils. Some people are born with a nose or throat structure that lends itself to this problem.
If you think that you or someone that you know may have sleep apnea, it is important that you arrange a visit with a doctor as quickly as possible. If your doctor does not have experience with sleep related problems, you may ask to be referred to an otolaryngologist, pulmonologist, or sleep disorder expert.
How is sleep apnea diagnosed?
Unfortunately, sleep apnea often goes undiagnosed and may be particularly overlooked in women because it is thought of as a man's problem.
Diagnosis begins with a physical exam and review of your medical history. If these exams reveal a likelihood of sleep apnea, you will need to undergo an overnight study for a night or two at a sleep laboratory. Several tests may be performed concurrently.
How is sleep apnea treated?
There are several treatments for sleep apnea. Each treatment is specially designed with the individual patient's needs in mind.
Weight loss: In some mild cases of OSA, weight loss is the only treatment necessary for a complete reversal of symptoms. Other simple changes in behavior can also decrease the likelihood of problems with apnea. Some patients benefit from discontinuing use of alcohol, tobacco, and sleeping pills. Changes in the sleeping position may also be helpful. However, weight loss and other behavioral changes most often must be combined with other treatments.
Nasal Continuous Airway Pressure (CPAP): CPAP is the most reliable treatment in many cases, and it is often the first treatment tried. This device is something like a facemask that creates a constant stream of air in the nasal passage. The device keeps the airway open during sleep so that breathing is not interrupted. It takes some getting used to, and some patients find that they are never comfortable enough with it to sleep soundly.
Bilevel positive airway pressure (BiPAP): Another option is BiPAP, which, instead of delivering constant pressure, varies the pressure that keeps the airway open, providing just the level of pressure that is necessary during inhaling and exhaling (higher pressure is needed on inhalation than on exhalation) to keep the passages open. One drawback to this treatment is that Bi-level pressure devices are more expensive than regular CPAP devices.
Dental appliances: Another noninvasive treatment is a dental appliance, particularly useful when the cause of the problem is retrogrognathia, a receding jaw, or an obstructive tongue. Some mouth pieces move the jaw forward, while others keep the tongue in a downward, forward position so that the airway behind the tongue remains open.
Surgery: When noninvasive treatments are ineffective, surgery may be used. There are two common types of surgery used to correct sleep apnea problems: uvulopalatalpharyngoplasty (UPPP) and maxillofacial surgery.
Uvulopathatopharyngoplasty (UPPP, UP3): This surgery is used to treat OSA by correcting the soft tissue. The surgeon surgically removes tissue, reducing tightening up the tissue in the airway, thereby reducing the risk of obstruction.
Lasers: Recently, surgery to reduce the tissue in the palate and the pharynx has begun to be performed with lasers. At this point, there is little data about its effectiveness over traditional surgery. But the laser surgery is appealing to some patients because it is performed as an outpatient procedure.
Maxillofacial surgery: Other surgical procedures bring the jaw forward and reduce the size of the cheek bones to facilitate breathing.
Tracheostomy: In extreme and extremely rare, life threatening cases of sleep apnea, trachesostomy is performed. A small hole is created in the windpipe and a tube is placed in the opening. This tube is opened during sleep so that air can enter directly into the lungs.
The information on this web site is only intended as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed, nor as a guarantee of the results. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.