Check If You Have Sleep Apnoea
Symptoms of sleep apnoea mainly happen while you sleep.
- making gasping, snorting or choking noises
- waking up a lot
During the day, you may also:
- feel very tired
- find it hard to concentrate
- have mood swings
- have a headache when you wake up
It can be hard to tell if you have sleep apnoea. It may help to ask someone to stay with you while you sleep so they can check for the symptoms.
Health Consequences Of Sleep Apnea
The chronic sleep deprivation caused by sleep apnea can result in daytime sleepiness, fatigue, difficulty concentrating, forgetfulness, and an increased risk of accidents and errors in your daily activities.
Sleep apnea also has a mental impact. It can trigger moodiness and irritability and cause anxiety and depression. It also increases your risk of other serious health problems like high blood pressure, heart disease, diabetes, atrial fibrillation, and stroke.
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Symptoms Range From Mild To Severe
Mild sleep apnea presents in unpredictable ways. Not all snorers have sleep apnea, but snoring is usually the first symptom, says Dr. Foldvary.
When apnea is mild, you may experience mild daytime sleepiness, sleep that isnt refreshing, and fatigue. You may wake up often without knowing why, or get morning headaches.
When apnea is severe, you can wake up breathless, gasping for air. You may feel like youre choking.
You may face declining performance at work or school, and mood changes . You can experience problems with sex, whether youre male or female.
Your bed partner may tell you that its pretty scary watching you sleep.
Its easy to forget to bring up these symptoms at your annual checkup, but you have to tell your doctor, says Dr. Foldvary. Otherwise, sleep apnea can be missed for many, many years.
Its quite likely that your doctor wont ask you about sleep apnea, she says. Sleep medicine is a young specialty and not a focus of training in medical education.
Furthermore, doctors are challenged with the need to manage increasingly difficult health issues in less and less time, leaving sleep concerns off their radar, she says.
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Teenage Sleep Deprivation Other Issues To Consider
If lack of sleep is still a problem despite your best efforts, suggestions include:
- Assess your sleep hygiene. For example, factors that may be interfering with your quality of sleep include a noisy bedroom, a lumpy mattress or the habit of lying awake and worrying.
- Consider learning a relaxation technique to help you wind down in readiness for sleep.
- Avoid having any food or drink that contains caffeine after dinnertime. This includes coffee, tea, cola drinks and chocolate.
- Avoid recreational drugs as they can cause you to have broken and poor quality sleep.
- See your GP if self-help techniques dont increase your nightly sleep quota.
Continuous Positive Airway Pressure
CPAP therapy may be used in children or teenagers who have persistent sleep apnea despite other treatment efforts. After other interventions are made, a sleep study may be useful to reassess the condition. If it persists, CPAP can be an effective option. With CPAP, a constant flow of air is delivered through a face mask worn over the nose or nose and mouth during sleep. It is important to select a mask that does not apply too much pressure to the mid-face as there are reports of growth restriction. Many teenagers gradually lose interest in CPAP therapy and long-term adherence may be disrupted, especially when teenagers go off to college and sleep in dormitory environments. It can be a treatment that is returned to later as needed.
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The Importance Of Testing
Adequate testing is important because sleep apnea is sometimes overlooked in children. This can happen when a child doesnt display typical symptoms of the disorder.
For example, instead of snoring and taking frequent daytime naps, a child with sleep apnea may become hyperactive, irritable, and develop mood swings, resulting in the diagnosis of a behavioral problem.
If your child meets the criteria for sleep apnea and exhibits hyperactivity or symptoms of behavioral problems, see their doctor.
Outlook For Children With Sleep Apnea
Sleep apnea treatment works for many children.
According to a 2018 review of studies, surgery to remove the tonsils and adenoids reduces obstructive sleep apnea symptoms in anywhere from 27 to 79 percent of children. Children were more likely to experience symptoms after surgery if they were older, had childhood obesity, or had more severe apnea prior to surgery.
