Let’s know about obstructive sleep apnea – causes, symptoms, diagnosis, treatment, and more. By the end of the post, you will know everything about obstructive sleep apnea symptoms, obstructive sleep apnea treatment, obstructive sleep apnea causes, obstructive sleep apnea diagnosis, obstructive sleep apnea definition.
Obstructive sleep apnea definition
Obstructive sleep apnea (OSA), is a serious sleep disorder that causes your breath to stop repeatedly while sleeping. Your normal airflow suddenly stops during OSA, this time is called apneic episodes or apnea. Your throat muscles intermittently narrow your airway during sleep, therefore there is a decrease in airflow.
Snoring may be an indication of OSA. Long-term sleep apnea can cause new health problems. For example, stroke, hypertension, diabetes, heart diseases, etc. Therefore it is important to treat OSA properly.
Types of sleep apnea
There are basically three types of sleep apnea. They are:
- Obstructive sleep apnea: In this type of sleep apnea, the victim’s airway becomes narrowed, inactive, or blocked duration of sleeping periods. The most common sleep apnea is obstructive sleep apnea.
- Central sleep apnea: In this central apnea your brain does not send any signal to the respiratory muscles to breathe.
- Mixed sleep apnea: In this sleep apnea, the behavior of both obstructive sleep apnea and central sleep apnea are seen.
Sleep apnea symptoms
Due to the reduction in airflow during sleep apneas, the volume of flow of oxygen in your brain as well as the entire body decreases. Due to this, you do not sleep well and as a result, your energy is low during the day. Some such syndromes are seen in people suffering from sleep apneas:
- Drowsiness and sleepiness in the daytime. Which can lead to industrial accidents and motor vehicle accidents.
- Memory-related problems.
- Concentrating issue.
- Daytime fatigue.
- Grumpy and fatigue feeling.
- Due to the stoppage of breathing during sleep, you become a victim of intolerable headaches.
- Anxiety & depression.
- Low productivity and activity.
- Low-performance of children’s in school.
- Headache in the morning.
- Levels of blood pressure are increased.
- Swelling in the leg. This symptom appears in severe sleep apnea.
- Sweating in the night.
- Loud snoring.
- Nocturia (The need to urinate at night increases).
- People with sleep apnea have difficulty in their sex life.
When to go to a doctor
Consult a sleep specialist if you experience or your sleep partner observes such signs on you:
- Intermittent pauses in breathing at bedtime and trouble in breathing.
- Snoring very loudly.
- Waking up with choking or gasping.
Not every snores person suffers from OSA. Some people do not take snoring too seriously, it is also wrong. Because these may be the basic symptoms of an OSA. Therefore, if you are a victim of loud snoring then you must consult a physician.
The snoring of people suffering from obstructive sleep apneas is most loud when they sleep on their back. Sleeping on the side makes your snoring quieter and increases your sleep hours.
Obstructive sleep apnea causes
When the muscle on the back of your throat becomes more relaxed then the problem of obstructive sleep apneas starts. These special muscle groups support important structures of your mouth. They are all: the tongue and the tonsils, the back of the roof of your mouth (soft palate), the triangular piece of tissue hanging from the soft palate (uvula).
When you breathe, due to the muscles being relaxed, your airway becomes closed or narrow. Due to which you cannot get sufficient oxygen and carbon dioxide increases in your blood. When your airway is closed or narrow, the brain wakes you up for a while during sleep, so that you can open your airway again.
You do not usually remember this wake-up, because it happens within a very short time. After that, it gets fixed on its own. That’s why many people remain unaware of this. They feel that their sleep is normal. This process can last all night.
As a result, the blood oxygen levels decrease and you do not sleep well. The disease severity increases in excess weight people and older people.
The common risk factors of obstructive sleep apneas
- Overweight: Excess fat in the upper airway muscles can increase the risk of obstructive sleep apneas. Obesity can block the breathing airway. Sleep study has shown that people who suffer from OSA are mostly overweight. So if you are overweight then weight loss.
- This does not mean that thin people are not victims of OSA. Syndromes of OSA are also seen in thin people. Some medical conditions related to obesity may promote OSA. Like: polycystic ovary and hypothyroidism syndrome.
- Nasal congestion: People who have nasal congestion at bedtime have an increased risk of OSA. Nasal obstruction can be caused by narrowed or blocked airways.
- Diabetes: Diabetes patients can become victims of OSA quickly.
- Smoking: Smoking can affect sleep apnea. A non-smoker is less likely to see OSA symptoms than a smoker.
- Asthma: Many studies have also said that asthma can increase the severity of the disease.
- The generation effects: The risk of OSA increases if a member of your family is a victim of OSA.
- Narrowed and blocked airway: Your adenoids or tonsils sometimes get enlarged. Because of which your airway can be block or narrow. On the other hand, some people naturally have narrow airways.
- Sex: Obstructive sleep apnea is most commonly seen in women, after the menopause period.
