Causes Of Sleep Apnoea
Obesity is one of the most common causes of sleep apnoea. Other contributing factors include:
- alcohol, especially in the evening this relaxes the throat muscles and hampers the brains reaction to sleep disordered breathing
- certain illnesses, such as reduced thyroid production or the presence of a very large goitre
- large tonsils, especially in children
- medications, such as sleeping tablets and sedatives
- nasal congestion and obstruction
- facial bone shape and the size of muscles, such as an undershot jaw.
What Are The Effects Of Sleep Apnea
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.
Bmi For Adults Widget
The STOP-BANG survey below is a self-evaluation you can take to assess the chances of having sleep apnea. However, to get a proper diagnosis, you must see a healthcare practitionereither a primary care physician/clinician or a sleep specialist. He or she will obtain additional information and determine whether there are alternative explanations for your symptoms. Your doctor will decide whether further evaluation is necessary. Sometimes excessive daytime sleepiness is simply related to insufficient sleep. If it seems likely that you have OSA, then additional diagnostic testing will be required.
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When To Seek Medical Advice
See your GP if you think you might have OSA.
They can check for other possible reasons for your symptoms and can arrange for an assessment of your sleep to be carried out through a local sleep centre.
As someone with OSA may not notice they have the condition, it often goes undiagnosed.
Read more about diagnosing OSA.
Causes Of Sleep Apnea
To treat sleep apnea, or to get rid of it for good, youll need to get down to the root cause. Some causes of sleep apnea include:
- Weight – Being overweight or obese is a common cause. The extra tissue in the upper airway and around the neck can obstruct your airway, keeping you from breathing during sleep.
- Sleep Position – Some people only have periods of apnea while sleeping on their backs .
- Anatomy – Sometimes your anatomy can be the cause of your sleep apnea. This could be from large tonsils that narrow the upper airway or a deviated septum, for example.
- Alcohol – Alcohol can relax muscles and tissues that can block the airway.
- Smoking – Smoking can cause inflammation in the airway, contributing to sleep apnea.
- Medication – Certain medications may also play a role in causing sleep apnea.
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Sleep Insight With Vihealth App
The next morning, you wake up, take off the device and enter the ViHealth APP to view the detailed report. You will see your overnight blood oxygen level, how many times your oxygen drops, how long your oxygen is below 90%, heart rate, body movement, and O2 score. O2 score is an easy and simple index to tell if your SpO2 is healthy while sleeping. It is calculated based on the drop time and how severe it drops, the higher the better. You can also log notes to record your comments, such as lifestyle or therapy. Or share overnight oximetry data and trends with doctors or friends for advice.
Get Better Quality Sleep
Good sleeping habits and sleep patterns are important to feeling well and happy, and are a supplement to other sleep treatments.
Try to go to bed and get up at the same time every day. Keep your bedroom dark and quiet and get seven to eight hours sleep a night.
If you sleep on your back, try sleeping on your side instead to relieve your symptoms.
For a good nights sleep:
- exercise every day – in the morning is best
- go outdoors during the day and into sunlight or bright light
- keep your bedroom at a comfortable temperature for you
- use your bed for sleep and sex only
- do something to relax just before you go to bed, such as having a warm bath
- if you find yourself always worrying at bedtime, try to find a time in the day to write down your worries and get them out of your system
What to avoid:
- exercise late in the day
- going to bed too hungry or too full
- eating heavy, spicy or sugary foods close to bedtime
- coffee or tea in the evening
- drinking alcohol within four to six hours of your bedtime
- looking at a bright screen within 30 minutes of bedtime. Their light interferes with your bodys sleepiness cues
- taking a nap during the day
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Lifestyle Changes And Weight Reduction
Obesity results in fatty deposits around the neck, which contribute to pharyngeal collapse.35 Although a decrease in weight has been shown to decrease critical closing pressures of the airway, there are inconsistent findings on the association between weight reduction and overall improvement in sleep and breathing patterns.36 Studies have shown that sleeping in the supine position compared with the lateral position may double the apnea-hypopnea index in patients with OSA. Strategies to avoid the supine position include placing tennis balls in a sock or pocket and pinning or sewing them onto the back of a shirt; wearing vests with posterior bumpers; and using positional alarms, verbal instruction, and pillows.37 Because of poor long-term compliance, positional therapy is not routinely recommended over standard positive airway pressure therapy.38,39
Articles On Restless Legs Syndrome
In some cases, personal habits can make a sleeping disorder like restless legs syndrome worse. Sometimes they play a big role in the problem.
Here are 10 steps you can take to lessen the symptoms of RLS and get you sleeping better:
- Avoid or limit alcohol, caffeine, and nicotine for at least several hours before bedtime.
- Review all the medications you take with your doctor.
- Exercise every day.
