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What Is Obstructive Sleep Apnea

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What Happens When The Airway Is Blocked Or Partially Blocked

ResMed – What is obstructive sleep apnea ?

When sufficient air doesn’t get into a person’s lungs, the level of oxygen in the blood falls and the level of carbon dioxide rises. After a few minutes of not breathing, a person may die. Fortunately, with OSA, after a period of not breathing, the brain wakes up, and breathing resumes. This period of time can range from a few seconds to over a minute. When breathing resumes, the size of the airway remains reduced in size. The tissues surrounding this narrow airway vibratewhat we call snoring. In other words, snoring is a sign of an obstructed airway, but it does mean that a person is breathing silence might indicate that the airway is completely blocked.

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

What Happens When You Stop Breathing

When you stop breathing, your heart rate also tends to drop the longer your body is deprived of oxygen. Then, your involuntary reflexes cause you to startle awake at the end of that period of not breathing. When this occurs, your heart rate tends to accelerate quickly and your blood pressure rises.

These are changes that take place acutely when you stop breathing. However, your body starts to experience chronic effects if you experience frequent apnea. Data suggests increased risk, particularly when you stop breathing roughly 30 times or more per hour. But there is likely a risk at even lower frequency rates.

For example, your blood pressure tends to go up, your heart walls thicken due to increased workload and the structure of your heart changes. It tends to become stiffer and less flexible because there are more fibrous cells growing in between the muscle cells.

All of those things increase the risk that you can have either atrial or ventricular arrhythmias. They also tend to reduce the function of the heart so that its less efficient at pumping blood.

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What Is Continuous Positive Airway Pressure Or Cpap Treatment For Obstructive Sleep Apnea

Continuous positive airway pressure is the gold standard one-size-fits-all treatment of obstructive sleep apnea. Continuous positive airway pressure therapy involves wearing a mask over your nose, mouth, or both. A small machine, or CPAP machine forces pressurized air into the airway to stop the airway closing during sleep.

What Is Central Sleep Apnea

Do You Have Obstructive Sleep Apnea?

Central sleep apnea occurs when the brain temporarily fails to signal the muscles responsible for controlling breathing. Unlike obstructive sleep apnea, which can be thought of as a mechanical problem, central sleep apnea is more of a communication problem.

Central sleep apnea is also much less common than obstructive sleep apnea. Some estimates claim that approximately 20% of sleep apnea cases are CSA, but many others believe that number to be much lower .

Central sleep apnea is often caused by medical problems and conditions that affect the brainstem. These different causes often lead to varying symptoms and different types of central sleep apnea.

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Commonalities In Sleep Apnea

Whether it is central vs obstructive sleep apnea, there are complications that arise from periods of low oxygen due to breathing disruption while sleeping. The sudden drops in blood oxygen levels can tax the cardiovascular system, leading to spikes in blood pressure and overall hypertension or high blood pressure.6

Sleep apnea sufferers report daytime fatigue and grogginess, as well as difficulty staying focused. Sleep apnea can even increase your risk of developing Type II diabetes.

All types of sleep apnea can be treated with sleep apnea equipment such as a continuous positive airway pressure machine, or a CPAP machine.7

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.

References

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Obstructive Vs Central Sleep Apnea: Key Differences And Treatment Options

    Sleep apnea is a common sleep disorder that affects thousands of individuals. With this condition, you have an interruption in your breathing while sleeping that occurs through repetitive pauses, referred to as apneic events. There are several types of sleep apnea, but two prominent types include obstructive sleep apnea and central sleep apnea.

    As a sleep technologist, its important for you to know the key differences between central and obstructive apnea so you know how to best treat your patients who may have one or the other disorder.

    Continuous Positive Airway Pressure

    What is Obstructive Sleep Apnea?

    Continuous positive airway pressure therapy is the first line of treatment for obstructive sleep apnea. CPAP is administered through a facemask thats worn at night. The facemask gently delivers positive airflow to keep the airways open at night. The positive airflow props the airways open. CPAP is a highly effective treatment for sleep apnea. A dental device may also be necessary to keep the lower jaw positioned forward.

