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Know everything about obstructive sleep apnea - Causes, Symptoms & Treatment

Updated: Sep 15, 2021

SLEEP APNEA

Apnea refers to shortness of breath. Sleep apnea is a disorder where one experiences disturbances in breathing during their sleep.


What causes Sleep apnea?

  • Obesity- Most cases of sleep apnea are due to obesity. Fat deposition in the neck can obstruct the airway.

  • Smoking – Cigarette smoking can affect the sleep cycle and cause inflammation of the upper airway muscle.

  • Medical Conditions- People with hypothyroidism, diabetes, hypertension, Polycystic Ovary Syndrome are prone to sleep apnea.

  • Hereditary- People with a family history of sleep apnea have more chances of being diagnosed with it. Research shows that 40% of sleep apnea cases are due to genetics.

  • Age- People over the age of 50 are more prone to sleep apnea. It can also affect kids with enlarged tonsils and adenoids.

What are the symptoms of Sleep apnea?

  • Snoring

  • Tiredness during the day

  • Dry mouth as the patient tend to breathe through their mouth.

  • Mood swings

  • Depression and anxiety

  • Frequent headaches


What are the types of sleep apnea?


Obstructive sleep apnea:


This is the most common type. The throat muscles relaxes and obstructs the airway for a couple of seconds. This lowers the amount of oxygen in the blood and alerts the brain to supply oxygen. When breathing resumes, the size of the airway remains reduced in size. The tissues surrounding this narrow airway vibrate which causes snoring. This affects the patient’s quality of sleep, which is why they experience tiredness during the day.


Central sleep apnea

This occurs when the brain does not send signals for the muscles to take in air for breathing. This can happen to patients who suffered from heart failure and stroke. Some may experience this when they move to higher altitudes


Mixed Sleep apnea - This is a combination of both obstructive sleep apnea and central sleep apnea.


Is Sleep apnea fatal?

According to a study, the prevalence of Obstructive Sleep Apnea by Apnea-Hypopnea Index (AHI) criteria in rural India is 3.73% which amounts to 36.34 million individuals suffering from OSA. If left untreated, sleep apnea can cause serious complications. As sleep apnea lowers the amount of oxygen in the blood, it can lead to:

  • Elevated blood pressure

  • Higher heart rate

  • Artery inflammation and stress

  • Stroke

  • Cardiac arrest - increases the risk of heart failure by 140%, the risk of stroke by 60%, and the risk of coronary heart disease by 30%.

  • Chronic Obstructive Pulmonary Disease

  • Few studies have found a link to sleep apnea and the development of diabetes. Patients with sleep apnea have twice the risk of developing Type-2 diabetes.

How is sleep apnea diagnosed?

  • Polysomnogram - Polysomnography or sleep study is used to diagnose sleep disorders. The test monitors the patient’s brain waves, oxygen saturation levels, heart rate, breathing rate, eye and leg movements. The sleep specialist analyses the recordings to check if the patient has sleep apnea.


  • Home Sleep test- This test is used to monitor the patient’s breathing pattern. It consists of a finger probe which measures the oxygen levels, nasal cannula, sensors placed on the abdomen and chest to monitor the chest movement as the patient breathes. The results will be reviewed by the sleep technologist .


Patients with central sleep apnea might need imaging of the head or heart to identify the cause for it.


What is AHI?

Apnea-Hypopnea Index (AHI) is used to measure the sleep apnea severity. The AHI is the sum of the number of apnea and the number of hypopneas (periods of shallow breathing) that occur, every hour.

Apnea–hypopnea index
Apnea–hypopnea index | Source: Sleep Health Org

How to prevent sleep apnea?

  • Maintain a healthy diet plan- Obesity is a major cause that attributes to sleep apnea. Studies show that patients who maintain a healthy weight might not need long term CPAP therapy and upper airway surgery. Making few lifestyle changes can help control sleep apnea

  • Breathing exercises- Practicing yoga or doing exercises that improves the respiratory strength regularly can increase the oxygen levels and improve the sleep cycle.

  • Avoid Alcohol and Smoking- Regular consumption of alcohol or smoking can cause inflammation of the airways. This can worsen snoring due to narrowing of the airways.

  • CPAP Therapy-Continuous Positive Airway Pressure (CPAP) therapy is one of the most recommended treatment options for patients who have obstructive sleep apnea. CPAP machines use mild air pressure to keep the airways open and ensure that the airway does not collapse when the patient breathes while asleep. The patient wears a mask, through which the pressurised air from the machine is given to them. The sleep technologist works with the patient to ensure that the air pressure from the machine is just enough to keep the airway open while they sleep.

BiPAP machine

  • BiPAP Therapy-Similar to CPAP therapy, Bilevel positive airway pressure therapy( BiPAP ) is a non-invasive form of therapy for patients suffering from sleep apnea.CPAP machines are usually recommended for patients with mild to moderate sleep apnea. CPAP machines can only be set to a single pressure that remains constant throughout the night. Some patients find the constant singular pressure from CPAP, difficult to exhale against. For patients with higher-pressure settings, exhaling against the incoming air can feel difficult. Depending on the severity of the condition doctors would recommend a BiPAP machine. BiPAP machines have two pressure settings: the prescribed pressure for inhalation (ipap), and a lower pressure for exhalation (epap). The dual settings allow the patient to get more air in and out of their lungs.


CPAP VS BIPAP THERAPY

Oral Appliances

  • Oral Appliances- In oral appliance therapy, the jaw is projected forward to open the airway. These devices are worn at night, to prevent the tongue from blocking the throat during their sleep. This is an alternative to patients who find it hard to stay on CPAP therapy for long.




AUTHOR

SHARANYA D

Project Engineer

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