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All About Sleep Apnea,
What You Need To Know!
What is OSA
(Obstructive Sleep Apnea)?
Sleep apnea is a serious, potentially
life-threatening condition that is far more common than
generally understood. First described in 1965, sleep
apnea is a breathing disorder characterized by brief
interruptions of breathing during sleep. It owes its
name to a Greek word, apnea, meaning "want of breath."
There are two types of sleep apnea: central and
obstructive. Central sleep apnea, which is less common,
occurs when the brain fails to send the appropriate
signals to the breathing muscles to initiate
respirations. Obstructive sleep apnea is far more common
and occurs when air cannot flow into or out of the
person's nose or mouth although efforts to breathe
continue.
In a
given night, the number of involuntary breathing pauses
or "apneic events" may be as high as 20 to 60 or more
per hour. These breathing pauses are almost always
accompanied by snoring between apnea episodes, although
not everyone who snores has this condition. Sleep apnea
can also be characterized by choking sensations. The
frequent interruptions of deep, restorative sleep often
leads to excessive daytime sleepiness and may be
associated with an early morning headache.
Early
recognition and treatment of sleep apnea is important
because it may be associated with irregular heartbeat,
high blood pressure, heart attack, and stroke.
Who Gets
Sleep Apnea?
Sleep apnea
occurs in all age groups and both sexes but is more
common in men (it may be under diagnosed in women) and
possibly young African Americans. It has been estimated
that as many as 18 million Americans have sleep apnea.
Four percent of middle-aged men and 2 percent of
middle-aged women have sleep apnea along with excessive
daytime sleepiness. People most likely to have or
develop sleep apnea include those who snore loudly and
also are overweight, or have high blood pressure, or
have some physical abnormality in the nose, throat, or
other parts of the upper airway. Sleep apnea seems to
run in some families, suggesting a possible genetic
basis
What causes OSA?
Certain
mechanical and structural problems in the airway cause
the interruptions in breathing during sleep. In some
people, apnea occurs when the throat muscles and tongue
relax during sleep and partially block the opening of
the airway. When the muscles of the soft palate at the
base of the tongue and the uvula (the small fleshy
tissue hanging from the center of the back of the
throat) relax and sag, the airway becomes blocked,
making breathing labored and noisy and even stopping it
altogether.
Sleep apnea also can occur in obese people when an
excess amount of tissue in the airway causes it to be
narrowed. With a narrowed airway, the person continues
his or her efforts to breathe, but air cannot easily
flow into or out of the nose or mouth. Unknown to the
person, this results in heavy snoring, periods of no
breathing, and frequent arousals (causing abrupt changes
from deep sleep to light sleep). Ingestion of alcohol
and sleeping pills increases the frequency and duration
of breathing pauses in people with sleep apnea.
How is OSA diagnosed?
Medical History: Be prepared to give your Doctor
medical and family history. Report incidence and
frequency of any related symptoms and features,
providing a written diary if possible. Also helpful is
an audio recording to illustrate snoring patterns and
characteristics and/or bed partner interview.
Physical Examination: Your Doctor will assess upper
airway for abnormalities, assess upper body obesity and
possibly take measurements of chest/body mass as well as
neck circumference. An EKG may be ordered to display
distinct heart rhythms.
Polysomnography Testing: Your Doctor may refer
you for testing at a sleep center. These are typically
overnight procedures involving electronic monitors and
should be conducted by certified sleep study specialists
or polysomnographers. Monitors will track the frequency
and duration of apnea and hypopnea. These tests clearly
show presence or absence of sleep-apnea, and indicate
the severity of the problem. Continuously monitored
functions include air flow, respiratory effort, blood
oxygen level, snoring, and body position. Brain waves,
eye movements, and muscle activity may also be
monitored.
Multiple Sleep Latency Test: Involves machine
testing of time it takes to fall asleep while lying in a
quiet room during the daytime. For people without
sleep-disorders, this takes about 10-20 minutes. People
suffering from sleep-apnea usually take about 5 minutes.
Based on the cumulative clinical picture, your Doctor
will determine the most appropriate treatment.
How is
normal breathing restored during sleep?
During
the apneic event, the person is unable to breathe in
oxygen and to exhale carbon dioxide, resulting in low
levels of oxygen and increased levels of carbon dioxide
in the blood. The reduction in oxygen and increase in
carbon dioxide alert the brain to resume breathing and
cause an arousal.
With each
arousal, a signal is sent from the brain to the upper
airway muscles to open the airway; breathing is resumed,
often with a loud snort or gasp. Frequent arousals,
although necessary for breathing to restart, prevent the
patient from getting enough restorative, deep sleep.
What are the
symptoms of sleep apnea?
Snoring
(particularly loud snoring)
Fatigue and daytime tiredness
Difficulty concentrating
Morning headaches
Dry mouth upon waking
Excessive perspiration during sleep
Heartburn
Change in personality (moodiness, irritability)
Memory lapses
Waking up and feeling as though you haven't been to
sleep or rested
Frequent night urination (nocturia)
Confusion and grogginess in the morning
Reduced sex drive
Small jaw / thick neck
Obesity
Rapid weight gain
Excessive daytime sleepiness while working or driving
What are the
effects of sleep apnea?
Because
of the serious disturbances in their normal sleep
patterns, people with sleep apnea often feel very sleepy
during the day and their concentration and daytime
performance suffer. The consequences of sleep apnea
range from annoying to life-threatening. They include
symptoms suggesting depression, irritability, sexual
dysfunction, learning and memory difficulties, and
falling asleep while at work, on the phone, or driving.
It has been estimated that up to 50 percent of sleep
apnea patients have high blood pressure. It has recently
been shown that sleep apnea contributes to high blood
pressure. Risk for heart attack and stroke may also
increase in those with sleep apnea.
Sleep
Disordered Breathing (SDB) affects around 20% of the
adult population, making it as widespread as diabetes or
asthma. However, awareness is low and we believe that
about 90% of people who have OSA remain undiagnosed and
untreated. Along with an increasing understanding of the
morbidity and mortality caused by SDB, this discrepancy
has created one of the fastest growing segments of the
respiratory industry. Our Hybrid is positioned to meet
the growing challenges of this under-diagnosed series of
conditions with the comfort of the patient in mind.
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