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How Common Is Obstructive Sleep Apnea

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Check If You Have Sleep Apnoea

Obstructive Sleep Apnea 1

Symptoms of sleep apnoea mainly happen while you sleep.

They include:

  • 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.

Getting Tested For Sleep Apnoea

If a GP thinks you might have sleep apnoea, they may refer you to a specialist sleep clinic for tests.

At the clinic, you may be given devices that check things like your breathing and heartbeat while you sleep.

You’ll be asked to wear these overnight so doctors can check for signs of sleep apnoea.

You can usually do this at home, but sometimes you may need to stay in the clinic overnight.

The test can show if you have sleep apnoea and how severe it is. This is based on how often your breathing stops while you sleep .

Your AHI score shows how severe your sleep apnoea is:

  • AHI of 5 to 14 mild
  • AHI of 15 to 30 moderate
  • AHI over 30 severe

Causes Of Sleep Apnea

The most common cause of obstructive sleep apnea in children is enlarged tonsils and/or adenoids. Both the tonsils and adenoids are lymph tissue. The tonsils are located in the back of the throat, and the adenoids are located at the back of the nose. During sleep there is a considerable decrease in muscle tone, which affects the airway and breathing. Many of these children have little difficulty breathing when awake however, with decreased muscle tone during sleep, the airway becomes smaller, and the tonsils and adenoids block the airway. This makes the flow of air more difficult and increases the work the child has to do to breathe. It can be compared to breathing through a small, flimsy straw with the straw occasionally collapsing and blocking airflow. Many of the short pauses in breathing cause a brief arousal that increases muscle tone, opens the airway and allows the child to resume breathing.

Although the actual number of minutes of arousal during the night may be small, the repeated disruptions can result in a poor night’s sleep, which can lead to significant daytime problems in children. The child is usually unaware of waking up because he/she is not waking up completely. The parents often describe the child as a very restless sleeper.

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Stick To A Regular Sleep Schedule

Going to bed and waking up at roughly the same times every day helps you to get the right kind of sleep. You need to experience the full cycle of deep- and lighter-stage sleep to feel well rested. A regular sleeping schedule also prevents you from getting overtired, which can make sleep apnea symptoms worse.

Obstructive Sleep Apnea Causes

Obstructive Sleep APNEA

In children, enlarged tonsils or adenoids are a common cause of obstructive sleep apnea. Surgical removal often leads to resolution of obstructive sleep apnea symptoms. For adults, causes may obstructive sleep apnea causes vary but include:

  • Age
  • Obesity, which may cause increased soft tissue around the airway
  • Structural deformities that obstruct the airways

Women are typically less likely to suffer from obstructive sleep apnea than men, because middle-aged men are more likely to have changing anatomy in their neck and soft tissues. Women could also be at a decreased risk because of the higher levels of progesterone, however they are more likely to suffer from obstructive sleep apnea symptoms during pregnancy and after menopause.

Furthermore, there seems to be a genetic component to obstructive sleep apnea. Studies have shown that sufferers often have a positive family history. Lifestyle factors like drinking, smoking, and overeating can increase the chances of developing obstructive sleep apnea.

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How Does Sleep Apnea Affect Pregnancy

Pregnant women often have a hard time sleeping well due to the general discomfort that comes with pregnancy. When pregnant women also have obstructive sleep apnea, the sleep they get can be fragmented and less restful due to frequent awakening.

However, the effects of sleep apnea during pregnancy go beyond poor sleep. Pregnant women with OSA have a significantly higher risk of pregnancy-specific complications compared to pregnant women without OSA.3 Additional research is needed to establish a causal relationship between OSA and pregnancy complications. However, the following are potential medical consequences associated with OSA and pregnancy:

Due to the potential medical complications associated with OSA and pregnancy, OSA can have a significant impact on maternal mortality rates.4 One study found that pregnant women with obstructive sleep apnea were five times more likely to die during a pregnancy-related admission to the hospital. When educating pregnant patients with OSA, it is important to discuss potential health consequences for their unborn children as well.

