Sleep Apnea

Sleep Apnea Explained: Risks, Symptoms & Diagnosis

Sleep Apnea Explained: Risks, Symptoms & Diagnosis

Sleep apnea is a condition when you stop breathing temporarily while you sleep or the breath you take is shallow. Temporary breathing can last from a few seconds and go on for several minutes. This respiratory disorder can occur many times in one hour, even more than 30 times in that 60-minute span. After that, you will breathe back to normal. It may be accompanied by a loud grunt or choking. This condition can disturb you from a deep sleep. It causes you not to sleep as much as you need. Sleep apnea makes you tired and sleepy during the day.

This condition is not one that is easily diagnosed. Also usually not detected during routine checks with your doctor. Because it happens when you are sleeping, you might not know that you have it unless someone sees an unusual pattern in your sleep. The way you find out is if someone notices it while you sleep.

Millions of adults suffer from sleep apnea and don't know it. The majority of them are overweight or obese. Men suffer from this condition more than women. The older a person is, the more likely they are able to inherit this condition. With women, they can develop sleep apnea at the post-menopausal stage in their lives.

Minority groups, such as African-Americans, Hispanics, and Pacific Islands, develop more sleep apnea than other ethnic groups. It can also be inherited from family members. If you have small airways in your throat, mouth or nose, you are more likely to experience this condition.

Small children who have tonsil tissue that is larger than normal can also experience sleep apnea.

Types Of Sleep Apnea

There are three types of sleep apnea, but only two are the most widely discussed. Obstructive sleep apnea, which is the most common type for this condition. With obstructive sleep apnea, your throat muscles collapse while you sleep.

Another type of sleep apnea is called central sleep apnea. This type occurs when your breathing muscles are not receiving the right signals. The third, which most people do not experience, is called complex or mixed sleep apnea. This type is a combination of both conditions.

Obstructive Sleep Apnea

Obstructive sleep apnea, or OSA, blocks the airways in your throat. Some other things that happen with this type of sleep disorder are:

  • When you sleep, throat muscles collapse inward when you breathe.
  • The air will pass through the upper airway. This includes the nose, mouth and throat area.
  • When the muscles get wider, they block the collapse to keep the airway open.
  • You will have less oxygen in your blood. This causes your lungs to absorb air from the outside.
  • Apnea occurs when the back throat tissue is temporarily obstructed. You stop breathing and if you wake up you may have to gasp.
  • Even if you do gasp for air or make snorting sounds, you may not necessarily wake up.

If you experience five or more episodes of apnea per hour, it is considered part of obstructive sleep apnea.

Factors that increase the risk of this form of sleep apnea include:

  • Overweight. Obesity increases the risk of sleep apnea. Excessive fat around the upper airway can inhibit your breathing.
  • Neck circumference. People with thicker necks may have narrower airways.
  • Narrow airway. You might have inherited a narrow throat. The tonsils or thyroid gland can also enlarge and block the airway, especially in children.
  • Be a man. Men are two to three times more likely to have sleep apnea than women. However, women increase their risk if they are overweight, and their risk also seems to increase after menopause.
  • Being older. Sleep apnea is significantly more common in older adults.
  • Family history. Having a family member with sleep apnea can increase your risk.
  • Use of alcohol, sedatives or tranquilizers. These substances relax the muscles of the throat, which can intensify obstructive sleep apnea.
  • Smoke. Smokers are three times more likely to experience obstructive sleep apnea than people who have never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.
  • Nasal congestion. If you have difficulty breathing through the nose - either due to anatomical or allergic problems - you are more likely to develop obstructive sleep apnea.

Central Sleep Apnea

Central sleep apnea is not as common as obstructive sleep apnea. This type of sleep apnea starts in the brain (central nervous system). The brain will not send signals to the muscles of the airway so they can breathe. The oxygen level decreases and you might wake up. With this type of sleep apnea, people usually remember waking up. If you have heart disease or heart failure, then you are experiencing central sleep apnea.

Factors that increase the risk of this form of sleep apnea include:

  • Being older. Middle-aged and older people have a higher risk of developing central sleep apnea.
  • Be a man. Central sleep apnea is more common in men than in women.
  • Heart Disorders. Congestive heart failure increases risk.
  • Using narcotic painkillers. Opioid drugs, especially those that work long hours such as methadone, increase the risk of central sleep apnea.
  • Stroke. Having a stroke increases your risk of central sleep apnea or central sleep apnea that occurs during treatment.

