Sleep Apnea and Snoring

Have you been told that you snore loudly?
Do you wake up feeling tired after a full night's sleep?
Are you sleepy during the day?
 
If so, you may have sleep apnea. In this potentially serious sleep disorder, breathing repeatedly stops and starts during sleep.

 

"Apnea" is Greek for "without breath."

Snoring…
While we are breathing, air flows in and out in a steady stream from our nose or mouth to our lungs. When we are asleep, the area at the back of the throat sometimes narrows. The same amount of air passing through this smaller opening can cause the tissues surrounding the opening to vibrate, which in turn can cause the sounds of snoring. Different people who snore may have various reasons for the narrowing of the area at the back of the throat. The narrowing can be in the nose, mouth, or throat.
 
What is sleep apnea?
Snoring can be a lot more than a social nuisance. In some cases, it can be a very serious health risk. Snoring is caused by a partial obstruction of the airway. When that obstruction becomes complete, the person experiences obstructive sleep apnea and is not able to breath. Oxygen levels in the blood fall and the brain attempts to wake up the body by causing, among other things, increased heart rate, and coughing/chocking. Someone who suffers from mild sleep apnea may experience this between 5 and 19 times an hour while sleeping. Severe sufferers can experience 40 or more episodes an hour.
 
The consequences of Sleep Apnea are significant. Apnea suffers often do not get a restful night sleep, causing headaches and drowsiness during the day. This can also put someone at an increased risk of vehicular or industrial accidents. The oxygen deprivation apnea sufferers experience every night is also associated with high blood pressure, heart attacks and strokes. It has also been linked to depression, heartburn and reduced sex drive.

Sleep apnea occurs in two main types: obstructive sleep apnea, the more common form that occurs when throat muscles relax, and central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing. Additionally, some people have mixed sleep apnea, which is a combination of both obstructive and central sleep apneas.

1. Central Apnea
The upper airway is open, but no oxygen is getting into the system. This occurs because the patient is not getting a chemical response from the brain to stimulate the lungs and the diaphragm to assist with breathing.
 
2. Obstructive Sleep Apnea
The lungs and the diaphragm are functioning normally, but no oxygen is entering the system because there is an obstruction in the upper airway.
 
3. Mixed Apnea
This is a combination of central and obstructive sleep apnea.

The results of a sleep study will show both the type of sleep apnea, and provide a number of measures of its severity. The Apnea Index (AHI) is the number of apneas and hypopneas per hour. Normal is AHI 0-10, mild 10-15, moderate 15-30, and severe 30+. The degree and frequency of oxygen desaturations may also be an important parameter, particularly in patients with cardiovascular compromise. In general, most clinicians use a subjective mild, moderate, or severe classification if referring to oxygen desaturations.

Who Does Sleep Apnea Affect?
One in five adults has at least mild sleep apnea and one in fifteen adults have at least moderate sleep apnea. Children can also have sleep apnea; obstructive sleep apnea (OSA) affects 1-3% of children.
 
Factors that affect obstructive sleep apnea are as follows:
  1. Age
  2. Weight
  3. Alcohol
  4. Sedative Hypnotics (sleeping pills)
  5. Smoking
  6. Narrow Throat
  7. Large Tongue
  8. Large adenoids and tonsils (in children)
Children and Sleep Apnea
Children can also snore and suffer from obstructive sleep apnea. Often they are highly allergic and their airway is blocked due to enlarged adenoids, tonsils or swollen nasal mucosa. Clinical signs would indicate a turned up nose, allergic shiners under the eyes, mucous draining out of the nose, mouth breathing, and a nasal sound to the voice. Other signs are bed-wetting, irritability, difficulty in concentrating at school and hyperactivity.
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