A 2013 random trial found that Black children were also more likely than other children to experience symptoms after surgery. However, they also had more severe apnea overall.
Symptoms tend to improve with weight management, a CPAP machine, or an oral appliance.
If left untreated, sleep apnea can worsen and interfere with your childs quality of life. It can become difficult for them to concentrate in school. If it persists into adulthood, this disorder may put them at risk for complications such as stroke or heart disease.
If you observe any of the following symptoms in your child, speak with their doctor about the possibility of sleep apnea:
- loud snoring
- pauses in breathing while they sleep
- severe daytime fatigue
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How Is Obstructive Sleep Apnea Diagnosed
Talk to your doctor if your child:
- snores regularly
- falls asleep during the day
- has other signs of sleep apnea
Your doctor might refer you to a sleep specialist or recommend a sleep study.
A sleep study can help doctors diagnose sleep apnea and other sleep disorders. Sleep studies are painless and risk-free, but kids usually need to spend the night in a hospital or sleep center.
During a sleep study, doctors check:
- eye movements
- body movements and sleep positions
What Natural Treatments Are Available For Sleep Apnea In Children
The following natural treatments may help reduce obstructive sleep apnea in children. A childâs healthcare provider will be in the best position to discuss the risks and benefits of the natural treatment listed below:
- Weight loss: In children with obesity and obstructive sleep apnea, weight loss can alleviate symptoms. A pediatrician can assist with healthy diet and exercise planning. A dietician or nutritionist can also help create a weight loss plan. However, weight loss can take time, and a child with severe symptoms may benefit from initiating treatment that provides relief more quickly.
- Avoiding allergens: It may be helpful to avoid substancesâsuch as pollen and moldâthat can cause allergic rhinitis . Allergic rhinitis leads to congestion and airway restriction, which contribute to sleep apnea symptoms.
- Nasal breathing retraining: Nasal breathing retraining is a type of physical therapy that aims to strengthen the tongue and surrounding muscles to help a child breathe effectively at night. It may help reduce symptoms, but data is limited.
- Positional therapy: Positional therapy involves training a person to sleep in a different position. It may be used in children whose sleep apnea occurs only when they sleep on their back. Elevating the head of the bed can also help alleviate sleep apnea. However, limited information is available about the effectiveness of positional therapy in children.
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Causes Of Central Sleep Apnea
In many cases, doctors cannot figure out the root cause of CSA. Doctors call this primary, or âidiopathic,â CSA.
But some CSA is linked to another illness, a medication, or your environment:
- Stroke, heart failure, or kidney failure can cause CSA with a distinctive Cheyne-Stokes breathing pattern. Doctors call this CSB-CSA.
- Heart conditions, kidney problems, and other illnesses can also cause non-CSB CSA.
- High-altitude CSA typically happens during sleep when youâre very high up . It usually goes away when you return to lower altitudes.
- Some medications and drugs, especially opiates like hydrocodone or fentanyl, can cause CSA. Your doctor may be able to help you adjust your medication. Talk to a doctor or therapist if you think you may be misusing medications, especially opiates.
In children, the reason for CSA is typically unclear .
Still, there are a number of things that can interfere with the brain signals that normally help your child breathe. And these could lead to CSA:
- Premature birth
- Problems at the base of the skull, or brain stem
Just What Should I Do If I Suspect A Problem
If youve attempted improving your rest, however still snore or wake up feeling worn out, its time to talk with your physician.
If you have been informed you snore, as well as really feel tired as well as indifferent a lot of the time, take some time to review this with your medical professional.
Restored interest for living as well as a wondrous vitality could simply be your incentive.
Dr Carmel Harrington, Sleep Consultant
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Does Sleep Apnea Increase The Risk Of Dementia
While there is no treatment or cure for dementia, researchers strive to develop other methods for slowing the effects of dementia on patients. Mild cognitive impairment is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia.