Complex or Mixed Apnea

As mentioned earlier in this report, this is a combination of obstructive and central sleep apnea. With this type of sleep apnea, you will be dealing with obstructive sleep apnea or OSA. In addition to that with good pressure from the airway, you will have constantly central sleep apnea.

If you use CPAP (Continuous Positive Airway Pressure), the central sleep apnea will be acknowledged. This occurs after the obstruction is cleared.

Signs And Symptoms

The most obvious sign of sleep apnea is loud and consistent snoring. You may pause while you are snoring. You may also choke or gasp after you have paused. When you sleep on your back, the snoring gets louder. If you sleep on your side, the snoring may not be as loud.

You may or may not snore every night. Eventually, the snoring may increase and it may get louder as you sleep.

Since you’re sleeping while you’re snoring or gasping, you may not know that you’re having breathing issues. Others will see the signs before you and will let you know if it becomes a pattern. Know that just because you might be a chronic snorer, that doesn't mean you suffer from sleep apnea.

Are you are fighting sleep during the day? It can be a sign that you have sleep apnea. While not involved in any activity, you may fall asleep very quickly (hypersomnia). If this happens while you’re at work or you’re driving, the chances are greater that you may end up in a work-related accident or an accident while you’re driving.

There are other signs and symptoms that people may not associate with sleep apnea. They are:

  • Headaches in the morning
  • Frequent urination in the evening or night hours
  • Moody or experiencing a change in your personality
  • Can’t concentrate, focus or loss of memory
  • Dry throat in the morning when you wake up

The muscles in your throat are used to keep the airway open so that you can get air into your lungs. However, when you sleep, your throat muscles relax. This means that your airway can be blocked and air won’t get into your lungs.

With obstructive sleep apnea, you can also experience the following:

  • The muscles in your throat and your tongue are more relaxed than they should be.
  • Being overweight or obese, you will have more adipose tissue. This tissue can become thick in the wall of the trachea. There is not much of an opening and what is available may not stay open.
  • If you are an older adult, the signals of your brain may not keep the muscles of your throat stiff as they should.
  • With the blocked airways, you may end up snoring loudly as you sleep.

Low oxygen levels cause you not to be able to get a good night’s sleep. The muscles in the upper airway become tight and your throat is open. You are able to breathe normally again until you start snorting or choking.

In addition to low levels of oxygen and fewer hours of sleep, your stress hormones are released. This can cause you to have high blood pressure, a stroke, a heart attack, and abnormal heartbeats. The stress hormones can also cause you to have heart failure.

If your condition is not treated, you could be at a greater risk of obesity and diabetes.

Diagnosis of Sleep Apnea

How doctors diagnose sleep apnea depends on their medical and family history. They will also do a physical examination and study your symptoms. If they feel the signs, symptoms, and patterns that match this condition, then you will be referred for a sleep study.

Sleep studies are measurements that show your sleep patterns. The results show how much and how well you sleep. If you have problems with your sleep, studies will show that result.

If you are referred for a sleep study, it is important for you to get it. This research can determine whether you have been diagnosed with a sleep disorder, such as sleep apnea. Sleep apnea and other sleep disorders can increase your health risk for stroke, high blood pressure, and heart attacks.

Doctors experienced in reading sleep studies can easily diagnose sleep apnea and provide treatment so you can sleep better at night. What's important is to tell your doctor about your bad sleep habits.

They include chronic fatigue and sleepiness during the day. Also, tell your doctor if you have trouble sleeping or wake up in the middle of the night and cannot go back to sleep.

You may be suffering from a sleep disorder that you are not aware of. Doctors who experience sleep disorders will ask about your sleep schedule. They will also ask your family members about the chronic snoring that they have handled.

Experienced doctors with sleep disorders are known as sleep specialists. They can easily diagnose and provide care for those who have sleep problems.
To help experts determine exactly what is happening, you should keep and keep a sleep diary for no more than two weeks. This is the beginning of the sleep study.