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Avoid Alcohol And Sleeping Pills
If you have trouble sleeping, try a cup of decaffeinated herbal tea or juice instead of unwinding with a glass of wine. Alcohol and certain medications can make throat muscles relax more than normal. As a result, airways can get blocked. Alcohol and medications can also make it harder for your brain to “wake up” and register a lack of oxygen in the body. This can cause longer and more serious pauses in breathing. If you find it hard to fall asleep, try reading a book or taking a warm bath.
What Does Restless Legs Syndrome Feel Like
Restless legs syndrome feels a little different for every person, said Dr. Lee-Iannotti. But most describe a tingling or the sensation of ants crawling on their legs. For some it can feel like pins and needles. In some cases, the feeling may progress beyond simple sensations to be painful.
Dr. Lee-Iannotti commented that as much as 10% of the U.S. could be suffering from RLS, however the condition is sometimes misdiagnosed. Even more often, patients never bring the issues to their doctors attention. RLS tends to develop slowly, over decades. However, if left untreated the symptoms can become severe. In advanced cases, nights become extremely stressful and symptoms can persist throughout the day, spreading from the legs to other extremities.
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Treatment Options For Obstructive Sleep Apnea
Important things to know about OSA treatments
- As the causes of sleep apnea vary there is no single treatment that works for everyone.
- Weight loss is advisable in anyone who is overweight.
- Reduction of alcohol consumption, avoidance of sleep on your back, and the use of nasal sprays can be helpful in some cases.
- When the sleep apnea is mild, treatment may be optional and a range of options may be considered.
- When the sleep apnea is moderate or severe, the use of CPAP is generally recommended.
- Oral appliances generally work best in mild to moderate sleep apnea.
- Surgery may be considered where there is a distinct obstruction to the nose and/or throat.
What is sleep apnea and how is it diagnosed?
is present when the airway at the back of the throat is repeatedly blocked, partly or completely, during sleep. Snoring, obesity, observed apneas and sleepiness in the day may suggest that a person has sleep apnea. See our link. The best way to be really sure about an OSA diagnosis is with an overnight and a clinical assessment by your doctor.
What are the treatment options?
Once a diagnosis of OSA is established, talk with your doctor about the need for treatment and the options available for you. The circumstances often vary from person to person, since the underlying causes may be different. Generally speaking, the options can include one or more of the following:
How Is Obstructive Sleep Apnea Treated
These are common treatments to maintain consistent breathing and stop or reduce apnea episodes:
Sleeping with a CPAP machine and mask this treatment provides a constant flow of air to help keep your airway open
Wearing an oral appliance, a custom-fit mouthpiece your dentist or orthodontist can make for you to keep airways open while you sleep
Several types of surgery can be done to treat obstructive sleep apnea:
Surgery to repair defects in facial structures
Surgery to get rid of extra tissues that can block airways
Surgery to repair abnormalities that cause obstructions when you breathe or to create a wider airway
Removal of adenoids and tonsils; this is most effective in children
Hypoglossal nerve stimulator- an implant device that delivers upper airway stimulation synchronized to your breathing to relieve obstruction during sleep
Making a few changes to your sleep and other behaviors can also help manage obstructive sleep apnea:
Shed any excess weight.
Limit your use of sedatives.
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How Is It Treated
You may be able to treat mild sleep apnea by making changes in how you live and the way you sleep. For example:
- Lose weight if you are overweight.
- Sleep on your side and not your back.
- Avoid alcohol and medicines such as sedatives before bed.
If lifestyle changes don’t help sleep apnea, you may be able to use an oral breathing device or other types of devices. These devices help keep your airway open while you sleep.
Sleep apnea is often treated with a machine that helps you breathe while you sleep. This treatment is called continuous positive airway pressure, or CPAP . Sometimes medicine that helps you stay awake during the day may be used along with CPAP. If your tonsils, adenoids, uvula, or other tissues are blocking your airway, your doctor may suggest surgery to open your airway.
Patient Education And Lifestyle Changes
An initial component of treatment for obstructive sleep apnea is informing the patient about the condition and how it may be helped by specific lifestyle changes.
Obstructive sleep apnea can cause significant daytime drowsiness, and its important for people with OSA to be aware of this issue, especially if they spend significant time driving or operating heavy machinery.
Patient education also involves explaining the factors that contribute to OSA. Making lifestyle changes described in the following sections losing weight, exercising regularly, limiting use of alcohol and sedatives, avoiding cigarette smoking, and adjusting sleeping position can reduce the severity of OSA.While these changes can play an important part in obstructive sleep apnea treatment, they may not resolve the condition completely and often need to be combined with other therapies to reduce symptoms of OSA.