- Hypertension: Obstructive sleep apnea is more common in individuals with high blood pressure (Hypertension) than normal people.
These are the main risk factors of obstructive sleep apneas.
Complications
The consequences of long-term obstructive sleep apnea can be dangerous. They are:
Daytime drowsiness
Due to obstructive sleep apnea, you wake up frequently while sleeping. Because of this, you cannot get enough sleep. As a result, there is a negative effect on the performance of the day’s work and overall health collapse.
You feel sleepy while doing any work, irritability and fatigue experience, you cannot concentrate in work, the risk of road accidents and work-related accidents also increases.
Children with obstructive sleep apnea may face problems associated with concentration and remembering during school or college.
Medications and surgery
Anesthesia and medicines can impact your sleep apneas. Medications such as narcotic analgesics, sedatives, and general anesthetics can promote obstructive sleep apnea by making your upper airway more relaxed and promoting upper airway obstruction.
Complications of people with obstructive sleep apnea may further increase after surgery. If you are suffering from obstructive sleep apneas then your breathing problems may increase after surgeries.
If you are suffering from obstructive sleep apneas, then tell your surgeon about it before surgery. This will help the doctor to take precautions before surgery.
Cardiovascular risks
Due to obstructive sleep apnea, there is a decrease in blood oxygen saturation. This can cause exertion in your cardiovascular system and increase cardiovascular disease. There is evidence that heart diseases are also likely to increase due to high blood pressure.
Obstructive sleep apnea promotes arrhythmias (abnormal heart rhythms). These arrhythmias can lower blood pressure. If you are already a patient of heart disease, then abnormal heart rhythms for a long time can also cause death.
When obstructive sleep apneas increases, the likelihood of heart attack, stroke, coronary artery disease, heart failure, etc. also increases.
Loud snoring
We all know that people suffering from obstructive sleep apnea do loud snoring while sleeping. Which causes their sleeping partner discomfort. Nobody likes to sleep with snoring people. Because the sleeping partner’s sleep is disturbed by the sound of snoring.
Eye related problems signs
Many studies have found that obstructive sleep apneas can promote eye-related problems.
Obstructive sleep apnea diagnosis
The doctor first examines your snoring record, history of sleep, and daytime drowsiness for obstructive sleep apnea diagnosis. The doctor also checks on your quality of sleep, daytime sleepiness, and sleep habits, etc.
It also includes some physical examination. The doctor examines your neck and head thoroughly to find some physical factors related to obstructive sleep apnea. You may have to go through some tests to diagnose obstructive sleep apnea properly. They are:
Polysomnography
Polysomnogram is used to measure the activity of each organ associated with sleep while sleeping. Contains:
- To measures, muscle activity an electromyogram (EMG) is used.
- To measures, heart rate and rhythm electrocardiogram (EKG or ECG) are used.
- To measures, changes in your oxygen levels in your blood the pulse oximetry test are used.
- To measures, brain waves an electroencephalogram (EEG) is used.
- To measures, eye movement an electrooculogram (EOM) is used.
- Arterial blood gas analysis (ABG).
The Polysomnogram test is done by keeping you up all night in a sleep study center.
EMG test
The EMG test is done by applying two electrodes to your chin. These electrodes measure the electrical stimulation that occurs during muscle movements. EMG electrodes accurately measure each movement and relaxation of your muscle during sleep. During the test, one electrode is placed below your jawline and one above the jawline.
EKG or ECG test
EKG or ECG test is done to find hidden heart disease in you. In the EKG test, your heart rate and rhythm are monitored to detect cardiac issues during the episode of apnea. Prolonged high blood pressure can aggravate the heart problem.
Pulse oximetry test
During this test, a small instrument called a pulse oximeter is placed on a thin area of your body. Like, in your earlobe or fingertip. Pulse oximeter with a teeny emitter checks the amount of oxygen in your blood.
Along with that the oxygen decreasing level, oxygen saturation, etc are also measured by infrared and red LEDs fitted in the oximeter.
EOM and EEG
EOM appliance is used to record eye movement. In this process, a special small electrode is placed in your eye in such a way that it can record your eye movement. The electrode is placed 1 centimeter above the outer corner of the right eye and another electrode is placed 1 centimeter below the outer corner of the left eye.
On the other hand, electrodes are placed in your scalp to monitor the brain waves at bedtime, before bedtime, and after bedtime. This process is called EEG.
The EOM and EEG test help the doctor to understand the timing of your different phases of sleep (rapid eye movement and non-rapid eye movement).
ABG test
During this test, blood is extracted from your artery by a syringe. This test provides a comprehensive fact to the doctor about the amount of oxygen and carbon dioxide present in the blood. The ABG test measures many important things in the blood. Like:
- Bicarbonate level
- The partial pressure of oxygen
- Oxygen content
- The partial pressure of carbon dioxide
- Oxygen saturation
Obstructive sleep apnea treatment
In mild to moderate obstructive sleep apnea cases, the doctor may advise you for some simple lifestyle changes. Like:
- Say no to smoking and avoid drinking alcohol before bed.
