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How Common Is Sleep Apnea

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Family History And Genetics

Common Sleep Problems (Sleep Apnea and Insomnia) | Ask The Expert

Researchers have identified family history as a risk factor for sleep apnea, but maintaining a healthy lifestyle can decrease this risk. Studies in twins have shown that sleep apnea can be inherited. Some of the genes related to sleep apnea are associated with the structural development of the face and skull and with how the brain controls sleep and breathing during sleep. Some genes are also associated with obesity and inflammation.

Sleep Apnea Cardiovascular Risk And Metabolism

Several studies have shown an association between sleep apnea and problems like type 2 diabetes , strokes , heart attacks and even a shortened lifespan, says Jun. Why this connection? For one thing, obesity is common in sleep apnea patients, and obesity greatly increases risks of diabetes, stroke and heart attack, he says. In most cases, obesity is the main culprit behind both conditions, Jun explains.

Still, its important to note that not everyone with sleep apnea is obese. Furthermore, evidence suggests an independent link between sleep apnea and diabetes. Our lab and others have shown that sleep apnea is associated with higher risks of diabetes, independent of obesity, and that sleep apnea can increase blood sugar levels, says Jun.

For people who are overweight or obese, weight loss is key for treating or avoiding sleep apnea. People who accumulate fat in the neck, tongue and upper belly are especially vulnerable to getting sleep apnea. This weight reduces the diameter of the throat and pushes against the lungs, contributing to airway collapse during sleep.

Women in particular should be careful as they age. While premenopausal women tend to put on weight in the hips and in the lower body instead of the belly, this shifts with time. Weight begins to accumulate in traditionally male areas like the tummy, and this leads to a greater chance of sleep apnea.

Who Gets Sleep Apnoea

Anyone can get sleep apnoea. Its estimated that about 5% of Australians have sleep apnoea, with around 1 in 4 men over the age of 30 affected.In the over-30 age group, the disorder is about 3 times more common in men than women.

People with narrow throats are more likely to have sleep apnoea and snore during sleep as their throat muscles relax.

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What Causes Obstructive Sleep Apnea

When we sleep, our muscles relax. This includes the muscles in the back of the throat that help keep the airway open. In obstructive sleep apnea, these muscles can relax too much and block the airway, making it hard to breathe.

This is especially true if someone has large tonsils or adenoids, which can block the airway during sleep.

Other things that can make a child likely to have OSA include:

  • a family history of OSA
  • medical conditions such as Down syndrome or cerebral palsy
  • problems of the mouth, jaw, or throat that narrow the airway
  • a large tongue, which can fall back and block the airway during sleep

Diagnosing And Treating Sleep Apnea For Better Health

Sleep Apnea  How Common is it?

Its important to treat sleep apnea, because it can have long-term consequences for your health. While there have been some high-profile deaths linked to sleep apneasuch as with Judge Antonin Scalia Jun says that the true risk is from damage done over time.

Obstructive sleep apnea can range from mild to severe, based on a measurement system called the apnea-hypopnea index . The AHI measures the number of breathing pauses that you experience per hour that you sleep.

Obstructive sleep apnea is classified by severity:

  • Severe obstructive sleep apnea means that your AHI is greater than 30
  • Moderate obstructive sleep apnea means that your AHI is between 15 and 30
  • Mild obstructive sleep apnea means that your AHI is between 5 and 15

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We provide high quality, individualized care for patients of all ages where you feel most comfortable your home or community. Our services and equipment are designed to help you regain and retain a level of independence.

Whether or not you need treatment for sleep apnea depends on its severity, whether or not you have symptoms such as sleepiness and other health conditions. For example, if you have risk factors for heart disease, your doctor might opt to treat you even for mild sleep apnea. On the other hand, if you have a severe case of sleep apnea, your doctor might insist on treatment even if youre not sleepy.

Not very relaxing, right? Luckily, its treatable.

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Obstructive Sleep Apnea Is A Common Disorder In The Populationa Review On The Epidemiology Of Sleep Apnea

Karl A. Franklin1, Eva Lindberg2

1 Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden

Contributions: Conception and design: All authors Administrative support: None Provision of study materials or patients: Not applicable Collection and assembly of data: All authors Data analysis and interpretation: All authors Manuscript writing: All authors Final approval of manuscript: All authors.