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    What Are The Health Risks Of Sleep Apnea

    Sleep apnea can lead to sleep deprivation from constant nightly interruptions and shallower overall sleep. Lack of sleep is associated with far-reaching health consequences that affect a person physically, mentally, and emotionally, and as a result, it comes as no surprise that sleep apnea has been tied to diverse health problems.

    Because of how it affects oxygen balance in the body, untreated sleep apnea raises dangers for various types of cardiovascular issues including high blood pressure, heart attack, heart disease, and stroke.

    Diagnosis And Treatment Of Obstructive Sleep Apnea In Adults

    MICHAEL SEMELKA, DO JONATHAN WILSON, MD and RYAN FLOYD, MD, Excela Health Latrobe Hospital, Latrobe, Pennsylvania

    Am Fam Physician. 2016 Sep 1 94:355-360.

    Patient information: See related handout on obstructive sleep apnea, written by the authors of this article.

    Obstructive sleep apnea is a common, chronic disorder that disrupts breathing during sleep. It affects persons of all ages but especially those middle-aged and older.1 Patients with OSA temporarily stop or decrease their breathing repeatedly during sleep.25 This cessation or decrease in breathing is the result of repetitive partial or complete obstruction of the airway caused by narrowing of the respiratory passages.4,68 These breathing disruptions can awaken a person or prevent deep, restful sleep. The effects of fragmented sleep on daytime fatigue and sleepiness are widely recognized.3,6

    WHAT IS NEW ON THIS TOPIC: OBSTRUCTIVE SLEEP APNEA

    In patients with obstructive sleep apnea, continuous positive airway pressure lowers blood pressure and rates of arrhythmia and stroke, improves left ventricular ejection fraction in patients with heart failure, and reduces fatal and nonfatal cardiovascular events.

    A recent meta-analysis demonstrated similar rates of blood pressure lowering between continuous positive airway pressure and mandibular advancement devices.

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    American Sleep Apnea Association

    We envision a world in which most people suffering from sleep apnea are diagnosed, aware, educated and treated. This serious syndrome, when left untreated has a large influence on quality of life and multiple life-threatening implications. Yet it is highly treatable. Unfortunately it is estimated that more than 80% of people suffering from sleep apnea are undiagnosed. To help those living with sleep apnea, we work relentlessly to promote

  • better awareness in the general public and among health professionals and,
  • affordable, convenient and highly effective diagnoses and treatments.
  • What Causes Obstructive Sleep Apnea In A Child

    Obstructive Sleep Apnea Treatments to Reduce ...

    The muscles in the head and neck help keep the upper airway open. When a child falls asleep, these muscles tend to relax. That allows tissues to fold closer together. If the airway is partially closed while awake, falling asleep may cause the passage to close completely.

    In children, the most common cause for such a blockage is enlarged tonsils and adenoids. These glands are located at the back and to the sides of the throat. They may grow too large. Or an infection may cause them to swell. They may then briefly block the airway during sleep.

    Obstructive sleep apnea may also be caused by:

    • Being overweight
    • A tumor or growth in the airway
    • Certain syndromes or birth defects, such as Down syndrome and Pierre-Robin syndrome

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    Diagnosing And Treating Sleep Apnea For Better Health

    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

    Johns Hopkins Home Care

    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.

    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 Obstructive Sleep Apnea Diagnosed

    Diagnosis of obstructive sleep apnea usually involves participating in a sleep study, in which you’re observed as you sleep. You may participate in a test called a polysomnogram at a hospital or sleep center. But you may also use a take-home version of the test. Your doctor may give you a monitor to wear when you sleep that measures your oxygen levels and heart rate, to help diagnose sleep apnea.

    Your doctor will also typically do a physical exam, including an exam of the throat, neck, and mouth, and take your medical history. You’ll probably also have to answer questions about your sleep and bedtime routine, as well as your symptoms.

