Sleep Apnea


The name apnea means absence of breath and everyone has small number of these disturbances for short durations when sleeping. However Sleep Apnea can also occur frequently and for longer periods throughout the sleep cycle, disturbing your sleep and starving the body of oxygen.

Medical issues with sleep apnea

There is strong evidence that links cardiovascular disease to people with sleep apnea. The reason being after each apnea episode, the blood pressure can rise substantially and the heart rate
becomes irregular, all of which can lead to increased blood pressure during the day and eventually contribute to causing heart attacks or strokes.

There are two types of sleep apnea:

  • Obstructive sleep apnea is more common and this is where the air from the nose/mouth into the lungs is blocked by the narrowing of the windpipe and/or it being blocked by loose tissue within it.
  • Central sleep apnea is rare and this is where the signals from the brain to regulate breathing are  disrupted in some way.

Sleep Apnea can affect people at any age:

  • In young people, the narrowing of the airway is due to enlargement of the tonsils/adenoids,  deviated nasal  septum (the cartilage/bone in the inside middle of the nose), or the position and growth of the jaws.
  • Adults can also have the same structural problems as young people, but they can also develop loose soft tissue in the airways. About 2-4% of the adultsare affected but is more common in middle-aged people that snore and are overweight (especially those who carry fat around the neck). It is more common in males than females; however it becomes more common in females after menopause.

Symptoms of Sleep Apnea

a) What is usually noticed by the partner

  1. Loud snoring;
  2. Restless sleep;
  3. Breathing pauses of 10 seconds to minutes;
  4. Each pause ends with very deep gasping or snoring.

 b) Sleep Apnea person

  1. They can be awoken gasping for air;
  2. The disturbed sleep pattern and lack of oxygen causes drowsiness and a feeling of being hung over during the day, and so can easily lead to falling asleep during the day (especially in passive situations)
  3. Finding it difficult to concentrate or function at work
  4. lncreased frequency of urinating at night, impotency, personality changes, irritability, short term memory loss, increased lack of interest in life and family.

 

Diagnosis of sleep apnea

This is based on symptoms provided by the partner and the person themselves. Sleep studies are required to confirm sleep apnea and are usually performed via an overnight stay in hospital in a monitored environment. This will determine its extent and if any sleep apnea management has achieved the desired results.

Management of sleep apnea

Preventive Measures

  1. Reduce weight (if overweight) and exercise regularly
  2. Reduce alcohol intake (alcohol relaxes the muscles and can block the air passages)
  3. Sleeping tablets should be avoided (as they can reduce the drive to breathe)
  4. Have regular sleeping patterns, as sleep deprivation makes it worse
  5. Avoid caffeine and eating late at night, as this can disrupt sleeping patterns

Conservative Measures

  1. There are various dental appliances to help move the lower jaw forward to increase the airway space
  2. CPAP machines which pump in air at positive pressure to keep the tissue from collapsing in and blocking the airway

Surgical Measures

Surgical treatment for sleep apnea can consist of:

  1. Removal of any enlarged tissue which reduces the air movement e.g. adenoids/ tonsils, soft palate reduction;
  2. Improve the air flow by straightening a deviated nasal septum, removal of the uvula etc;
  3. Create larger airway passages by widening the internal nasal passage, repositioning the lower jaw forward and also possibly the upper jaw.

It must be realised that not all of these approaches are required and your doctor will explain each one to you and which one would be most beneficial to you.

 

Remember at times it may not be possible to achieve the desired results no matter what course of treatment is undertaken.