One medical condition that is being diagnosed more frequently is sleep apnea. This is probably because doctors and the public are becoming more aware of the problem. It is estimated to affect about 18 million Americans and it is seen more often in men and people who are over 40 years old, but it can affect anyone at any age.
People who have sleep apnea stop breathing while they are sleeping. These periods of not breathing can last for 10 to 30 seconds at a time and can happen up to 400 times every night. With each episode the individual’s sleep is disrupted. Sufferers may not remember waking up from sleep, but the periods of not breathing are enough to keep them from getting adequate rest.
There are two kinds of sleep apnea: obstructive apnea and central apnea. Obstructive sleep apnea is the most common, occurring in 90% of people with sleep apnea. In obstructive apnea, something is blocking the breathing passage and airflow. It might be the tongue, tonsils, fatty tissue in the throat, relaxed throat muscles, or the uvula. Individuals who are overweight or have a large neck size are more likely to have obstruction.
Central sleep apnea is rare. This type of sleep apnea is related to the function of the central nervous system. In this type of apnea, the muscles used to breathe don’t get the “go-ahead” signal from the brain. Either the brain doesn’t send the signal, or the signal gets interrupted.
Because some of the symptoms of sleep apnea occur during sleep, the bed partner may notice it first. There may be heavy snoring or long pauses in the breathing during sleep. Sufferers will notice excessive daytime sleepiness (such as falling asleep at work or while driving), irritability or fatigue. Other symptoms include morning headaches, forgetfulness and mood changes.
Sleep apnea can cause serious problems if it isn’t treated. Over time there may be an elevation of blood pressure along with an increased risk of heart disease and stroke. It also increases the chance of having traffic accidents while driving due to drowsiness.
Diagnosing sleep apnea starts by identifying the above mentioned symptoms (snoring, excessive daytime drowsiness, etc). A sleep study can then be performed to identify specific disruptions in the individual’s sleep. The individual is monitored during sleep for periods of apnea and obstruction, arousals from sleep, and drops in oxygen level. Appropriate treatment can then be recommended based on the findings.
A common treatment for sleep apnea is called “continuous positive airway pressure,” or CPAP. A special mask is worn over the nose and mouth while the individual sleeps. This mask keeps the airway open by adding pressure to the air that’s breathed in during sleep. Certain dental devices can also be used to treat mild cases of obstructive sleep apnea. These devices move the jaw forward to make breathing easier. In very few cases, surgery is necessary to remove tonsils or extra tissue from the throat.
There are also some general recommendations to help those who have sleep apnea to sleep better. If you smoke, quit smoking. If you are overweight, lose weight. Avoid the use of alcohol or sleep medicines at bedtime. These tend to relax the muscles in the back of your throat, making it harder for you to breathe. Sleeping on your side instead of on your back may help as well.
The content in this column is for informational purposes only. Consult your physician for appropriate individual treatment. Dr. Reynolds practices Family Medicine in Chesterfield.
