What Happens During An Apnea
To understand what is going on in an apnea, it’s helpful to think of this analogy. Imagine trying to drink a milkshake through a paper soda straw. As you suck in, the weak paper straw collapses, and you don’t get any of the milkshake. This collapsing is similar to what happens to people with OSA, but instead of missing out on a milkshake, they don’t get enough air into their lungs. This does not occur with normal breathing during wakefulness because signals from the brain activate the tongue and the muscles surrounding the airway and stiffen the airway. Therefore, air can flow into the lungs uninterrupted. In other words, normal breathing during wakefulness is like drinking the milkshake through a plastic soda straw.
When we sleep, there is an increased risk for the airway behind the tongue to collapse with each breath . For most people this collapse does not occur because activation of the muscles surrounding the airway during sleep is still strong enough to prevent any blockage. However, for someone with OSA, the muscles do not respond adequately. Like the paper straw that collapses, the airway collapses and air does not reach the lungs.
Clues You Might Have Sleep Apnea
Feeling tired when you wake up in the morning? Or do you wake up with frequent headaches? Has your bed partner moved to the next room? If so, you may have obstructive sleep apnea .
The surest way to find out if you have this condition is through a sleep study a test used to record what happens to you during sleep. However, there are a few common signs of sleep apnea, including:
Loud and consistent snoring
But should everyone who snores see a specialist?
Most people use the words snoring and sleep apnea interchangeably. However, most people who snore dont necessarily have sleep apnea, but people with sleep apnea snore. People with sleep apnea wake up frequently mid-sleep to gasp for air. If youre sleeping alone and dont have someone to monitor your sleep, you may have to record yourself and contact a doctor for a diagnosis.
Another less common sign of sleep apnea is waking up with a dry mouth and gummy front teeth. It is visible in people with sleep apnea as they sleep with their mouths open. Other studies also show that people with sleep apnea wake up frequently with a desperate urge to urinate.
Some people with sleep apnea have also reported symptoms like mood changes, lower back pain, depression, or issues concentrating.
Tissue Shrinkage Or Removal
Several tissue removal surgeries include uvulopalatopharyngoplasty, radiofrequency tissue reduction, and adenoidectomy. These surgeries will either remove the uvula, adenoid, and other glands that may cause blockage of the airway. The most invasive surgery is tracheotomy, where a hole is created in the patients neck to release airflow. This surgery is only recommended for treating adult obstructive sleep apnea or when a persons life is at risk.
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What Happens When You Sleep
When you sleep, your body undergoes a series of changes that enable the rest that is vital to your overall health. Sleep allows the brain and body to slow down and engage in processes of recovery, promoting better physical and mental performance the next day and over the long-term.
What happens when you dont sleep is that these fundamental processes are short-circuited, affecting thinking, concentration, energy levels, and mood. As a result, getting the sleep you need seven to nine hours for adults and even more for children and teens is crucial.
What happens during sleep, including how distinct stages of sleep unfold, demonstrates the complexity of sleep and its importance for our well-being.
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.
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What Are The Effects Of Apnea
Because waking up is necessary to end an episode of apnea or hypopnea, a person with OSA wakes up again and again throughout sleep. This reduces the duration and quality of sleep. In most cases, a person with OSA is not aware of these repeated awakenings because they occur below the level of consciousness. As a result, people with OSA frequently complain of daytime sleepiness, fatigue, and/or insomnia. This poor sleep may also cause problems with memory, concentration, and mood changes.
There are other physical effects of apnea. In people with OSA, repeated episodes of falling oxygen levels lead to a variety of physiological changes that affect the heart and blood vessels. During these episodes, the heart is stressed, which increases blood pressure and heart rate. There is increased secretion of hormones and substances that are released with stress as well as increased production of compounds that produce inflammation.
Degrees Of Severity Of Sleep Apnoea
The severity of sleep apnoea depends on how often your breathing is interrupted. As a guide:
- normal sleep fewer than 5 interruptions per hour
- mild sleep apnoea between 5 and 15 interruptions per hour
- moderate sleep apnoea between 15 and 30 interruptions per hour
- severe sleep apnoea more than 30 interruptions per hour.
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Who Is At Risk For Sleep Apnea
Sleep apnea seems to run in some families, suggesting a possible genetic basis. People most likely to have or develop sleep apnea include those who:
Have high blood pressure
Have some physical abnormality in the nose, throat, or other parts of the upper airway
Use of alcohol and sleeping pills increases the frequency and duration of breathing pauses in people with sleep apnea.
A Timeline Of Effects
If sleep apnea isnt treated, youre likely to experience adverse side effects and cause long-lasting damage .
However, these effects are minimized if sleep apnea is treated.
It is impossible to say whether your sleep apnea is going to directly cause X side effect in X amount of time.
But if you take the steps to improve what you can change you are reducing the risk of this happening altogether.
Focus on what you can change today, and feel better tomorrow. Do it for your mind and body.
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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.
Sleep Apnea Puts You At Greater Risk Of Accidents And Other Safety Issues
In addition to the health effects of inadequate sleep, sleep apnea has also been shown to increase risk of accidents from driving while drowsy, according to the AASM. A study published in March 2015 in the journal Sleep found that people with sleep apnea were 2.5 times more likely to be the drivers in motor vehicle accidents than people who dont have apnea.
One of the ways sleep apnea presents is as excessive daytime sleepiness, says Dasgupta. People may fall asleep behind the wheel or experience microsleep brief moments of sleep that last one to 30 seconds that you may not even realize you are experiencing.