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If You Are Concerned You Might Have Osa Talk To Your Doctor
Based on your symptoms, exam, and risk factors, your doctor may recommend a sleep study, or you might be referred to see a sleep medicine specialist. A comprehensive sleep assessment is needed to accurately evaluate sleep complaints, since sleep disorders tend to overlap. Treatment for mild OSA may improve sleep-related symptoms and your quality of life. However, there is no one-size-fits-all approach when it comes to sleep disorders, but rather a multidimensional and individualized approach to find what works for you.
Obstructive Sleep Apnea Treatment
Possible treatment options for obstructive sleep apnea include:
Not drinking alcohol or taking sleeping pills. These make your airway more likely to close during sleep and keep you from breathing like you should for longer periods.
Sleeping on your side.Â This can help if you get mildÂ sleep apneaÂ only when you sleep on your back.
Nasal sprays.Â These can help ifÂ sinusÂ problems or nasal congestion make it harder to breathe while you sleep.
CPAPÂ machine.Â This device includes a mask that you wear over your nose,Â mouth, or both. An air blower forces constant air through your nose orÂ mouth. The air pressure is just enough to keep your upper airway tissues from relaxing too much while you sleep. A similar device is the BPAP, which has two levels of air flow that change when you breathe in and out.
Oral devices.Â If you have mildÂ sleep apnea, you might get dental appliances or oral “mandibular advancement” devices that keep yourÂ tongueÂ from blocking your throat or bring your lower jaw forward. That may help keep your airway open while you sleep. A trained dental expert can decide which type of device may be best for you.
Types of surgery for obstructive sleep apnea include:
Somnoplasty.Â Your doctors uses radiofrequency energy to tighten the tissue at the back of your throat.
Nasal surgery. These operations correct obstructions in your nose, such as a deviated septum .
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Dont Sleep On Your Back
Sleeping on your back is a risk factor for sleep apnea. In this position, gravity draws the tongue and other tissues down and toward the airway, exacerbating the risk of disordered breathing. Adjusting to a different sleeping position may prevent this airway constriction in some patients and can work in conjunction with other types of OSA therapy.
Changing your sleeping position is easier said than done. Some natural back sleepers will struggle to fall asleep in another position, or they may revert to lying on their back while asleep. Different methods have been developed to discourage back sleeping.
One basic method involves sewing a tennis ball into the back of a shirt, which prevents lying in a supine position. While this is effective in the short-term, few people stick with this technique.
Cpap For Treatment Of Sleep Apnea
A CPAP machine is typically the go-to treatment for how to get rid of sleep apnea. CPAP, which stands for continuous positive airway pressure, is a machine that hooks to a hose and mask and is worn over the nose during sleep. The continuous pressure from the machine works to hold open your airway during sleep, allowing air to flow freely to prevent periods of apnea. In other words, it holds your airway open while you sleep so you can keep breathing.
The reason CPAP machines work so well is that generally, it is soft tissues in the neck, throat, and upper airway, along with the tongue, that relax during sleep and obstruct the airway. This obstruction is what causes you to stop breathing for several seconds or minutes while youre asleep. This type of sleep apnea is known as obstructive sleep apnea , and is the most common.
CPAP will not cure sleep apnea but can be an effective treatment if used properly.
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Central Sleep Apnea Causes And Risk Factors
Like obstructive sleep apnea, central sleep apnea is more common in men and people over the age of 65. But unlike obstructive sleep apnea, central sleep apnea is often associated with serious illness, such as heart disease, stroke, neurological disease, or spinal or brainstem injury. Some people with obstructive sleep apnea can also develop central sleep apnea when theyre being treated with positive airway pressure devices.
Diagnosis Of Plmd And Rls
For restless legs syndrome, a doctors evaluation
For periodic limb movement disorder, polysomnography
For either disorder, tests to check for a cause
Doctors can often diagnose restless legs syndrome based on symptoms reported by the person or the personâs bed partner. Doctors may suspect periodic limb movement disorder based on symptoms, such as insomnia, excessive daytime sleepiness, and/or excessive twitching just before going to sleep or during sleep.
Polysomnography, including electromyography , is always done to diagnose periodic limb movement disorder. These tests are done overnight in a sleep laboratory and are not done at home. In polysomnography, brain activity, heart rate, breathing, muscle activity, and eye movements are monitored while people sleep. People may also be videotaped during an entire nights sleep to document limb movements. These tests may also be done after restless legs syndrome is diagnosed to determine whether people also have periodic limb movement disorder.
If either disorder is diagnosed, blood and urine tests are done to check for disorders that can contribute, such as anemia, iron deficiency, and kidney and liver disorders.
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Raise The Head Of The Bed
Sleeping with the head of the bed at an angle of about 60 degrees may help reduce the number of apnea episodes. This solution may be effective for people who have sleep apnea that worsens when they lie on their back but who find it difficult to sleep on their side.
