Sleep apnea is a sleep disorder that you might of heard of before. There are many symptoms, causes and treatment options for this sleep disorder.
Before we go into more detail about what sleep apnea is. The first thing to do is to ask yourself these important questions:
- Are you having a hard time breathing at night?
- Do you wake up in the middle of the night feeling that you are out of breath, choking or gasping for air?
- Has your roommate, your partner, or you took notice that you occasionally stop breathing while asleep?
- Do you snore loudly with long pauses between each snore?
- Do you have insomnia and also feel sleepy through the day?
- Are you feeling tired throughout the day even after you have slept a lot?
If your answer is yes to any of questions listed above. There is a chance that you might have a sleep disorder known as “sleep apnea”.
Those who have this disorder struggle for air and stop breathing while asleep.
These disruptions can happen several times every hour (greater than 30 times in extreme cases) and have duration of a few seconds to a few minutes between each breath. If left unchecked, sleep apnea can have major consequences to your health.
Some sleep disorders can be managed by themselves with healthy sleep habits. However, sleep apnea is a sleep disorder that requires professional assistance.
In this article, you will learn about the two major types of sleep apnea, the symptoms, causes and treatment options. The two types also share some traits in common as well as having their differences.
Let us explore what sleep apnea is and help shed some light on this sleep disorder.
The Two Major Types of Sleep
There are two major types of sleep apnea. Both of the types fall under the category of sleep related breathing disorders in the newest version of the International Classification of Sleep Disorders 3rd Edition.
Obstructive Sleep Apnea
Obstructive sleep apnea occurs more frequently than central sleep apnea and is related with the blockage of an individual’s airways.
This sleep disorder is estimated to affect 3 to 7% of the world’s population. However, a newer study indicates that 10 to 17% of the US population are affected as well, though many people are not aware of this. There are also distinctions between child and adult forms of sleep apnea.
Central Sleep Apnea
Central sleep apnea does not occur as frequently as obstructive sleep apnea and is tied to the limited amount of physical effort from the body’s respiratory system. The can result in the limited or stoppage of the flow of air to a person’s lungs.
Although the exact generalization is unknown, there is a hunch that many people remain diagnosed to this sleep disorder. The number of people who have this also varies because of this sub-type as well as a distinct group of people.
It is known that there are a larger percentage of elderly people who have this rather than younger people.
There are eight sub-types of central sleep apnea that exist such as cause, the age when the disorder started, and several other features. There are also individuals out there that can have a blend of the two major types of sleep apnea.
Symptoms of Sleep Apnea
The symptoms listed here are known to both of types of sleep apnea. However, not everybody will experience all the symptoms:
- Feeling irritable.
- Having a hard time paying attention throughout the day.
- Insomnia and daytime sleepiness can be a result.
- Those with this disorder report that they feel especially sleepy throughout the day due to the disruptions that make it more challenging to obtain deep sleep.
- Waking up suddenly with the possibility of feeling breathless.
- The individual frequently stops breathing while asleep due to either a blocked airway or a weakness in their central respiratory system. This is occassionally observed by another person.
- Snoring that is loud.
In addition, there are also symptoms that are associated with one type of apnea only:
- While anybody can snore, those with obstructive sleep apnea snore more loudly and frequently. The snoring has a tendancy to be more shocking or unanticipated, especially when they return to sleep from a breathing disruption. They can also wake up holding there breath, choking, or gasping for air.
- Central sleep apnea can indentified by a decreased amount of abdominal and chest movements when a person is breathing. This symptom is not as noticeable so it can be a difficult to detect by experience or observations.
Potential Risk Factors Of Obstructive Sleep Apnea
If you maintain a healthy lifestyle, you can minimize developing OSA. These risk factors are ones to pay attention to:
- Being exposed to tobacco products and tobacco smoke.
- Children that have neuromuscular diseases such as sickle cell disease, gastroesophageal reflux, and cerebral palsy.
- Having a recessed chin also known as “tucked in” chin that is often seen as an overbite.
- Having a history of people in your family that have had sleep apnea.
- Being over 40 years in age.
- Those with “Down Syndrome” are at a higher risk.
- Males have a higher risk.
- Having a large neck even at a healthy weight range.
- Having large tonsils.
Obesity from being extremely overweight meaning that one has a body mass index with a minimum of 20% higher than recommended.
Potential Risk Factors For Central Sleep Apnea
- Moving to a higher altitude than normal can disrupt breathing because there is less oxygen available.