- If you are overweight, then lose weight.
- Don’t take sedative medications.
- Sleep on your side instead of back.
- Do physical activity exercise.
- Use nasal decongestants to get relief from snoring.
But if you are suffering from severe obstructive sleep apnea or simple lifestyle changes are not able to reduce your symptoms then you may have to undergo some therapies. In some cases, surgery may also be necessary. Let’s know the common therapies and surgery for obstructive sleep apnea:
Therapies
The positive airway pressure device
This machine provides you with air pressure through a mask at bedtime to reduce the cessation of airflow. Which reduces the likelihood of respiratory events and helps you to fall asleep faster. As a result, the quality of your day’s work improves.
Constant positive airway pressure (CPAP) is the most commonly used efficacy machine for sleep apnea treatment. This positive pressure is larger than the surrounding air. This pressure keeps patients’ breath normal by reducing upper airway resistance.
CPAP is an effective machine for treating obstructive sleep apnea. But many people do not like to use it. They feel uncomfortable sleeping with it. You may face difficulties in using the machine first.
But over time you are able to use it comfortably by practice. Therefore, you should try different masks before using CPAP. This will help you find a mask that is fitted to you.
Nowadays an upgrade version of these machines has also arrived. It is more comfortable and less noisy than the older one. This also comes with several mask options. Like: nasal pillows, nasal masks face masks.
Some machines also come with special pressure functions for better comfort. The pressure in CPAP is constant. But pressure is not constant in auto-titrating CPAP machines. In this machine, the pressure is adjusted.
Bilevel positive airway pressure (BPAP) is another different type of airway pressure device. When you inhale at bedtime, the pressure of this machine decreases automatically and increases while exhaling.
If you face difficulty in airway pressure treatment, instead of stopping using it, consult a doctor. Ask the doctor how you can use the machine comfortably.
If your weight is increased or reduced by 10%, then you should change the pressure settings of your machine. So in this condition, please consult your doctor. And if the snoring has not stopped even after treatment then you should go to the doctor.
Oral appliances device
Oral appliances are an efficacy way of treating mild to moderate obstructive sleep apnea. This therapy frees the airway by bringing your lower jaw forward. Some devices reduce your snoring by positioning the tongue correctly. Basically, these oral devices keep patients’ throats open and maintain proper airflow while sleeping.
You must consult an experienced dentist to use oral appliances therapy safely. Because it is very necessary to fitting the devices properly. There are many devices available to use. Therefore, to find the right device for you, please consult a doctor.
Sleep positional therapy
According to research, sleeping in the back can increase the symptoms of obstructive sleep apnea. So the positional therapy helps back sleepers to sleep on their sides to overcome sleep apnea.
Surgery
If the rest of the treatment of obstructive sleep apnea is not curing you, then only the doctor asks you to do surgery. Surgical options for obstructive sleep apnea:
Tissue removal
Uvulopalatopharyngoplasty (UPPP) is the most common efficacy surgical option for obstructive sleep apnea. During this surgery, extra tissues are removed from the back of the throat to reduce snoring and apnea events. In addition, patients’ adenoids and tonsils can also be removed.
But there is no solid evidence yet about whether these surgeries can completely eliminate sleep apnea or not. There are may also have complications after surgery.
Implants
It is an ideal option for mild obstructive sleep apnea treatment. During this surgery, three soft polyester rods are implanted on your soft palate. These rods protect your upper airway from being more relaxed and helps to reduce your snoring and apneic events.
Upper airway stimulation
During this surgery, a hypoglossal nerve stimulator is implanted inside the skin in your upper chest muscles. This thin impulse generator stimulates your nerve which controls the movement of the tongue. It also monitors your breathing patterns.
According to a study, the nerve stimulator helps a lot in reducing obstructive sleep apnea. It is an ideal option for moderate to severe disease of obstructive sleep apnea.
Jaw surgery
This surgery is done by repositioning the jaw by moving your jaw ahead from the rest of the bones of your face. This surgery is done to enlarge the space behind the soft palate and tongue. It helps to reduce obstructive events.
Tracheostomy
When all the treatment for sleep apnea given earlier does not work on you, then the therapist advises you to do tracheostomy surgery. During this surgery, a plastic or metal tube is inserted through a hole in your neck to breathe.
Surgery is done to remove enlarged tonsils or adenoids and weight-loss surgery (bariatric) is used to treat snoring. This is done by enlarging and clearing the air passages. These surgeries also help in reducing sleep apnea symptoms.
Conclusion
Hope you guys liked this article about obstructive sleep apnea – causes, symptoms, diagnosis, treatments, and more. Obstructive sleep apnea is a real sleep disorder. So if you have been facing sleeping problems and airway resistance syndrome for a long time, then consult a doctor soon.
The doctor will study your symptoms and give you effective treatment for sleep apnea. Depending on your symptoms, the doctor may recommend patients make some basic lifestyle changes or stay in a sleep center or sleep lab.
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