Correspondence to:

Keywords: Epidemiology population-based sleep apnea prevalence

Submitted Nov 27, 2014. Accepted for publication Jun 14, 2015.

doi: 10.3978/j.issn.2072-1439.2015.06.11

How Is Central Sleep Apnoea Syndrome Treated

  • MaturityApnoea of prematurity/infancy may improve as the child gets older and the respiratory centre matures. It is likely the sleep consultants will check this by organising follow-up sleep studies.
  • Supplemental oxygenBreathing extra oxygen during sleep may help reduce the number of apnoeic pauses and lessen the effects of CSA by improving the oxygen levels in the blood.
  • Bilevel Positive Airway Pressure BPAP is a form of breathing assistance using a ventilator device that delivers extra air pressure into the airway via a mask placed on the face. The level of air pressure provided varies on breathing in or breathing out. BPAP can also be set to deliver a breath if there has not been a breath within a certain number of seconds.
  • MedicationsIt is possible that medication may be available to help stimulate breathing in patients with CSA.
  • SurgicalIf the brainstem is affected by either an abnormality or a compression from the skull, such as in Chiari malformation, surgical options may be available.

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What About Mild Sleep Apnea

There have not always been consistent outcomes data or consensus about treatment recommendations for people with mild sleep apnea. Nonetheless, there are several studies that have demonstrated quality of life benefits in treating mild OSA, including a recent study published in The Lancet, where researchers from 11 centers throughout the United Kingdom recruited and randomized 301 patients with mild OSA to receive CPAP plus standard of care vs. standard of care alone, and followed them over three months. The results found that in patients with mild OSA, treatment with CPAP improved their quality of life, based on a validated questionnaire.

This study supports a comprehensive approach to evaluation and treatment of mild OSA. While all people with mild OSA may not need to be treated with CPAP, there are patients who can greatly benefit from it.

Getting Tested For Sleep Apnoea

Dr. Richard Kearley: Common Sleep Disorders: Apnea & Insomnia

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

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Why Is It Important To Treat Obstructive Sleep Apnea

When a person with obstructive sleep apnea considers all the options for treatment, he or she may be tempted to not choose any of them. The masks and dental appliances have to be worn every night and the surgeries are painful and have no guarantee that they will be successful. When considering the consequences of all the treatments, however, it is important to remember that there are consequences of not receiving treatment.

It is estimated that only a small percentage of patients with obstructive sleep apnea are being treated. Some of the remaining people with obstructive sleep apnea know that they have a problem, but they choose not to pursue treatment. People with obstructive sleep apnea may have a right to accept the risks to their health that refusing treatment poses however, when they drive they put everyone else at risk as well. People who refuse treatment for their obstructive sleep apnea should be reported to the DMV, which often will suspend their driver’s licenses. Untreated obstructive sleep apnea also increases the risk of:

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.

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What Is Central Sleep Apnea And What Causes It

Central sleep apnea occurs when the brain does not send the signal to breathe to the muscles of breathing. This usually occurs in infants or in adults with heart disease, cerebrovascular disease, or congenital diseases, but it also can be caused by some medications and high altitudes.

Central sleep apnea may occur in premature infants or in full-term infants. It is defined as apneas lasting more than 20 seconds, usually with a change in the heart rate, a reduction in blood oxygen, or hypotonia . These children often will require an apnea monitor that sounds an alarm when apneas occur. Central sleep apnea in children is not the same thing as sudden infant death syndrome .

Under normal circumstances, the brain monitors several things to determine how often to breathe. If it senses a lack of oxygen or an excess of carbon dioxide in the blood it will speed up breathing. The increase in breathing increases the oxygen and decreases the carbon dioxide in blood. Some people with heart or lung disease have an increase in carbon dioxide in their blood at all times.

Central sleep apnea usually occurs in adults with other medical problems. In infants, it usually occurs with prematurity or other congenital disorders. In both patient groups it is usually suspected by the primary care doctor. Central sleep apnea can be diagnosed with a sleep study or overnight monitoring while the patient is in the hospital.

Screening For Sleep Apnea

Five Adult Sleep Disorders

To screen for sleep apnea or other sleep disorders, your doctor may ask you about common signs and symptoms of this condition, such as how sleepy you feel during the day or when driving, and whether you or your partner has noticed that you snore, stop breathing, or gasp during your sleep. Your doctor may ask questions to assess your risk for developing this condition and take your physical measurements. Your doctor will also want to see whether you have any complications of undiagnosed sleep apnea, such as high blood pressure that is difficult to control. If the screening suggests a sleep breathing disorder, you may get a referral to a sleep specialist to help confirm a diagnosis.

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Getting Up To Urinate A Lot

Did you know that the reason most of us can sleep six to eight hours without having to go to the bathroom is because when we are sleeping well, we dont notice the urge to urinate? For men who suffer from Sleep Apnea, this isnt the case. Because they are lighter sleepers, every need to go to the restroom is noticed. One common Sleep Apnea sign for men is urinating frequently throughout the night.

If you or someone you care for exhibits these or similar symptoms, it would make sense to suggest a sleep study or at the very least, a consultation with the individuals primary care doctor. Sleep apnea is highly treatable, yet only about 20% of patients with moderate to severe Sleep Apnea ever do anything about it. Getting diagnosed doesnt have to be hard, taking a sleep apnea test at home has grown in popularity and may be a great option for you or your partner. Understanding the common symptoms of Sleep Apnea in men and taking action can save lives and improve your wellbeing.

