If you or your loved one has sleep apnea, you may be wondering what that means. Find out all about sleep apnea or get some quick answers here
What is Obstructive Sleep Apnea?
Obstructive Sleep Apnea (OSA) occurs when your airway temporarily collapses during sleep. You continue to make efforts to breath but are unable to move air in and out of your lungs because of the obstruction at the back of your throat. During the collapse, which can last from 10 seconds to over a minute, your breathing muscles continue to work with a progressive effort until you awaken and resume normal breathing. After a few breaths, your oxygen levels return to normal. You fall back to sleep and the airway obstruction occurs again. This cycle may continue throughout the night, disrupting your normal sleep pattern. As a result, you may complain of un-refreshing sleep and excessive daytime sleepiness.” Visit our page on What is Sleep Apnea for more information.
What is the cycle of OSA?
The cycle of OSA starts with snoring and continues until the airway collapses or closes off. The person tries to breathe but is unable to get air into their lungs through the collapsed airway and an apnea (cessation of breathing) occurs. The brain realizes that it is not getting enough oxygen and fresh air so it wakes the person from a deep level, to a lighter level, of sleep. The airway then opens and normal breathing resumes. The person falls back into a deeper sleep, begins snoring again and the cycle repeats.
What causes the airway to collapse during sleep?
- Extra tissue in the back of the airway such as large tonsils
- Decrease in the tone of the muscles holding the airway open
- The tongue falling back and closing off the airway
- Abnormal anatomy such as a recessed jaw
How common is sleep apnea?
- 1 in 15 people have moderate to severe OSA (Young et al. JAMA 2004
- 9% women and 25% men in the middle-aged working population have OSA (Marshall et al. Sleep 2008)
- Sleep apnea is as common as diabetes and asthma.
- Most OSA sufferers remain undiagnosed and untreated.
- 50% of patients with Type II Diabetes have OSA
- 35% of patients with high blood pressure have OSA 6
Common Signs and Symptoms
For many sleep apnea patients, it is usually their partner or family members that suspect something is wrong. They may complain about their snoring and apparent struggle to breath at night. The typical sleep apnea patient may have the following symptoms:
- Excessive daytime sleepiness (EDS)
- Loud irregular snoring
- Witnessed apneic or choking periods
- Morning headaches
- Frequent awakenings during the night
- Rapid onset of sleep
- Leg cramping
- Falling asleep while driving
What happens if OSA is not treated
The consequences of sleep apnea range from both annoying to life threatening. Symptoms range from depression, irritability, sexual dysfunction, increased weight gain to learning and memory difficulties. You may find yourself falling asleep at work, on the phone or even while driving. In fact, untreated sleep apnea patients are 3 times more likely to have automobile accidents. OSA has also been strongly associated with several cardiovascular disorders such as high blood pressure, cardiac dysrhythmias, strokes and congestive heart failure.
How is obstructive sleep apnea diagnosed?
The following tests may be ordered by your family physician, Respirologist or Sleep Specialist to help evaluate you for obstructive sleep apnea: Overnight oximetry testing is the most common form of screening for sleep apnea. This includes a probe worn on your finger while you sleep that measures your blood oxygen levels and heart rate. Repeat overnight oximetry tests may be required to ensure adequate treatment with the CPAP machine. Overnight oximetry testing is provided free of charge through Coastal Sleep Homecare. Sleep Surveys including the common Epworth Sleepiness Scale or Berlin Score are common assessment tools to help medical professionals gauge your daytime sleepiness and treatment improvement. Sleep surveys are performed during the sleep disorder program. Polysomnography is a test done at a sleep lab that records a variety of body functions during sleep, such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow and blood oxygen levels. This test is considered the “Gold Standard” to diagnose sleep apnea and to determine its severity. (Some extended health care companies require a polysomnography test for medical coverage.)
What is the treatment for sleep apnea?
Sleep apnea, like many other disorders comes in varying degrees of severity and occurs for various reasons. To effectively treat all patients with sleep apnea there are many different therapeutic options. These include:
- Lifestyle changes
- Body positioning
- Dental appliances
- Continuous Positive Airway Pressure (CPAP)
LIFESTYLE CHANGE Many of the lifestyle changes that improve OSA will also improve one’s overall health. Lifestyle changes are often the hardest things to accomplish, but perseverance can make a dramatic improvement in people with OSA. Regardless of the final treatment or treatments chosen, the items described below are worthwhile goals.