Here are some questions that you might see in your sleep diary:

  • When you went to bed the night before
  • How many hours did you sleep the night before
  • When you wake up in the morning
  • How many times do you wake up at night
  • What medicine did you take the night before
  • If you are really awake when you wake up in the morning
  • If you are, you are awake and tired when you wake up in the morning
  • How long did you fall asleep the night before
  • If you are sleepy when you wake up in the morning
  • The number of drinks with caffeine that you have throughout the day
  • When you consume alcoholic drinks
  • The number of naps you have
  • How long does a nap last
  • If you are very sleepy during the day
  • If you are a little tired during the day
  • The number of alcoholic drinks you have during the day
  • If you are a bit wary during the day
  • If you are awake during the day

Physical Examination to Check Sleep Apnea

During a physical examination, your doctor will examine the area of your throat, nose, and mouth. They will look for enlargement or additional tissue. For children diagnosed with sleep apnea, they usually experience enlarged tonsils. With them, it doesn't take much to give a diagnosis other than examinations and medical history.

For adults, doctors look for enlarged uvula, which is a piece of tissue that sits and hangs from the middle of the back of your mouth. They also look for the soft palate, which is behind your throat and is known as the roof of your mouth in that area.

How Family Members Can Help To Detect Sleep Apnea

Because most people don’t know that they’re suffering from sleep apnea, it’s important that there is someone that can detect abnormalities while you sleep. The person doesn’t know that their breathing can start and stop at any time during the night. They also don’t take into consideration when someone tells them that they are a chronic and loud snorer.

There are things that family members can do to help out:

  • Let them know that they have a chronic case of loud snoring.
  • Ask them to consult their physician.
  • If they are diagnosed with sleep apnea, advise them to follow the instructions, including any post-op follow up and treatments.
  • Be there for them emotionally. This can be a trying time for them, and they need all of the support that they can get.

How To Diagnose Sleep Apnea With Sleep Studies

Sleep studies are normally performed in a sleep center or a sleep lab. This may or may not be in a hospital. If the study is conducted in the sleep center, you may have an overnight stay. However, this is not always etched in stone.

The good thing about sleep studies is you will not endure any pain. The only thing that may affect you is skin irritation from the sensors. When the sensors are removed from your skin, you will not experience any more irritation.

If your sleep study is during the day, bring a book or a magazine to keep you from getting bored. Although the risk of sleep studies is minimal, this study requires time (at least a few hours).

There are different tests for sleep studies. One of them is called a polysomnogram (poly-SOM-no-gram) or PSG test. This test is conducted in a sleep center or sleep lab. More than likely with this test, it will require an overnight stay.

You will have electrodes and monitors on your scalp, face, chest, limbs and fingers.

As you are sleeping, the following items will be monitored:

  • The movement of your eyes
  • The activity in your brain
  • Blood pressure
  • The activity in your muscles
  • The rate of your heart
  • Air movement in and out of your lungs
  • The rhythm of your heart
  • How much oxygen is in your blood

As you sleep, the staff on duty will use sensors to check on your as you sleep during the night. After the PSG is complete, the sleep specialist will go over the results with you. They will be able to determine whether or not you have sleep apnea and if it is serious or not. From the results, they will be able to chart a course of treatment.

A Multiple Sleep Latency Test or MSLT, is used to determine how sleepy you are in the daytime. This test is usually performed after a PSG. You will have devices placed on your scalp for monitoring purposes.

With this test, you will have to take a nap at least five times at 20 minutes for each one. This is supposed to be done every 2 hours during times that you would be alert. The testers will check how long it will take you to go to sleep and how long you napped.

For those people who take less than five minutes to get to sleep are more likely candidates for a sleep disorder. When the testing is completed, the sleep specialist will provide you with the results and consult you about treatment options.

Where To Find A Sleep Specialist

If you need assistance finding a sleep specialist, there are several organizations that can assist you with that, such as:

These organizations are made up of physicians, researchers and dentists that work with people affected with this sleep disorder. They work to further the advancement of sleep medicine and sleep research.

The physicians and researches that serve on the related boards are noted as “Board Certified” in the specialty of sleep medicine. The ABSM keeps an updated listing of sleep specialists. They can be located by state or by their name. The AADSM keeps an updated listing of dentists that specialize in treating sleep apnea patients by using oral devices.

Posted by wpx_streamni in Sleep Apnea