(Obstructive Apnea; Central Apnea; Mixed Apnea)
Definition
Definition
Sleep apnea occurs when breathing stops for brief periods of time while a person is sleeping. It can last for 10-30 seconds, and may occur up to 20-30 times per hour. During 1 night of sleep, this can cause up to 400 episodes of interrupted breathing.
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Causes
Causes
There are three types of respiratory events:
- Obstructive apnea—caused by a temporary, partial, or complete blockage of the airway
- Central apnea—caused by a temporary failure to make an effort to breathe
- Mixed apnea—a combination of the first 2 types
Risk Factors
Risk Factors
Sleep apnea is more common in men and in adults over 40 years of age.
Factors that increase your chances of developing sleep apnea include:
- Overweight
- Large neck circumference
- Family history of apnea
-
Structural abnormalities of the nose, throat, or other part of the respiratory tract. Examples include:
- Polyps
- Severely enlarged tonsils
- Deviated nasal septum
- Hypothyroidism
- Asthma
- Certain medications, such as sedatives and sleeping aids
- Alcohol consumption
- Smoking
Symptoms
Symptoms
Symptoms may include:
- Fatigue and sleepiness during waking hours
- Loud snoring
- Breathing that stops during the night—as noticed by a bed partner
- Repeated waking at night
- Unrefreshing sleep
- Morning headaches
- Poor concentration or problems with memory
- Irritability or short temper
People with chronic, untreated sleep apnea may be at risk for:
- Motor vehicle accidents
- Depression
- Hypertension
- Heart disease
- Stroke
- Kidney disease
Diagnosis
Diagnosis
An overnight sleep study is used to help diagnose sleep apnea.
Overnight Sleep Study (Polysomnography)
This test helps detect the presence and severity of sleep apnea. During sleep, it measures your:
- Eye and muscle movements
- Brain activity using an electroencephalogram
- Heart rate
- Breathing pattern and depth
- The percent of your red blood cells that are saturated with oxygen
Other Studies
In addition to sleep studies, your doctor may order:
- Blood tests to check thyroid function
- Electrocardiogram
- Pulmonary function tests
Treatment
Treatment
There are a number of treatment options for sleep apnea, including:
Behavioral Therapy
- Lose weight if you are overweight.
- Avoid using sedatives, sleeping pills, alcohol, and nicotine, which can make the condition worse.
- Try sleeping on your side instead of on your back.
- Use pillows to increase your level of comfort when sleeping.
- For daytime sleepiness, practice safety measures, such as avoiding driving or operating potentially hazardous equipment.
Mechanical Therapy
Continuous positive airway pressure (CPAP) is done by wearing a mask over your nose and/or mouth during sleep. An air blower forces enough constant and continuous air through your air passages to prevent the tissues from collapsing and blocking the airway.
Oral Appliances
Oral appliances that help keep the tongue or jaw in a more forward position may help those with mild to moderate sleep apnea. They can also be used for those with severe obstructive sleep apnea who cannot use CPAP therapy or have tried it without success.
Surgery
In some cases, surgery may be advised. It is most often helpful in children.
Types of surgery that may be done to treat severe cases of sleep apnea include:
- Adenotonsillectomy—The adenoids and tonsils are removed.
- Uvulopalatopharyngoplasty—Excess soft tissue is removed from the nose and/or throat.
- Maxillomandibular advancement—The jawbone is repositioned forward.
- Tracheotomy —For life-threatening cases of sleep apnea, an opening is made in the windpipe to allow for normal breathing.
Bariatric surgery may help with weight loss in some people who are obese. This surgery may reduce many of the complications that are related to obesity, including sleep apnea.
Medications
Only used in central apnea, acetazolamide may help improve the ability to regulate breathing.
Supplemental oxygen may be given if blood levels of oxygen fall too low during sleep, even after opening the airway.
Prevention
Prevention
You may be able to prevent sleep apnea by maintaining a healthy weight. Avoid alcohol, nicotine, and sedatives, which may contribute to airway obstruction.
RESOURCES:
National Sleep Foundation http://www.sleepfoundation.org
CANADIAN RESOURCES:
Canadian Sleep Society http://www.canadiansleepsociety.ca
References:
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Last Updated: 8/11/2015