OBESITY Obstructive sleep apnea is often associated with obesity. Overweight individuals often have respiratory problems due to thick chest walls and increased compression on the diaphragm from abdominal contents. The thick neck often seen in obesity also increases airway resistance. Weight loss, even in small amounts, can therefore have a profound effect on improving sleep apnea.
ALCOHOL Alcohol when consumed in excess can exacerbate snoring and OSA. The muscles of the upper airway have been shown to loose muscle tone after consumption of even a small amount of alcohol. Individuals with sleep apnea should avoid alcohol 4-6 hours before bedtime. interested in quitting smoking, talk to your family physician or one of our respiratory therapists.
MEDICATIONS As with alcohol, certain medications like narcotic pain relievers and barbituates often worsen OSA. Talk with your physician to decide if you are currently taking any medications that should be avoided.
What can I do for my Sleep Apnea?
SLEEP HYGIENE: The following is a brief list of general tips to promoting a better night’s sleep:
- Establish a regular routine that includes going to bed and getting up at the same time every day, even on weekends. Regular sleep is key to better health overall.
- Do not nap during the day as this results in poor sleep at night.
- Go to bed when you are sleepy. If you have difficulty falling asleep or wake up shortly after going to sleep, leave the bedroom and read quietly or do some other relaxing activity. Avoid overly bright lights as this can cue your wake cycle.
- Develop sleep rituals before going to bed. Do the same things in the same order before going to bed to cue your body to slow down and relax.
- Avoid stress and worries at bedtime. Address tomorrow’s activities, concerns, or distractions earlier in the day. Certain activities, such as listening to soft music, reading, or taking a warm bath, can help you wind down.
- Use your bed for sleeping only. Often, doing other activities in bed like watching TV, paying bills, or working only serve to initiate worries and concerns. Let your mind associate the bed with sleeping and relaxing.
- Avoid heavy meals late in the evening; similarly, avoid going to bed hungry. A light snack, especially dairy foods, can help you sleep.
- Reduce your intake of caffeine and nicotine 4-6 hours before going to sleep. Stimulants interfere with your ability to fall asleep and progress into deep sleep.
- Exercise regularly. Regular exercise, even for 20 minutes, 3 times a week, promotes deep sleep. Avoid exercise in the evening within 3 hours of bedtime.
- Don’t nap for more than 30 minutes or after 3 p.m. Avoiding naps all together will ensure that you are tired at night. Longer naps disrupt the body’s ability to stay asleep.
- Maintain a dark, quiet, and cool room for sleep.
What should I do about body positioning?
Snoring and OSA are usually worse when you sleep on your back. This is because gravity promotes collapse of the soft palate and the tongue, especially during deep sleep when the muscles are most relaxed. There are several body positioning strategies that can help you if you have mild apnea only when lying on your back. Some patients sew a tennis ball or marble into the back of their pajamas to train themselves to sleep on their sides. Another technique is to use positional pillows to assist you in sleeping on your side. For some patients who are very overweight, sleeping with their torso elevated 30 degrees relieves the pressure on the diaphragm (from the abdomen) and improves patency of the upper airway. Positional techniques have their limits, but many have been tried with success.
What are dental appliances?
A dental appliance is a special mouthpiece fashioned by a dentist to fit your teeth and jaw. Dental appliances work by pulling the jaw and tongue forward in order to open the air passage while you sleep. There are various different kinds of dental appliances, which claim to be effective. Consult with your physician or a dentist experienced in the use of these devices before trying one. People do have issues with sore jaw muscles and ineffective treatment depending on the patient’s severity.
Is there a surgical option?
Surgical intervention is generally regarded as a fairly extreme form of treatment. If you have been diagnosed with OSA and are considering surgery, talk to a sleep specialist and/or experienced surgeon about the different procedures. Discuss with him/her the chances that surgery will be effective for you with your anatomy and the risks involved with the surgery. Success rates with surgical procedures to treat OSA vary depending on the individual and the type of surgery.
What is CPAP therapy?
CPAP, which stands for Continuous Positive Airway Pressure is a specific pressure-generating machine that provides air pressure to a mask worn on your nose or mouth. The pressure generated within this mask is applied to your airways and lungs. This applied pressure acts like a splint, keeping the airway patent and free of snoring and obstruction. CPAP is 99% effective when used appropriately and is considered the GOLD STANDARD.
We are happy to help you and provide you with more information about our sleep products and services. We can schedule an appointment for you or get you set up with a free CPAP trial. You can contact us by calling us at 1-877-241-9066 or sending us an email. We’d love to hear from you and get your sleep back on track.