- Individuals over the age of 65 have a higher risk of developing risk factors of this sleep disorder.
- Certain OSA treatments such as using a forced air device can promote central sleep apnea.
- Having certain medical conditions such as strokes, brain tumors and heart disorders.
- Any usage of opiods.
- Those who breathing is affected more by carbon dioxide.
- Individuals who wake up more in the middle of the night, whether they wake up more easily or have sleep maintenance insomnia.
This sleep disorder is usually not fatal on its own, however they are linked with higher risk of life threatening conditions that we will explore more of below.
The symptoms of this sleep disorder need to be taken seriously and you need to seek help from a medical professional as soon as the symptoms appear.
Causes of Sleep Apnea
The two major types of sleep apnea can be caused a variety of different issues. The examples listed here are some of the causes:
Causes of Obstructive Sleep Apnea
- Airways that narrow naturally.
- Fatty tissue that is obstructing the airway.
- The tongue obstructing the airway.
- Relaxing throat muscles that are blocking the airway. (These throat muscles are much more relaxed than normal)
- A deviated septum also known as “displaced nasal tissue” blocking the airway.
Causes of Central Sleep Apnea
- Being exposed to high altitude that you are not accustomed to. This can disruptions to breathing due to the fact that there is less oxygen available.
- Using any kind of narcotic. These substances depress the respiratory system.
- Being obese can also depress your respiratory system.
- Areas of the brain that are related to breathing that have been disrupted by tumors, strokes, and other health problems.
- Many other medical conditions that you might have already.
Diagnosis Of Sleep Apnea
The best method to see if sleep apnea is present is to confirm it by using a test that is conducted in a sleep laboratory. The patient would spend one or a few nights resting in the lab while there breathing and other vitals are observed.
To properly diagnose sleep apnea, a minimum of one symptom above has to be found. In addition, a “polysomnography” test needs to display certain results with regard to actual breathing irregularities.
The polysomnography records many important things that include:
- Breathing Patterns.
- Blood Oxygen Levels.
- Body Movements.
- Heart Rate.
- Eye Movements.
- Progression in sleep stages.
- Electrical Brain Activities.
With a test such as this, you can envision that are several pieces of equipment that a patient must wear during sleep in order for the measurements to be recorded that include, yet are not limited to: Finger clips that pay attention to blow flow properties such as (pressure, saturation of oxygen, and heart rate).
- Elastic bands that are stretched to secure the patient’s abdominal and chest area. These bands are used to measure and record their breathing movements.
- Wires and pads attached to different areas of the body that are used to record electrical activity in the patient’s nervous system.
There are other test that can be done if sleep apnea is suspected. Magnetic resonance imaging also known as an “MRI” can be used to search for any type of physical obstruction in the neck or the chest. Heart and lung tests may also be needed as well.
Visits to the sleep lab are the best option for a sleep apnea diagnosis, however, there are portable kits that patients can take home if obstructive sleep apnea is suspected.
These portable devices measure breathing through a series of short tubes that are placed in the mouth and nose. There are also clips and belts that are used for testing blood flow and the mechanics of the abdominal/chest area.
The results are recorded in the machine so that a physician can access them at a later time. Afterwards, the physician will assess the results.
Diagnosis for central sleep apnea is always done in person and is monitored by medical professionals. The tests are always completed in the lab if a doctor suspects central sleep apnea is present.
Prior to the diagnosis, a physician will eliminate other potential explanations that include other medical disorders, other sleep disorders, substance or medication usage.
Treatments for Obstructive Sleep Apnea
The most familiar treatment for obstructive sleep apnea is using a “CPAP” machine. CPAP stands for “continuous positive airway pressure”.
These devices have a primary base, a hose that attaches to the base, and a face mask with straps that fastened to your head.
When the patient is sleeping. The CPAP machine forces a gentle, yet steady stream of air into the nasal passages to prevent the airways from closing.
A prescription is required to gain a CPAP machine and it calibrated for each patient’s individual needs. A few visits to hospital may be needed.
There are changes that you can make to your lifestyle that will help alleviate those with light to moderate cases of obstructive sleep apnea.
Those changes are:
- Establishing a consistent exercise schedule. (This is one of the many lifestyle changes that I have made and it has helped me out with a number of different problems)
- Quitting tobacco products.
- Practice sleeping on your side.
- Steer clear of any sedatives or alcohol that can relax your muscles.
- Weight reduction.
Certain dental appliances may be used in cases that are not as severe. These appliances can move the tongue and other tissues from obstructing the airway. They can also align the jaw to allow for better air flow to the air passage.
