Sleep and Sleep Apnea
Are you operating with a low battery? Just like a battery or a cellphone needs to be recharged, our brains and our bodies also need to be recharged. That brain and body recharge comes when we get a sufficient amount of undisrupted sleep. It might be a busy schedule that doesn’t permit enough time for sleep or one of the many sleep disorders such as Obstructive Sleep Apnea.
What is obstructive sleep apnea?
Obstructive sleep apnea is a condition in which there are breathing pauses (apnea) during sleep. These breathing pauses can last up to 30 seconds or more! Breathing always restarts, so this is not an immediate danger, but… it can cause problems.
When we fall asleep, the muscles of the throat relax. The airway narrows somewhat but not enough to interfere with breathing. If there are factors which cause additional narrowing of the airway, breathing becomes restricted and cause breathing to stop momentarily (apnea). When there is a long breathing pause, oxygen levels decline and carbon dioxide levels rise until… the brain is suddenly jolted out of sleep. A bedpartner may hear a gasp or a snort as breathing restarts. To the bedpartner, it would appear as though the person remained asleep through the episode. When an apnea episode occurs during a sleep study, the EEG recording brain waves show a sudden “wake up” of the brain. These “mini-wakeups” disrupt the normal recharging of the brain. A person who had “slept for 8 hours”, may have received only 4 hours of effective brain recharge. When these episodes occur night after night, for months and years, the inevitable result is sleepiness and other problems during the day.
What causes sleep apnea?
- Obesity is by far the most common cause
- Abnormalities of jaw, palate, and throat
- Enlarged tonsils
- Narrow facial bone structure
- Small jaw or receding chin
- Cleft palate even after surgical correction
- Alteration of facial structure such as down syndrome
What are the signs of obstructive sleep apnea?
- Loud or noisy breathing, snoring, or mouth breathing during sleep
- Pauses in breathing during sleep or difficulty breathing during sleep
- Restless sleep (i.e., lots of tossing and turning)
- Sweating heavily during sleep
What symptoms can be caused by sleep apnea?
- Daytime sleepiness
- Difficulty focusing, poor work or school performance
- Irritability, depression
- Morning headaches
- High blood pressure
How is obstructive sleep apnea diagnosed?
- Detailed sleep history
- Physical examination
- Sinus and neck x-rays
- Sleep study (polysomnogram). This test is conducted in a specialized bedroom in a sleep laboratory. It records brain activity, heart rate, air flow through the mouth and nose, blood oxygen levels, muscle activity, chest wall movement and sleep interruption. No needles!
How is obstructive sleep apnea treated?
Sleep apnea is treated in different ways, depending on the cause of the obstruction.
- Continuous positive airway pressure (CPAP) – CPAP involves wearing a mask over the nose during sleep. The mask is attached to a small portable machine that blows air through the nasal passages. The air pressure keeps the airway open to allow normal breathing during sleep
- Mandibular advance device – a special kind of “bite splint” can be fitted by a dentist
- Lifestyle modification – weight loss is often recommended
- Nasal/sinus management – important that the nasal passageway is health and “open”
- Surgery – removal of enlarged tonsils and adenoids or correction of structural abnormalities of their head and neck area
Additional sleep information and suggested readings:
- The National Sleep Foundation