Definition

Sleep apnea is a condition in which breathing stops for more than ten seconds during sleep. This results in prevention of oxygen to the lungs and brain that can lead to feeling drowsy and tired during the day. This can lead to more severe and life threatening complications such as stroke and heart failure.

Description

Sleep apnea is divided into two types central and obstructive. Central sleep apnea (less common) is when the brain does not signal the respiratory muscles to begin breathing. Obstructive sleep apnea is the repeated episodes of airway obstruction during sleep, which typically reduces oxygen in the blood.

A distinctive but not the only form of sleep apnea is known as the Pickwickian Syndrome named after a character in Charles Dickens Oliver Twist. Like the individual mentioned persons that had the Pickwickian Syndrome are overweight. This indicates fat buildup around the soft tissues of the neck along with the loss of muscle tone. When neck muscles relax during sleep this causes the windpipe to collapse resulting in loud snoring with intervals of silence. The collapse of the airway causes the blood oxygen level to drop and send a signal to the brain to awaken the person enough to tighten the upper airway muscles. This reopens the windpipe that produces a sound like a snort or gasp before snoring resumes. This entire cycle can occur hundreds of times each night.  More recently it has been recognized that sleep apnea also occurs even in individuals of normal weight, who lack distinctive features of Pickwickian Syndrome. Their conditions can be caused by other factors including deviated nasal septum and excess soft palate tissue. Obstructive sleep apnea in children can be caused by enlarged tonsils and adenoids. This can be corrected by tonsillectomy and adenoidectomy. In adults surgery to remove airway obstruction may be needed, depending on the anatomical structure.

Statistics

Approximately 6-7% of the population of the United States, or 18 million Americans are thought to have sleep apnea. But only around 10 million have symptoms and only 0.8 million have yet been diagnosed. In Americans aged 30-60 years, obstructive sleep apnea affects nearly one in four men and one in ten women. Other predisposing factors include age. Nearly 20-60% of the elderly may be affected. Overweight status or obesity; use of alcohol or sedatives are other factors.

Treatment

1)Seeing an internist or family practitioner to receive and provide information of the symptoms that are experienced not only by the individual and witnessed by a family member. They are then referred to a sleep specialist

2) Get testing by means of a sleep apnea study that can be done at home, physician’s office or sleep lab in a hospital.

3) Devices such as CPAP (Continuous Positive Airway Pressure) and BIPAP (Bi-level Inspiratory Positive Airway Pressure) are beneficial to keep airways open during sleep. A flow of pressurized air is delivered to a mask that fits over the nose or both nose and mouth. This is considered to be the most effective and widely used therapy.

4) Exercise 20-30 minutes each day at least five to six hours prior to bedtime, maybe better for both better sleep and weight loss.

5) Avoid caffeine related stimulants found in coffee, tea, chocolate, and some diet drugs.

6) Smoking disrupts sleep by causing early morning awakening in response to nicotine withdrawal.

Prognosis

Treating sleep apnea usually prevents or reverses complications such as pulmonary hypertension, high blood pressure and heart disease. Individuals with obstructive sleep apnea who are unable or unwilling to tolerate CPAP or BIPAP may suffer from abnormal heart rhythms, reduced alertness, and sleep deprivation. Quality of life is of primary concern to all people and should be sought and achieved with the resources that are available.

Closing

endeavors to provide the latest equipment and services for hospitals, rehab and nursing home and individual home care.