Sleep Apnea - Getting Diagnosis
One of the most common sleep disorders is sleep apnea but what is sleep apnea? This is a chronic condition where an individual has pauses in breathing or has abnormally low breathing during sleep. The pauses are called apnea and can last from a few seconds to several minutes. They can occur 5-30 times or more per hour. When normal breathing restarts again, there will sometimes be a loud snort or choking sound. This article is the part II of my insomnia article, as someone personally requested this topic.
African Americans, Hispanics and Pacific Islanders more commonly develop this condition than Caucasians. A family history is another important risk factor.
What Happens When Breathing Stops?
Sleep apnea is typically a chronic condition that disrupts your sleep. Of course, the result is poor quality sleep, which of course makes you tired during the day and is the leading cause of excessive daytime sleepiness. Sleep apnea often goes undiagnosed. It really isn’t a condition that can be diagnosed in a routine visit with the doctor. If a doctor suspects you have sleep apnea, he will order a sleep test.
There is more than one type of sleep apnea with obstructive sleep apnea (OSA) being the most common. This means the airway is blocked or collapsed in someway during sleep which may cause very shallow breathing or pauses. As your body is trying to breathe any air that squeezes by may cause loud snoring. When you stop breathing and your blood oxygen level gets too low, the stress hormones kick in. They raise your heart rated and blood pressure. Over time they can increase your risk of heart attacks or strokes.
Anatomy of Airway When Asleep
Sleep Apnea Treatment
Sleep Apnea Types
Obstructive sleep apnea is more common for people who smoke, drink alcohol or who are overweight, but it can happen to anyone. It most commonly happens to men between the ages of 30 and 50. However, it can happen to a small child with large tonsils and adenoids, or if they are very obese. Roughly 4-9% of sleep apnea sufferers are middle-aged men, 2-4% are middle aged women and 80-90% are never diagnosed. One half of people with obstructive sleep apnea are obese. Other reasons for sleep apnea are an individual who has a larger tongue and tonsils. In contrast, a small framed person will also have a smaller mouth and throat, causing sleep apnea symptoms.
Central sleep apnea is a less common form of sleep apnea which is caused when the area of your brain that controls breathing doesn’t send the correct nerve signals to your breathing muscles. In this case the body makes no effort to breath. This type of apnea can happen to anyone but is usually associated with individuals over age 65. Approximately 10% of sleep apnea sufferers have this type..
Sleep Apnea Symptoms
Sleep apnea symptoms including both types:
- Restless sleep
- Daytime sleepiness
- Poor memory and concentration
- Headache in the morning
- Loud snoring
- Change in personality
- Frequent urination during the night
Sleep apnea is diagnosed by a test called polynomnography which is a diagnosed
Components of Sleep Testing
Physiologic sensors leads are placed on the patient to record several items:
- Brain electrical activity
- Eye and jaw muscle movement
- Leg muscle movement
- Respiratory effort (chest and abdominal excursion)
- Oxygen saturation
All the information is placed in a computer which puts out a series of waveform tracings which tell the technician to visualize the various waveforms, assign a score for the test which will assist in the diagnostic process.
Physiologic Variables measured and recorded (as done per the KUMC Sleep Disorders Center protocols). Electrical activity of the brain is recorded which tells the technician what stage of sleep the patient is in during any given period of the night.
Patient with CPAP Mask
Sleep Apnea and CPAP
Risks of Sleep Apnea
Untreated sleep apnea is dangerous and untreated in can increase the risk of high blood pressure, heart attack, stroke diabetes obesity and worsen heart failure. Irregular heat beats are more likely and the chance of having work related or car accidents is increased,
Sleep apnea is treated by with lifestyle changes and/or sleep appliances. For overweight patients even a loss of 5% weight loss can help and patients should avoid evening alcohol. Oxygen is used with patients that have central sleep apnea. There is no medication available to treat sleep apnea.
Cpap Treatment or Surgery
Cpap sleep apnea is the most common treatment which is a Continuous Positive Airway Pressure (CPAP) appliance which is a nose mask that blows air applying pressure from an air blower forcing air through the nasal passage worn during sleep to prevent airway collapse. The air pressure is applied continuously so there is just enough pressure to prevent collapse of the airway. This is generally effective, but many patients dislike wearing them.
Some of the side effects that may occur are nasal irritation and drying, facial skin irritation, abdominal bloating, mask leaks, sore eyes, and headaches. There are some dental appliances which are sometimes helpful to reposition the lower jaw and tongue.
There are some types of surgery that are tried in some cases which might involve removal of tonsils, adenoids or part of the uvula. Sometimes there are repairs of bone or tissue but there are risks and sometimes it takes more than one surgical procedure.
I hope this hub has answered your questions about sleep apnea. It is a serious, chronic disease, and it is important to get diagnosed, to know what the symptoms are and what type of treatment is available. Considering the number of people who are undiagnosed, it is important to pay attention to the people in your life so if you notice the listed symptoms you can get some medical attention to treat the problem.
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