The dental devices need to be fitted by a dentist who has a lot of experience and they are available in a variety of different models. However, they can cause problems with chewing and jaw pain.
There is also the option of having surgery to treat certain forms of obstructive sleep apnea. An example would be, if the tonsils are the obstructing the airway then a tonsillectomy could be an option to have them removed.
However, surgery is normally avoided because there is a chance of getting an infection and other serious respiratory complications.
Treatments for Central Sleep Apnea
Each individual case of central sleep apnea has to be very carefully diagnosed and pinpointed for treating the underlying problem. A CPAP or other stronger machine can be used to help out in the meanwhile.
If it is the case that medication is discovered to be the issue, then the dosage can be reduced or changed to an alternative medication. In more severe cases, oxygen therapy is an option that might be needed.
The important thing to keep in mind is to manage sleep apnea by practicing healthy lifestyle habits and adhering to a treatment plan. If sleep apnea is left unchecked, it can lead to other serious conditions that include:
- Automotive accidents.
- Decreased concentration and memory.
- Abnormal heartbeats.
- Type 2 Diabetes.
- Higher risk of heart disease such as strokes and heart attacks.
- High Blood Pressure.
As you can see sleep apnea is a sleep disorder that requires both a diagnosis and a proper treatment plan.
Taking action on these two important factors will minimize your chances for more serious health conditions.
Breathe deep and well!
- Punjabi, Naresh M. (2008). The Epidemiology of Adult Obstructive Sleep Apnea. Proceedings of the American Thoraric Society 5(2) 136-143.
- Qaseem, Amir, Dallas, P., Owens, D.K, Starkey, M., Holty. J.E.C., & Shekelle, P. (2014). Diagnosis of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From The American College of Physicians. Annals of of Internal Medicine, 161(3), 210-220.
- Chowdhuri, Susmita, Badr, Safwan M., Dingell, John D., Veteran Affairs Medical Center & Wayne State University, Detriot, USA. Indian J Med Res 131, February 2010, pp 150-165.
- Cure My Sleep Apnea (2014, January 13). Is There a Connection Between Sleep Apnea and High Altitude? Retrived on July 7th, 2018.
- Batool‐Anwar, S., Goodwin, J. L., Kushida, C. A., Walsh, J. A., Simon, R. D., Nichols, D. A., & Quan, S. F. (2016). Impact of continuous positive airway pressure (CPAP) on quality of life in patients with obstructive sleep apnea (OSA). Journal of Sleep Research.
- Mutter, T. C., Chateau, D., Moffatt, M., Ramsey, C., Roos, L. L., & Kryger, M. (2015). A matched cohort study of postoperative outcomes in obstructive sleep apnea: Could preoperative diagnosis and treatment prevent complications? Survey of Anesthesiology, 59(2), 94-95
- Kendzerska, T., Mollayeva, T., Gershon, A. S., Leung, R. S., Hawker, G., & Tomlinson, G. (2014). Untreated obstructive sleep apnea and the risk for serious long-term adverse outcomes: a systematic review. Sleep medicine reviews, 18(1), 49-59.
- Llanos, O., Ayoub, K., Ayub, S., Colaco, C., Khasawneh, K., & Prince, A. (2016). Variation in sleep apnea severity according to hypopnea definition. In A80-A. Are HSTS Obsolete? Novel Diagnostics in SDB (pp. A2518-A2518). American Thoracic Society.
- American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.
- LaGrotte, C., Fernandez-Mendoza, J., Calhoun, S. L., Liao, D., Bixler, E. O., & Vgontzas, A. N. (2016). The relative association of obstructive sleep apnea, obesity and excessive daytime sleepiness with incident depression: A longitudinal, population-based study. International Journal of Obesity.
- Eckert, D. J., Jordan, A. S., Merchia, P., & Malhotra, A. (2007). Central sleep apnea: Pathophysiology and treatment. Chest Journal, 131(2), 595-607.
- Kimoff, R. J. (2015). When to suspect sleep apnea and what to do about it. Canadian Journal of Cardiology, 31(7), 945-948.
- Latshang, T. D., Bloch, K.E., Lynm, C., & Livingston, E. H. (2012). Traveling to high altitude when you have sleep apnea. JAMA, 308(22), 2418-2418.
- Mayoclinic (2016, June 28). Central Sleep Apnea. Retrieved on (2018, July 7th).
- Photo Credit: Pexels, Pixabay and Unsplash