Sleep Apnea

We all know the importance of a good nights sleep. It helps us to feel alive, awake, and on the ball the following morning. Compared to the nights we sleep very little, or didn't sleep so deeply, we feel sluggish, run down, and it generally affects the whole of a person's day in a negative way.

Whilst their may be many different reasons for poor quality of sleep, for some people it is a disorder called Sleep Apnea. When a person has sleep apnea, they suffer reoccurring suspensions of breathing during sleep.

Sleep apnea comes in three forms:

OSA (Obstructive Sleep Apnea): This form of sleep apnea is the most common, and is caused by an obstruction to the airways within the nose or mouth, even though the abdominal and throat breathing mechanisms continue trying to draw oxygen in. This eventually causes the person to wake up gasping for air before going back to sleep, where the same thing usually happens again multiples times throughout the night, whether the person is fully aware of this or not. Snoring is another symptom of Obstructive Sleep Apnea.

CSA (Central Sleep Apnea): This form of sleep apnea is far less common than Obstructive Sleep Apnea, and isn't about obstructions within the airways, but an actual problem with brain signals. What happens is the signal which is sent from the brain to the body to breathe is delayed, therefore the bodies' entire breathing mechanisms cease causing a person to stop breathing for a few seconds, or the breathing becomes too shallow to supply the body with oxygen. People who have Central Sleep Apnea are much more likely to have an irregular heartbeat and high blood pressure, which also increase the risks of strokes and heart attacks.

MSA (Mixed Sleep Apnea): This form of sleep apnea is a combination of the two aforementioned.

Symptoms of Sleep Apnea

Because all of this occurs in a half-sleep state, a person may awake completely unaware they suffered any breathing difficulty during sleep. Often it is the partner of the sufferer who notices the repeated stoppages in breathing and sudden gasps for breath.

Upon waking, a person may experience a multitude of symptoms which indicate they have suffered from sleep apnea. Much of the symptoms are related to the lack of oxygen you were supplied with whilst asleep. Some of these symptoms include:

• Headaches

• Weight gain

• Irritability

• Lethargy

• Drowsiness

• Still feeling tired when you've woken up and washed, which is usually the time you start to feel refreshed and ready for the day ahead

• Depression

• A general feeling of been ‘out of it' during the day

Diagnosis and Treatment for Sleep Apnea

Sleep apnea is not only a problem which affects the individual suffering from it, but repeated awakenings and disturbances can also interrupt your partners sleep, so the sooner sleep apnea is diagnosed and treated the better for everybody. Because of this, a sufferer may be able to persuade their partner to monitor their sleep, making notes such as disturbance times, snoring volume, and if you responded to conversation to test whether or not you were actually awake. Having a tape recorder capture some of these disturbances may also be useful. Another way to do this is to arrange an appointment with your doctor who will be able to admit you to a professional sleep clinic for a night for thorough observation and diagnosis.

The method of treatment depends completely on the severity of the sleep apnea, and of course the type of sleep apnea. There are different treatments for sleep apnea which generally come under the umbrella of 4 different treatments. These are:

• Behavioural / Lifestyle Changes

• Surgery

• Medication

• Physical / Mechanical Therapy

In the case of OSA (Obstructive Sleep Apnea), a person may be able to make one or many ‘Behavioural / Lifestyle Changes' to combat sleep apnea. Some of these may include:

• Losing weight: This is one of the most effective ways to combat sleep apnea. By losing weight you reduce the amount of fatty cells in your throat tissue, thereby allowing the oxygen to flow more freely through your airways.

• Avoid alcohol / sedative consummation before bedtime: Alcohol and sleeping pills can cause the upper airways to relax excessively, making it harder to breath. By not consuming alcohol / sedatives before bed, you avoid this happening.

• Stopping smoking: Smoking inflames the upper airways, thus making it harder to breath. By stopping smoking and giving your throat time to repair itself, you will find it easier to breath, particularly during sleep.

• Sleep on your side: When a person sleeps on their back, their airways are at their most narrow as the tissues inside the throat tend to collapse from the front of the throat downwards. By sleeping on you side this doesn't happen so much.

• Don't use a pillow: Pillows bend the neck upwards, whilst the rest of the body generally sinks downward into the mattress. Matters can be even worse for people who use multiple pillows, as not only will the neck be bent, but the chest also, resulting in an almost ‘sit-up' position, which can make it even harder to draw breath.

• Have regular sleeping hours: By having a regular sleeping routine your body clock will be set, therefore your sleep in general will be much better.

In the Physical / Mechanical therapy category, there are a further 4 subcategories, which are:

• (CPAP) Continuous Positive Airway Pressure: This is one of the most common and most effective treatments for sleep apnea, but due to the uncomfortable and somewhat impractical nature of the apparatus used, is often be spurned or abandoned by sleep apnea sufferers. In this treatment, a mask is worn and keeps a continual flow of air into the airways, thus preventing them from closing up.

• Surgery: In the case of OSA (Obstructive Sleep Apnea), the source(s) of obstruction will be located, and then using various surgical techniques, will either be removed, reconstructed, or reduced. The overall aim of surgery is to create better uninhibited airways. Surgery can be risky, and there is the possibility sleep apnea may be made worse by surgery.

• Dental / Jaw Alteration Devices: Certain devices may be ‘fitted' permanently, or are to be worn only during sleep. Such devices may include a TRD (Tongue Retaining Device) which prevents the tongue flopping back over the airways during sleep. Another device is a MRD (Mandibular (Jaw) Repositioning Device) which works by keeping the jaw jutting forward, thus keeping the tongue forward also and opening up the airways more. One downside to this is over time a persons jaw may become damaged or permanently reset. Depending on the device – and there are many – there are also many other pitfalls such as tooth damage and jaw pain. Due to the oral nature of these devices, a dentist may be the one appointed to fit or advise upon the usage of these devices.

• Oxygen Administration: Oxygen administration can ensure a person suffering from sleep apnea at least has enough oxygen kept in their system, eliminating one factor of sleep apnea, but it does absolutely nothing to tackle any of the root causes of apnea. A person taking oxygen will still suffer disruptive sleep symptoms as well as the symptoms of lack of sleep when they awaken regardless.

What other disorders can sleep apnea cause?

Untreated sleep apnea not only makes for a rough day and the usual effects of having been deprived of good sleep and oxygen, but there are other health issues – some extremely severe – which can arise from sleep apnea. Some of these health issues might be:

• Heartburn

• Headaches

• Insomnia

• High Blood Pressure

• Type 2 Diabetes

• Hypertension

• Increased risk of stroke

• Heart attack

• Heart Disease

• Heart Failure

• Irregular Heart Beat

• Obesity

• Sexual Dysfunction

• Hypercapnia

• Premature Death

Sleep apnea (particularly Obstructive Sleep Apnea) is relatively common in varying degrees, but to the people who are worst affected it can become an absolute nightmare. Not only is it bad enough been unable to sleep well and still having to get on with your day regardless and the hazards this creates, but the risk of other illnesses which are directly or indirectly related to sleep apnea make this an extremely serious disorder. Not only this, but the constant disturbances to any partners who share your bed can have an immensely negative impact upon them two, putting them at increased risk of accidents due to tiredness. If you have experienced any of the symptoms mentioned in this article, or your partner has informed you that they have witnessed you experience some of the symptoms during your sleep to the point it is becoming a recurring problem, you should maybe think of consulting your G.P. for a firm diagnosis. Upon diagnosis you will then be instructed on the best ways to tackle your sleep apnea so both you and your partner can begin to have a good nights sleep.