Sleep apnea or Obstructive Sleep Apnea (OSA) is a condition that causes your upper airway collapse while you sleep.
Sadly, the number of people diagnosed with sleep apnea is continuously rising.
I chose to discuss this disorder because of the damage that this disease can cause while it remains undiagnosed.
Obstructive sleep apnea
ICD 10- G47.33
Central sleep apnea symptoms
Patients who have this condition complain of sleep deprivation, fatigue, exhaustion, poor concentration and sleepiness during the day.
Did you know that males have a higher rate of sleep apnea than females?
The statistics show that the rate of sleep apnea in males is 2-3 times higher than females.
Sleep apnea AHI
Apnea means no breathing, and hypopnea refers to shallow breathing.
We consider an Apnea-Hypopnea index under 5 normal, 5 to 15 mild, 16 to 30 moderate, and more than 30 a severe sleep apnea.
Causes and risk factors
Risk factors for sleep apnea include:
- Obesity and overweight
- Airway abnormalities
- Nasal congestion
- Menopausal and postmenopausal women
Stages of sleep
To better understand this disease, you should know about the stages of sleep.
We have two main stages of sleep:
- Rapid eye movement (REM)
- Non-rapid eye movement (NREM) sleep
In the REM (rapid eye movement) stage your brain is active and dreaming.
During this phase, the body paralyzes, most muscles don’t move, the tongue muscles become paralyzed, and airway obstruction worsens.
In the NREM phase, most brain activities and blood pressure, heart rate, and breathing are down.
In essence, most of the sleep (roughly 80%) is in the NREM phase.
Signs of sleep apnea
The most common symptoms of this disease are snoring and exhaustion.
While most patients aren’t aware of the snoring, they often complain of the exhaustion.
Usually, the family members are the once who report serious symptoms including snoring, choking, and gasping for air to the patients.
Diagnosis (sleep study)
To diagnose this disease, performing a sleep study is necessary. A home sleep study is usually sufficient to evaluate an individual for this condition.
However, a small percentage of people with complex health conditions including heart failure, severe obesity, or patients who would need an EEG (brain wave monitoring) might require a laboratory sleep study.
Sleep apnea treatment options
The non-invasive treatment of this disease is generally built on a continuous positive airway pressure (CPAP) machine and weight loss.
Mouthguard (oral appliances) shown to help people with a mild form of obstructive sleep apnea.
Patients who don’t respond to non-invasive treatment might benefit from a surgical procedure.
Individuals who have upper respiratory obstruction because of nasal or throat abnormalities could benefit from the correction of these problems.
Nevertheless, surgery should remain the last treatment option.
Children with sleep apnea
The presentation of sleep apnea in children is different than adults.
In adults, fatigue and sleepiness are the most common presentation of sleep apnea.
Contrary to adults, in children, the most common presentations are the behavioral changes of the child, symptoms such as irritation, poor concentration, attention deficit, cognition impairment, and aggression.
Children who aren’t treated might suffer from growth impairment, high blood pressure, and heart muscle thickenings.
Many children could benefit from adenoid and tonsil surgery. Some children might also benefit from CPAP and BIPAP (bilevel positive airway pressure [BPAP]).
Is sleep apnea dangerous?
Yes, sleep apnea can cause severe medical conditions. For instance:
- Poor concentration
- Increase the risk of diabetes
- Developing fatty liver
- High blood pressure
- Heart disease
Sleep apnea is another silent killer that requires early diagnosis and treatment.
Several conditions like low blood pressure, depression, lack of good quality sleep or hormonal issues that could result in fatigue during the day.
A home sleep study– in most patients– would be sufficient to evaluate you for possible sleep apnea.
If the home sleep study is inconclusive, then you might require a laboratory sleep apnea test.
The following changes might help you to prevent apnea, for instance, avoiding smoking and alcohol intake at night, regular exercise, maintaining a comfortable weight, not eating large amounts of foods after 7 PM, and elevating the back of the bed.