In mild cognitive impairment, the individual, family, and friends notice cognitive changes, but the individual can still successfully carry out everyday activities. Mild cognitive impairment is associated with an increased risk of developing dementia in subsequent years.
Researchers believe this is the optimal time to intervene to help prevent a future dementia diagnosis. Finding new ways to slow cognitive decline in those with mild cognitive impairment is therefore important.
What Are The Signs Of Sleep Apnea
There are two kinds of sleep apnea: obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea happens when air cant flow into or out of the nose or mouth, although youre trying to breathe. Central sleep apnea happens when the brain fails to send the right signals to your muscles to make you start breathing.
Sleep apnea may be noticed more by the bed partner than by the sleeper, says Jun. Your bed partner might notice that your breathing pauses, or they may complain of your loud snoring.
That said, snoring itselfthough annoyingisnt the same as sleep apnea. Snoring is just the vibration sound created by airway resistance. You can snore loudly and not have sleep apnea, and you may even have sleep apnea without much snoring.
People with sleep apnea might also suffer from unexplained fatigue and mood swings, because their breathing interruptions continually wake them and prevent them from settling into a deep, nourishing sleep.
The consequences can be significant, Jun says. We’re talking about car accidents in the daytime, lost productivity at work, mood swings, waking up feeling groggy and falling asleep in class.
Other sufferers might wake up with a dry mouth, since sleep apnea tends to make you breathe with an open mouth, drying out your saliva. Some awaken with a headache, which may be caused by low oxygen or high carbon dioxide levels during sleep.
How is Weight Control Linked to Sleep Apnea?
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How Obstructive Sleep Apnea Affects Your Breathing
Obstructive sleep apnea stops you from breathing normally at night. If you have obstructive sleep apnea, you probably repeat this cycle while you sleep:
First, you may sleep quietly and breathe normally. The air in your airway flows easily to your lungs.
Then, you begin to snore loudly. This is a sign that your airway is partly blocked. If the blockage worsens this may affect the amount of air that can enter your lungs and your oxygen level can drop.
Next, your airway closes off completely. No air reaches your lungs. Your brain is telling you to breathe as usual, but you cant take in a breath because your airway has closed off. This is called apnea. After a pause of 10-30 seconds or more, your brain realizes you havent been breathing, so it jolts you awake enough for you to take a breath. You take in a big gasp of air and start breathing again.
This cycle can continue through the night: you breathe quietly you snore you have a pause in your breathing you gasp for breath and you start breathing again. Most people have dozens or hundreds of sleep apnea events a night. This means dozens or hundreds of interruptions of sleep. You cant get the restful sleep you need to be healthy.
The combination of both apnea events and hyponea events is called obstructive sleep apnea-hyponea syndrome .
How Is Obstructive Sleep Apnoea Diagnosed
Breathing difficulties while sleeping can be caused by a variety of medical conditions, so a range of tests may be needed to confirm or rule out OSA. An overnight sleep study is the main method of investigating OSA and is best conducted by technologists/physiologists experienced in working with children.
The sleep study involves a recording of various measurements, such as breathing rate, heart rate and oxygen levels while the child sleeps. A video and sound recording will also be made. The test results are interpreted by a paediatric sleep medicine physician, who can make a diagnosis of OSA.
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How Is Obstructive Sleep Apnea Treated
When obstructive sleep apnea is mild, doctors might check a child’s sleep for a while to see if symptoms improve before deciding on treatment. Nasal sprays or other medicines may help some kids with mild OSA.
When big tonsils cause sleep apnea, doctors will refer families to an ear, nose, and throat doctor . The ENT might recommend:
- removing the tonsils
- removing large adenoids
- removing both
These surgeries often are effective treatments for obstructive sleep apnea.