Possible Signs Of Sleep Apnea

While catching an apnea as it happens is definitely proof of sleep apnea, there are other signs that indicate someone may be experiencing sleep apnea. Snoring is a key indicator of obstructive sleep apnea, as the partial obstruction of the airways that produces snoring may lead to a total obstruction. Following an apnea, someone with sleep apnea may gasp for air while sleeping.

Sleepiness, grogginess, inattentiveness, or irritability during the day is a sign of both central and obstructive sleep apnea. The structure of natural sleep is disrupted by sleep apnea, which means someone that is suffering from sleep apnea will not get as much high-quality sleep as they need. Although the hours spent in bed may be sufficient, they may be getting fitful sleep that is not very restful. Dry mouth or headaches upon waking are also signs of sleep apnea.

Many sleep apnea signs and symptoms could also be caused by other conditions. If you suspect that you may be experiencing sleep apnea, you should schedule a sleep observation study. During a sleep study, you will be observed sleeping and monitored closely. Any disruption of breathing will be readily apparent.

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Apnea Test In Determining Brain Death

A recommended practice for the clinical diagnosis of formulated by the hinges on the conjunction of three diagnostic criteria: , absence of reflexes, and apnea . The apnea test follows a delineated protocol. Apnea testing is not suitable in patients who are hemodynamically unstable with increasing vasopressor needs, metabolic acidosis, or require high levels of ventilatory support. Apnea testing carries the risk of arrhythmias, worsening hemodynamic instability, or metabolic acidosis beyond the level of recovery and can potentially make the patient unsuitable for organ donation. In this situation a confirmatory test is warranted as it is unsafe to perform the apnea test.

What Are The Effects Of Sleep Apnea

Identifying and Treating Common Sleep Disorders

If left untreated, sleep apnea can result in a number of health problems including hypertension, stroke, arrhythmias, cardiomyopathy , heart failure, diabetes, obesity and heart attacks.

Its likely that sleep apnea can cause arrhythmias and heart failure because if you have sleep apnea, you tend to have higher blood pressure. In fact, sleep apnea occurs in about 50% of people with heart failure or atrial fibrillation.

This is because sleep apnea can cause:

  • Repeated episodes of oxygen lowering .
  • Changes in carbon dioxide levels.
  • Direct effects on the heart due to pressure changes within the chest.
  • Increased levels of markers of inflammation.

With the high prevalence of sleep apnea in cardiac arrhythmias and heart failure , experts recommend that you dont delay in seeking the advice of your physician.

Last reviewed by a Cleveland Clinic medical professional on 03/03/2020.

References

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What Are The Nonsurgical Treatments For Obstructive Sleep Apnea

The nonsurgical treatments for obstructive sleep apnea are similar to the non-surgical treatments for snoring with a few differences. Treatments include

  • behavioral changes,
  • CPAP , and
  • medications.

Behavioral changes

Behavioral changes are the simplest treatments for mild obstructive sleep apnea, but often the hardest to make. Occasionally, apneas occur only in some positions . A person can change his or her sleeping position, reduce apneas, and improve their sleep.

Obesity is a known contributing factor to obstructive sleep apnea. It is estimated that a 10% weight gain will worsen the apnea-hypopnea index, and a 10% weight loss will decrease the apnea-hypopnea index. Therefore, a healthy lifestyle and diet that encourages weight loss will improve obstructive sleep apnea.

Unfortunately, most people with obstructive sleep apnea are tired and do not have much energy for exercise. This is a difficult behavioral spiral since the more tired a person is, the less they exercise, the more weight they gain, the worse the obstructive sleep apnea becomes, and the more tired they become. Frequently, after obstructive sleep apnea is treated by other methods people are able to lose weight and the obstructive sleep apnea may improve.

Sleep hygiene and other behavioral modifications known to improve the overall quality of sleep are also recommended. Below are some common practices that can induce sleep and enhance its quality:

Medication

Dental appliances

Continuous positive airway pressure

Scores For Osa Dont Always Correlate With Symptoms

Regardless of the criteria for categorizing OSA as mild, moderate, or severe, the severity of disease does not always correlate with the extent of symptoms. In other words, some people with very mild disease can be extremely symptomatic, with excessive sleepiness or severe insomnia, while others with severe disease have subjectively good sleep quality and do not have significant daytime impairment.

Sleep disorders also tend to overlap, and patients with OSA may suffer from comorbid insomnia, circadian disorders, sleep movement disorders , and/or conditions of hypersomnia . To truly improve a patients sleep and daytime functioning, a detailed sleep related history is needed, and sleep issues must be addressed via a comprehensive, multidimensional, and individualized approach.

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