Cardiovascular And Cerebrovascular Diseases

Many studies have examined the role of OSA as a pathogenetic factor in cardiovascular and cerebrovascular diseases, as well as the potential protective effects of CPAP treatment. OSA may increase cardiovascular risk through multiple intermediate mechanisms, such as intermittent hypoxia, high sympathetic nervous activity, systemic hypertension, endothelial cell dysfunction, oxidative stress, inflammation, and accelerated atherosclerosis . On the other hand, chronic intermittent hypoxia could also activate some protective mechanisms, for example through the development of coronary vessel collaterals in patients with ischemic heart disease .

Systemic hypertension

The best studied cardiovascular comorbidity in OSA is systemic hypertension . Respiratory events during sleep are associated with hypertensive peaks occurring at the end of apneas and hypopneas, increased mean nocturnal blood pressure, and increased variability of blood pressure . A dose-response relationship has been shown between OSA severity and blood pressure . OSA patients may show elevated blood pressure values during sleep only, or during sleep and wakefulness, making 24-hour monitoring of blood pressure highly advisable in the OSA population . Resistant hypertension, i.e. incomplete blood pressure control on three antihypertensive drugs, is also frequent in OSA patients.

Cardiovascular events and/or death

Arrhythmias

Cerebrovascular disease

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Treatment Of Obstructive Sleep Apnea

  • Control of risk factors such as obesity, hypertension, alcohol use, and sedative use

  • Continuous positive airway pressure or oral appliances

  • For anatomic encroachment or disease that does not respond to devices, surgery, or nerve stimulation

The aim of treatment is to reduce episodes of hypoxia and sleep fragmentation treatment is tailored to the patient and to the degree of impairment. Success is defined as a resolution of symptoms with AHI reduction below a threshold, usually 10/hour.

Treatment is directed at both risk factors and at obstructive sleep apnea itself. Specific treatments for obstructive sleep apnea include continuous positive airway pressure , oral appliances, and airway surgery.

Bilevel Positive Airway Pressure

Obstructive Sleep Apnea

Bilevel positive airway pressure machines are sometimes used for the treatment of OSA if CPAP therapy is not effective.

BPAP machines, sometimes called BiPAP machines, have settings that deliver two pressures in response to your breathing: inhaled pressure and exhaled pressure. This means the pressure changes during inhaling versus exhaling.

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What Treatments Are Available

If youre diagnosed with OSA, depending on the severity of your condition, you might be able to treat it with a few lifestyle changes. Cutting back on alcohol, losing weight, and quitting smoking can help reduce sleep apnea. Sleeping on your side or stomach instead of on your back can also improve your breathing while asleep, and some might find relief through nasal sprays and breathing strips that cut down snoring and improve airflow. Your sleep specialist might also refer you to a dentist for a mouth appliance to keep the tongue in place or to adjust the jaw to keep the airway open during sleep.

Some patients with OSA or central sleep apnea may be treated using Continuous Positive Airway Pressure therapy, which involves wearing a mask over the nose and mouth while sleeping. These devices prevent your airway from closing by using air pressure to hold up airway tissues while you sleep. If CPAP isnt effective for those with central sleep apnea, other breathing devices known as adaptive servo-ventilation or bilevel positive airway pressure may be used. However, these are not recommended for people with heart failure, so be sure to talk with your healthcare provider about what might be right for you.

For cases that dont improve through lifestyle changes or devices, surgery might be an alternative.

If you are experiencing any of the signs of sleep apnea, dont disregard them. Talk to your healthcare provider for diagnosis and treatment.

Who Gets Sleep Apnea

Sleep apnea occurs in about 25% of men and nearly 10% of women. Sleep apnea can affect people of all ages, including babies and children and particularly people over the age of 50 and those who are overweight.

