Sleep Apnea
Most discussions of sleep apnea focus on obstructive sleep apnea (OSA) and its treatment. Sleep apneas, however, come in more than one form.
The sleeper who suffers from Obstructive Sleep Apnea (OSA) periodically struggles to breathe but is unable to inhale effectively because his or her airway has become blocked or collapsed. The sleeper whose problem is central sleep apnea (CSA) periodically doesn’t breathe at all so oxygen intake is ineffectual. In either type of sleep apnea, the lack of oxygen usually causes the patient to wake up or arouse, at least briefly. The Obstructive Sleep Apnea patient has a mechanical problem, one that almost always can be corrected by a continuous positive airway pressure (CPAP) device.
Treatment of CSA is more challenging because the signal to the body to inhale is not being transmitted from the breathing center in the brain, or not received by the body. Sleep experts report that the great majority of central apnea sufferers also experience OSA although the CSA may not be noted until the OSA is treated. In some cases, the sleeping CSA sufferer displays a periodic shallow breathing or under-breathing that alternates with deep over-breathing, a condition known as Cheyne-Stokes breathing (CSB) Estimates vary as to the frequency of central sleep apnea. Some say it accounts for 20 percent of all cases of sleep apnea.
The symptoms of central sleep apnea are for the most part the same as those of obstructive sleep apnea. They include chronic fatigue, daytime sleepiness, morning headaches and restless sleep. But if the cause is a neurological disease, the CSA sufferer may also experience difficulty swallowing, voice changes, and an overall sense of weakness and numbness. A thorough sleep study with polysomnography will show whether the lapses in breathing result from airway blockage or irregular breathe signals from the brain.
CSA frequently occurs among people who are seriously ill from other causes: chronic heart failure; diseases of and injuries to the brainstem; the upper terminus of the spine; which controls breathing; Parkinson’s Disease; stroke; kidney failure; even severe arthritis with degenerative changes to the cervical spine and base of the skull. It is also seen among users of opiates. And there is idiopathic CSA, which simply means the cause is unknown. Read more in our Source
One of the most common sleep disorders in people with sleeping difficulties is obstructive sleep apnea (OSA).
OSA is diagnosed with a test called an overnight sleep study that records the activity of the body during sleep.
A sleep study can provide doctors with important information about a person’s sleep cycle, including how often and how long their breathing pauses (called apnea).
One of the most important measurements is a person’s oxygen level during the different stages of sleep. When the level falls below what the body needs to function normally, it is called oxygen desaturation. This not only tells the doctor how severe OSA is but is also an indication of future health concerns.
What Is Obstructive Sleep Apnea?
Obstructive sleep apnea occurs when your throat muscles relax and block your airway during sleep. When this happens, breathing can stop for anywhere from 10 seconds to over a minute in some cases.1
People with OSA experience frequent, repeated pauses in breathing during sleep. Some experience hundreds of these in a night.2 And, while the person may be completely unaware of these gaps, their partner will often notice and become alarmed.
During these breathing gaps, people receive less air, which causes their blood oxygen levels to drop. While these levels will generally return to normal once regular breathing starts again, frequent breathing gaps can pose serious health concerns. This is why OSA is something you can’t ignore.
Depending on the severity of the condition, other symptoms may occur, including:
Loud snoring, snorting, gasping, or choking during sleep
Night sweats
Nocturia (nighttime urination)
Nighttime acid reflux
Dry mouth when awakening
Insomnia
Headaches
Irritability
Memory problems
Depression
Low sex drive
Weight gain
Diagnosis Sleep Apnea
Based on the findings, the doctor may recommend an overnight sleep study, also known as level 1 polysomnography or a home sleep test. Considered the gold standard for the diagnosis of OSA, the test involves connecting you to sensors that monitor your temperature, heart rate, brain waves, breathing rate and depth, nasal and mouth airflow, and body movements during sleep.1
Risk Factors
You should also suspect OSA if you have risk factors for the disorder. People of any age, sex, or weight can have OSA, but it is much more common in people who:
Are obese
Are male
Are over 50 years of age
Smoke cigarettes
Sleep on their back
Regularly use alcohol or sedatives (medications for sleep and anxiety)
Have enlarged tonsils or adenoids
Have hypothyroidism (underactive thyroid gland)
Have had a stroke
Have certain head and face features contributing to narrow upper airway”
Have a neck circumference of 17 inches or more for a male or 16 inches or more for a female
The treatment of obstructive sleep apnea varies depending on how severe the condition is.
Treatment options may include:
Weight loss
Devices to help change your sleep position
Nasal steroids if allergies are affecting breathing
Continuous positive air pressure (CPAP) therapy, a device you wear at night that delivers pressurized room air through a mask
Tonsillectomy or adenoidectomy, surgery to remove the tonsils and/or adenoids, for children with OSA
surgical removal of the fleshy part of the soft palate
Pediatric obstructive sleep apnea
Pediatric obstructive sleep apneais a sleep disorder in which your child’s breathing is partially or completely blocked repeatedly during sleep. The condition is due to narrowing or blockage of the upper airway during sleep.
There are differences between pediatric obstructive sleep apnea and adult sleep apnea. While adults usually have daytime sleepiness, children are more likely to have behavioral problems. The underlying cause in adults is often obesity, while in children the most common underlying condition is enlargement of the adenoids and tonsils.
Early diagnosis and treatment are important to prevent complications that can affect children’s growth, cognitive development and behavior.
Causes
Obesity is a common factor underlying obstructive sleep apnea in adults. But in children the most common condition leading to obstructive sleep apnea is enlarged tonsils and adenoids. However, obesity also plays a role in children. Other underlying factors can be craniofacial anomalies and neuromuscular disorders.
Risk factors
Besides obesity, other risk factors for pediatric sleep apnea include having:
Down syndrome
Abnormalities in the skull or face
Cerebral palsy
Sickle cell disease
Neuromuscular disease
History of low birth weight
Family history of obstructive sleep apnea
Complications
Pediatric obstructive sleep apnea can have serious complications, including:
Failure to grow
Heart problems
Death