People will be able to achieve this position by sleeping in a bed or chair that has an adjustable upper portion. Alternatively, they can use pillows or purchase a body wedge for their torso to keep their head elevated.
Symptoms Of Sleep Apnea
The primary symptoms of sleep apnea include fatigue and low energy and experiencing daytime sleepiness. The bodys lack of oxygen and regular sleep disruptions at night are what cause issues such as the sleep apnea symptoms during the day. Your sleeping positions can have an impact on your sleep and can impact Sleep Apnea. Other symptoms include:
- Sore or Dry Throat
- Falling Asleep As You Drive
The above symptoms, combined with lacking energy during the daytime, means that people with sleep apnea have a higher risk of decreased performances at school or work and being involved in motor vehicle accidents.
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Restless Legs Syndrome Medication
Medication is currently considered the gold standard for people with moderate to severe RLS. To reduce the risk of unpleasant side effects, always work with a doctor to find the medication thats right for you.
People with RLS resulting from another condition, or those with another consideration such as pregnant women, children, people with anxiety or depression, or individuals with kidney disease, may need to exercise extra caution when taking medication.
RLS can be treated with several different families of medications, the most common being dopamine agonists and anti-seizure drugs.
Check Your Medicine Cabinet
There are many common medicationsboth prescription and over-the-counterthat can trigger the symptoms of RLS or make them worse. Medications to watch out for include:
- Cold and allergy medications containing antihistamines .
- Anti-nausea medications .
Get checked for iron and vitamin deficiencies
A number of vitamin and mineral deficiencies are linked to restless legs syndrome.
Iron. Iron deficiency is a well-known cause of RLS, so ask your doctor to test you for anemia. However, supplementing with iron can also improve RLS symptoms in those who arent anemic.
Magnesium. Magnesium can improve sleep and some studies have shown it to be beneficial for restless legs. Try experimenting with a magnesium supplement at bedtime to see if your symptoms improve.
Vitamin D. Recent studies show that RLS symptoms are more frequent and more severe in people with vitamin D deficiency. Your doctor can easily test your vitamin D levels or you can simply make it a point to get out more in the sun.
Folate . Folate deficiency has been linked to RLS, which may explain why restless legs are so common in pregnant women . When folic acid is low, B12 is often low as well, so you may want to try supplementing with a B-complex vitamin.
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What Surgical Treatment Options Are Available To My Osa Patients
Because OSA relates to the structure and tone of the upper airway, upper airways surgeries are aimed at reducing the degree of obstruction in the nose, oropharynx, or hypopharynx. Anatomical features that may predispose to OSA include retroposition of the maxilla or mandible, enlarged pharyngeal fat pads, enlarged soft palate, enlarged tongue, narrow posterior airway space, and upper airway hypotonia.
Phase I surgeries include nasal surgeries, palatal surgeries, and tongue-based surgeries that may initially alleviate and treat OSA. Phase II surgery, known as maxillomandibular advancement, is generally reserved for patients with major OSA due to velo-orohypopharyngeal airway obstruction that could not be resolved from phase I surgeries.
Surgical success is frequently defined when the individual achieves a greater than 50% reduction of the AHI or an AHI of 20/h., However, this oft-used definition of success for OSA surgeries may not represent a clinical cure, so careful attention must be paid to endpoints used in studies of surgical treatments for OSA. Determination of surgical candidacy on a case-by-case basis, with attention to severity of OSA, presence/absence of obesity, and presence/absence of craniofacial features amenable to surgery, can help increase the likelihood of surgical success. Continuous weight management and optimal treatment of medical comorbidities is imperative to reduce postoperative worsening or recurrence of OSA.
Treatments May Be Trial And Error Until You And Your Doctor Get It Right
When sleep apnea is mild, treatment recommendations are less clear-cut, and should be determined based on the severity of your symptoms, your preferences, and other co-occurring health problems. Working in conjunction with your doctor, you can try a stepwise approach if one treatment doesnt work, you can stop that and try an alternative. Managing mild sleep apnea involves shared decision-making between you and your doctor, and you should consider just how bothered you are by sleep apnea symptoms, as well as other components of your health that could be made worse by untreated sleep apnea.
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What Is Sleep Apnea And How Can It Be Prevented
It is never too late to start living a healthier lifestyle to prevent sleep apnea and other serious health conditions from developing.
Symptoms Of Sleep Apnoea
People with significant sleep apnoea have an increased risk of motor vehicle accidents and high blood pressure, and may have an increased risk of heart attack and stroke. In the over-30 age group, the disorder is about three times more common in men than women. Some of the associated symptoms include:
- daytime sleepiness, fatigue and tiredness
- poor concentration
- impotence and reduced sex drive
- need to get up to toilet frequently at night.
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