Certain physical traits and clinical features are common in patients with obstructive sleep apnea. These include excessive weight, large neck and structural abnormalities reducing the diameter of the upper airway, such as nasal obstruction, a low-hanging soft palate, enlarged tonsils or a small jaw with an overbite.

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Signs And Symptoms Of Sleep Apnea

Family members or bed partners often pick up on the signs of sleep apnea first. Many people with sleep apnea don’t know they’re snoring and gasping for breath at night. If you have any of the following signs, see your doctor:

  • daytime sleepiness
  • loud snoring followed by silent pauses
  • gasping or choking during sleep
  • morning headache
  • poor concentration or memory loss
  • lowered sex drive

Snoring by itself doesn’t necessarily mean that you have sleep apnea. It is true that loud snoring is common in people with this disorder, but there’s a big difference between simple snoring and sleep apnea.

Untreated sleep apnea can cause serious health problems. If it’s not treated, sleep apnea can lead to:

  • high blood pressure
  • work-related injuries

How Does Maternal Osa Affect The Developing Fetus

Second Medical Opinions Blog: What is Obstructive Sleep Apnea? Who is ...

While most of the health impacts of obstructive sleep apnea are on the mother, studies have shown possible effects on the developing fetus as well. Potential medical consequences of OSA on the fetus include the following:

  • Stillbirths2,9

Additional research is necessary to establish a causal relationship between OSA and adverse fetal outcomes. However, multiple studies have found the fetus can experience developmental and medical complications due to maternal OSA. A study of over 1 million women published in Sleep Medicinein 2020 concluded that OSA can cause a higher risk of congenital anomalies.

Maternal OSA is also associated with 1.5 to twofold increased frequency of low birth weight and small for gestational age.3 Neonates born to mothers with OSA are also more likely to require resuscitation, intensive care unit admission, and longer hospital stays.2 When caring for pregnant patients with gestational hypertension and diabetes, it is especially important to consider OSA diagnostic tests to ensure a healthier and safer pregnancy for both the mother and fetus.

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Testing And Diagnosis Of Sleep Apnea

Talk to your child’s physician if you are concerned about your child’s breathing during the night. Your child may be referred to a specialist, such as a sleep specialist, an otolaryngology physician or a pulmonary doctor for further evaluation.

In addition to a complete medical history and physical examination, diagnostic procedures for obstructive sleep apnea may include an overnight sleep study and an evaluation of the upper airway by visualization and/or X-rays. A lateral neck X-ray can be performed in the office on the same day of the appointment to allow for immediate review of the size of the adenoids. This is non-invasive and will allow the provider to determine if the adenoids are enlarged, which could be contributing to sleep apnea.

Your doctor will discuss the usefulness of a sleep study at our Sleep Laboratory in the evaluation of obstructive sleep apnea. During a sleep study, a total of 16 electrodes are placed on your child to record his sleep activities, from brain function and breathing patterns to eye activity and muscle tone. More than 1,000 sheets of readings are recorded for each child during the night, with two technologists present at all times to monitor your child and evaluate the recordings.

What Are The Typical Body Characteristics Of Someone With Osa

As mentioned before, OSA is more commonly found in people who are overweight and obese. In people with this type of body habitus, the upper airway usually is crowded due to the extra weight in that area. Furthermore, OSA is more prevalent in someone with a large neck and/or waist. Specifically, if the neck is larger than 17 inches in men and 16 inches in women, this will predispose you to OSA.

However, it is possible for crowding in the upper airways to be present. This could be due to a genetic predisposition. Signs of a crowded airway include small chin, receding chin, large tongue, large tonsils, long or large uvula, high arched or narrow palate, deviated septum, nasal polyps, enlarge turbinates.

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Does Sleep Apnea Qualify As A Disability

According to the Nolo legal network, the Social Security Administration doesnt have a disability listing for sleep apnea. It does, however, have listings for breathing disorders, heart problems, and mental deficits that might be attributed to sleep apnea.