For other causes, a doctor may recommend continuous positive airway pressure therapy. In CPAP therapy, a person wears a mask during sleep. The mask may cover the nose only or the nose and mouth. It’s connected to a machine that pumps air to open the airways.
When excess weight causes obstructive sleep apnea, it’s important to work with a doctor on diet changes, exercise, and other safe ways to lose weight. These patients often need CPAP to help them breathe during sleep.
How Is Obstructive Sleep Apnoea Treated
The decision to start treatment is made on a case-by-case basis once OSA has been confirmed. Surgery to remove the adenoids and/or the tonsils is the most common treatment for paediatric OSA. This procedure can usually be done at a local hospital although some children have risk factors which may mean that this procedure will need to be done in a specialist unit with intensive care facilities.
If removal of the adenoids and/or tonsils is not indicated or if surgery does not fully resolve the symptoms then Positive Airway Pressure therapy may be used. This requires the patient to wear a mask over the nose while a positive pressure is applied from a ventilator to keep the airway open while asleep.
Other treatments may include the use of a nasopharyngeal airway which acts as a splint to maintain an open airway and keep the tongue from falling back. This treatment is predominantly used in children less than one year of age.
Another alternative treatment is the use of nasal steroids or montelukast to clear any inflammation of the nasal passage. Orthodontic procedures may also be appropriate including mandibular advancement to move the jaw forward.
Children with OSA who are overweight or obese are strongly encouraged to follow a weight management program, including nutritional advice, exercise regime, and behavioural recommendations .
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Upper Airway Surgery For Sleep Apnea
If you have exhausted other sleep apnea treatment options, surgery to increase the size of your airway may be a possibility.
The surgeon may remove tonsils, adenoids, or excess tissue at the back of the throat or inside the nose, reconstruct the jaw to enlarge the upper airway, or implant plastic rods into the soft palate. Surgery carries risks of complications and infections, and in some rare cases, symptoms can become worse after surgery.
Tips To Improve Health And Comfort
Choose a CPAP device with a built-in humidifier. Most devices now include a built-in humidifier, which helps prevent the dryness and skin irritation that can sometimes occur.
If youre experiencing nasal congestion, you may prefer a full-face mask over a nasal or nasal pillow mask. Also be sure to keep your humidifier tank full, keep your tubing and mask clean, and make sure your filter is clean. Nasal sprays and antihistamines also help.
Keep your device clean. Its very important to clean your CPAP hose, nosepiece or mask, and humidifier tub regularly, as a dirty CPAP device can cause infections and even pneumonia. Your sleep doctor and device manufacturer will give you detailed cleaning instructions.
To ensure maximum comfort, ask your doctor about soft pads to reduce skin irritation, nasal pillows for nose discomfort, and chinstraps to keep your mouth closed and reduce throat irritation and dry mouth.
Mask the sound of the CPAP machine. Most new CPAP devices are quiet, but if the sound of your CPAP machine bothers you, try placing it beneath the bed and using a sound machine to muffle the noise.
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Living With Sleep Apnea
Snoring can be a dangerous condition. Here’s how to recognize if you’re at risk.
When Dave Williams fell asleep while stopped at a red light 12 years ago, he had to face up to a problem. “I was falling asleep at inappropriate times,” says Williams, then 45, a business consultant in Cordova, Tenn. His doctor diagnosed obstructive sleep apnea , a condition in which breathing pauses repeatedly during sleep, and symptoms include loud snoring at night and sleepiness during the day.
“People who have sleep apnea typically don’t have any problems with their breathing while they’re awake,” explains Nancy A. Collop, MD, professor of medicine and neurology at Emory University School of Medicine and director of the Emory Sleep Center. “But when people with OSA sleep, their throat narrows to such a degree that they can’t get enough oxygen.” When breathing stops, the brain sends an alarm and the sleeper wakes up, usually with a loud snort or chortle, and breathing resumes. Left untreated, OSA can increase a person’s risk of high blood pressure, heart disease, and stroke, says Collop.