    What Are The Complications Of Obstructive Sleep Apnea

    What is Obstructive Sleep Apnea (OSA)

    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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    How Sleep Apnea Impacts The Brain

    Sleep Apnea is a sleep condition that affects the breathing system. Sleep apnea prevents the brain from getting sufficient oxygen by interfering with breathing patterns. The most serious type of sleep apnea is called Obstructive Sleep Apnea when a persons airway becomes obstructed during sleep.

    The disruption of memory and imagination is one of the side impacts of sleep apnea. A blockage of the airway causes sleep apnea throughout sleep, many commonly thickening tissue in the back of the throat due to. VitalSleep

    Without sufficient oxygen, it can be hard to retain info or think creatively. Furthermore, individuals with severe cases of OSA are most likely to have hypertension and high cholesterol levels, which can lead to heart disease and diabetes.

    What Happens During Osa

    Figure 1: Airflow During Normal Breathing. Viewing the head and neck from the side, the blue arrows indicate that during normal inhalation, air flows into the upper airway through the nose as well as through the mouth , down behind the tongue and through the back of the throat into the lungs. During exhalation, the pattern of airflow is reversed.

    Figure 2: Obstruction of the Airway During Apnea. Viewing the head and neck from the side, the airway is blocked by the tongue falling back against the back of the throat . No airflow can occur.

    Daytime sleepiness, fatigue, and/or insomnia are common in people with untreated OSA.

    Normally when you breathe in, air flows through the nose and/or mouth, past the back of the throat, and down into the lungs . The reverse occurs when breathing out the flow goes from the lungs through the throat, and then out the nose and/or mouth. When you fall asleep, breathing remains more or less the same, except that the rate of breathing slows down slightly.

    Obstructive sleep apnea occurs when a person’ airway repeatedly becomes blocked despite efforts to breathe . This breathing cessation is called obstructive sleep apnea. In cases where there are frequent episodes of both complete and partial blockage, the term obstructive sleep apnea hypopnea is used.

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    What Is Sleep Apnea And How To Acknowledge It

    Sleep apnea is a condition that leads to breathing interruptions during sleep, resulting in less oxygen intake and fewer hours of sleep. VitalSleep

    The reason for sleep apnea is the unintended collapse of the airways because of muscles around them weakening or ending up being too relaxed.

    Sleep apnea can be diagnosed with a physical examination. An overnight video recording is called polysomnography or house screening tools that measure airflow.

    Frequently patients can identify if they have sleep apnea by self-monitoring their snoring patterns.

    Restless nights and chronic tiredness can be brought on by sleep apnea. Its hard to tell when youre snoring. Still, there are a couple of indications that you might have it: your partner informs you when they hear it, you get up with a sore throat or headache, or when your bedmate states that they awakened to discover that the position of the bed had actually been interrupted.

    What Are The Causes Of Sleep Apnea

    Diagnosing &  Treating Obstructive Sleep Apnea

    Obstructive sleep apnea occurs when a persons airway becomes blocked during sleep. Multiple factors have been found to increase the risk of blockage and OSA:

    • Anatomical characteristics. The size and positioning of a persons neck, jaw, tongue, tonsils, and other tissue near the back of the throat can directly affect airflow.
    • Obesity. Being overweight is a leading cause of OSA and may be an underlying risk factor in up to 60% of cases. Obesity contributes to anatomical narrowing of the airway, and research has found that a 10% increase in weight can equate to a six-fold increase in OSA risk.

    Related Reading

    • Sleeping on your back. This sleeping position makes it easier for tissue to collapse around the airway and cause blockages.
    • Nasal congestion. People whose ability to breathe through the nose is reduced because of congestion are more likely to experience OSA.
    • Hormone abnormalities. Hormone conditions like hypothyroidism and acromegaly may increase the risk of OSA by causing swelling of tissue near the airway and/or contributing to a persons risk of obesity.

    In CSA, breathing is affected in a different way than in OSA. Instead of an obstruction causing breathing lapses, the problem arises in how the brain communicates with the muscles responsible for respiration. In particular, the brain stem fails to adequately perceive the levels of carbon dioxide in the body, leading to breathing that is slower and shallower than it should be.

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