If you dont qualify for the conditions listed, you may still be able to receive benefits through a Residual Functional Capacity form. Both your doctor and a claims examiner from Disability Determination Services will fill out an RFC form to determine whether youre able to work due to:

  • your sleep apnea

Greetings Health Care Professional

Obstructive Sleep Apnea

Were glad you found your way to the American Sleep Apnea Association web site and to this page. Sleep apnea is finally becoming more widely recognized as the life-damaging and life-shortening disease that it is, but theres still much to be done in getting out the word about its hazards, how to recognize it, and how to treat it.

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Know Your Sleep Apnea Risk Level

Sleep apnea is a serious condition that affects more than 30 million Americans who suffer from lack of restorative sleep.

The majority are undiagnosed and unaware of their condition.

Typical symptoms include heavy snoring, excessive daytime sleepiness or fatigue, difficulty with concentration or memory, among many others.

Untreated, sleep apnea can lead to serious health consequences.

Anesthesia And Pain Medicine

The presence of sleep apnea presents special challenges to the administration of anesthesia and pain medications that may affect respiration or relax muscles. Since most people who have sleep apnea dont know it, the anesthesiologist or pain clinician is well advised to screen the patient for OSA before proceeding. One useful screening tool is the STOP-BANG questionnaire, which is rapidly becoming the standard for a quick assessment. Should it be determined there is a likelihood that OSA is present, a sleep study should be considered. If not possible, the patient should be considered to have sleep apnea and treated with appropriate precautionary steps. These procedures are laid out in greater detail here.

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Rising Prevalence Of Sleep Apnea In Us Threatens Public Health

DARIEN, IL Sept. 29, 2014 Public health and safety are threatened by the increasing prevalence of obstructive sleep apnea, which now afflicts at least 25 million adults in the U.S., according to the National Healthy Sleep Awareness Project. Several new studies highlight the destructive nature of obstructive sleep apnea, a chronic disease that increases the risk of high blood pressure, heart disease, Type 2 diabetes, stroke and depression.

Obstructive sleep apnea is destroying the health of millions of Americans, and the problem has only gotten worse over the last two decades, said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. The effective treatment of sleep apnea is one of the keys to success as our nation attempts to reduce health care spending and improve chronic disease management.

Data previously published in the American Journal of Epidemiology show that the estimated prevalence rates of obstructive sleep apnea have increased substantially over the last two decades, most likely due to the obesity epidemic. It is now estimated that 26 percent of adults between the ages of 30 and 70 years have sleep apnea.

Findings from new studies emphasize the negative effects of sleep apnea on brain and heart health however, these health risks can be reduced through the effective treatment of sleep apnea with continuous positive airway pressure therapy:

What Are The Complications Of Obstructive Sleep Apnea

Sleep Research

Letting obstructive sleep apnea continue untreated is risky you can get in a serious accident if you fall asleep while operating machinery or driving a car.

Health problems may develop as a result of obstructive sleep apnea, including:

  • Increased blood pressure

  • Changes in your body’s response to insulin and glucose

  • Changes in mental function and mood

  • Cardiovascular problems like heart failure, stroke, or abnormal heartbeat

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Meet The Three Sleep Apneas

Obstructive sleep apnea is caused by a blockage of the airway, usually when the tongue collapses against the soft palate and the soft palate collapses against the back of the throat during sleep, and the airway is closed. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Complex sleep apnea, as the name implies, is a combination of the two conditions. With each apnea event, the brain rouses the sleeper, usually only partially, to signal breathing to resume. In those with severe sleep apnea this can happen hundreds of times a night, often most intensely late in the sleep cycle during rapid-eye-movement sleep. As a result, the patients sleep is extremely fragmented and of poor quality. Meanwhile the disorder continuously reduces the oxygenation of the blood, further stressing the sleepers physical system.

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