If you suspect you have sleep apnea, its important to be treated as soon as possible. If you have been diagnosed with sleep apnea but continue to experience symptoms, such as excessive daytime sleepiness, talk to your doctor about whether you should try a new treatment.
The good news is that sleep apnea can be treated and the related health risks reduced, says Dasgupta. Some people may be reluctant to go see a doctor and have a sleep study done because theyve heard that you need to go to a sleep center to be hooked up to monitors and machines, he says, but the diagnosis process is much easier than it was in past decades.
Today, a sleep study is not the Frankensteins monster with tubes coming out you might picture, says Dasgupta. You can do a home sleep study in your own bed.
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How You Know You Might Have Sleep Apnea
It can be hard to know if you have sleep apnea. After all, youre asleep when it happens and many people dont notice or remember episodes of apnea.
Most individuals finally seek medical advice because their loud or frequent snoring is disrupting someone elses sleep, like a bed partner or roommate, says Dr. Doerr.
But theres more to sleep apnea than just snoring. If you think you might have sleep apnea, ask yourself these questions:
- Do I wake up feeling exhausted, even after a full nights sleep?
- Do I wake up with a dry mouth, sore throat or headaches?
- Am I unusually sleepy throughout the day?
- Am I overweight?
Do Certain Foods Trigger Sleep Apnea
Most dairy products rich in fat, such as cream and certain cheeses, can increase mucus production and trigger sleep apnea. Bananas have the same effect and should not be taken before sleep. Also, eating too much of these foods will cause weight gain and increase the risk of sleep apnea and other chronic illnesses.
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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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Sleep Apnea Is Linked To Depression And Anxiety
According to the NSF, obstructive sleep apnea is associated with major depression, regardless of factors like weight, age, sex, or race.
In a study published in January 2016 in the Journal of Clinical Sleep Medicine that assessed 284 newly diagnosed people with sleep apnea, researchers found that 15.5 percent had persistent, mild depression and 6 percent had major depression. The researchers also found that obesity, daytime sleepiness, low physical activity, insomnia, low quality of life, and the use of sleep medication were all related to depression.
Treating sleep apnea could help alleviate the symptoms of depression. In a study published in September 2015 in the Journal of Clinical Sleep Medicine, nearly 73 percent of the subjects suspected of having sleep apnea had significant depression. After 3 months of receiving continuous positive airway pressure treatment a facial mask that supplies air to the nasal passages that number dropped to 4 percent.
Other research, including a meta-review published in May 2019 in the journal EClinicalMedicine , has also found that CPAP treatment can reduce the symptoms of depression in people with obstructive sleep apnea and cardiovascular disease.
What Is Sleep Apnoea
Sleep apnoea occurs when the throat muscles relax too much during sleep. This is the common form of sleep apnoea.
A rarer form is central sleep apnoea where breathing stops during sleep and there is a pause before breathing begins again. It is caused by a disruption to the mechanisms that control the rate and depth of breathing.
If you have sleep apnoea, the walls of your throat will collapse and become narrow as you breath in while you sleep. Air tries to travel through the narrowed airway and causes vibrations in tissues in the back of the throat these vibrations produce sounds known as snoring.
Sometimes the throat can collapse so much that not enough air can get into the lungs , or it blocks off completely and no air gets into the lungs .
You may have partial or complete obstructions where your breathing may decline or stop for a short time . These are sometimes called episodes or interruptions.
When these things happen, the brain gets messages that something is wrong and will arouse itself from sleep for a few seconds. Most people are not aware of these arousals.
This pattern can repeat itself hundreds of times every night, causing you to have fragmented sleep. This can leave you feeling unrefreshed in the morning with fatigue and sleepiness throughout the day and contributing to poor concentration and work performance.
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
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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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How Sleep Apnea Affects Your Body
Sleep apnea occurs when the muscles and soft tissue at the back of the throat relax too much and collapse while you’re sleeping. This allows the soft tissues and the tongue to block your airway and your breathing. When the oxygen level in your blood starts to drop, your brain signals you to wake briefly and start breathing again. This cycle happens over and over throughout the nightoften you don’t even realize it is happening.
Daytime sleepiness, forgetfulness and irritability are just some of the ways sleep apnea may affect your health and well being. People with sleep apnea often feel as if they haven’t slept at all, even if they sleep for the recommended seven to nine hours each night. This is because waking up so often prevents high-quality sleep. In addition to being sleepy during the day, not getting enough sleep may make it harder to concentrate, or could make you forgetful, irritable and foggy-headed. Interestingly, children with sleep apnea often become hyperactive instead of sleepy.
There are serious potential consequences to undiagnosed or untreated sleep apnea. Besides making sleep difficult, it can lead to high blood pressure, heart disease, stroke, diabetes and result in early death.
Is It Sleep Apnea Or Just Snoring
Not everyone who snores has sleep apnea, and not everyone who has sleep apnea snores. So how do you tell the difference between normal snoring and a more serious case of sleep apnea?
The biggest telltale sign is how you feel during the day. Normal snoring doesnt interfere with the quality of your sleep as much as sleep apnea does, so youre less likely to suffer from extreme fatigue and sleepiness during the day. The way you sound when youre snoring also provides clues. As mentioned above, if youre gasping, choking, or making other unusual sounds, you should suspect sleep apnea.
Keep in mind that even if you dont have sleep apnea, a snoring problem can get in the way of your bed partners rest and affect your own sleep quality. But there are tips and treatments that can help you stop snoring.
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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.