Sleep Apnea is a sleeping disorder that an estimated 22 million Americans suffer from, with 80% of the cases of moderate and severe obstructive sleep apnea going undiagnosed. My wife has had sleep apnea for most of her adult life, so I have firsthand experience with it. My older brother has it as well. This article will attempt to explain what causes it, how to diagnose it, what populations tend to get it, whether it is inherited, what are the best treatments and equipment are available to help, and the reasons for non-compliance to treatments. I hope this article will help you and me to better understand this disorder and how to deal with in your family.
What causes Sleep Apnea
There are many causes to sleep apnea. One is uncontrolled weight or obesity, which can negatively effect soft tissues of the mouth and throat. While sleeping, when throat and tongue muscles are more relaxed, this soft tissue can cause the airway to become blocked. During the night, while sleeping, breathing may stop for 10 or more seconds which decreases the oxygen and can awaken the sleeper many times during the night, although the sleeper may not even remember waking up. For children, the causes can be adenoids, or tonsils or overbite. For adults, loud snoring may be an indication of someone having sleep apnea, as well as being sleepy during the day after sleeping all night. (Again, they may actually be waking up several times a night, but don’t realize it.)
How to diagnose Sleep Apnea
The method most doctors use is called Nocturnal polysomnography. This monitors your lungs, brain activity, heart, leg and arm movements, breathing patterns and your blood oxygen levels as you sleep. Another option for some people is to do a Home sleep test, which your doctor would provide. This is a simple test that tracks your heart rate, blood oxygen level, airflow and breathing patterns. Your doctor may prescribe therapy without any more testing or refer you to specialists like ears, eyes, or throat doctors, as well as a neurologist or cardiologist.
Who gets Sleep Apnea
In the male and female population, men are twice as likely to get sleep apnea and are eight more times likely to be diagnosed with it. Women are less often diagnosed because their symptoms are different from men’s, for example, their snoring is generally lighter and breathing is more normal. As far as race, black males seem to be effected more than their white male counterparts. Hispanic and Native Americans tend to be affected too, but to a lesser degree than blacks. Information about Asian groups seem more sparse than the information available for other races.
Is Sleep Apnea inherited
At this time it is unclear whether sleep apnea is directly inherited, but the risk of getting it is about 50 percent greater if you have a parent or siblings with sleep apnea compared to the general public. Also, inherited physical traits like body fat, features of your upper airway muscles, skull shape and face could lead to sleep apnea. More work needs to be done in this area.
Treatments and Equipment for Sleep Apnea
Machines that gently blow air into the airway to keep it open are called Positive Airway Pressure (PAP) machines. These machines are used with a variety of breathing masks, and are the most widely used treatment for moderate and severe sleep apnea.
The mask, which is worn over the nose, or sometimes over the mouth and nose during sleep, supplies continuous or intermittent pressurized air that flows into the sleeper’s throat. This increased air pressure prevents the sleeper’s airway from collapsing during the night.
The pressurized air is supplied through a flexible tube from one of several types of machines: CPAP (continuous positive airway pressure), BiPAP (bilevel positive airway pressure), VPAP (variable positive airway pressure), and so on. Studies of the effect of PAP therapy show that people with sleep apnea who consistently use their machines feel better and, as a result have a reduction of apneas (periods where the sleeper stops breathing) and encounter fewer complications of the disease. These PAP devices have been shown to eliminate snoring in addition to treating sleep apnea.
Sometimes treatments for sleep apnea involves life changes such as weight loss
Another treatment for sleep apnea is the use of oral appliances. Oral appliances are increasing in popularity as people become more and more aware that they are an effective first line treatment for sleep apnea. Over 100 different oral appliances are FDA approved for the treatment of snoring and sleep apnea. These appliances are worn in the mouth, just like a mouth guard in sports, while you sleep. Oral appliances keep the lower jaw forward just enough to keep the airway open and prevent the tongue (and muscles in the upper airway) from collapsing and blocking the airway.
Surgery is another option for sleep apnea. Removing the extra tissue in your throat that collapses and blocks your airway during sleep is one way to combat apneas. The level of invasiveness differs with patients. It may be slightly invasive for some and more invasive for others. The areas that surgery are commonly preformed are: the upper and lower jaw, the tongue and the tonsils and adenoids.
Reasons for non-compliance to treatments
People who don’t understand the health problems that sleep apnea can cause tend to be less compliant with treatments. Some people complain of feeling claustrophobic when wearing the mask that is used with the CPAP machine. Some will not wear the mask due to being self-conscious and not wanting their spouse to see them in it.
Other reasons for non-compliance with CPAP machines are because of the side affects, such as a dry, crusty nose, pressure sores on the bridge of the nose, difficulty exhaling, allergic reactions to the materials, and even the noise that is made by the machine. Many of these are avoidable if the patient is properly educated, and fitted for the most comfortable mask. Health care professionals need to follow-up with patients and try to trouble-shoot and make appropriate corrections early on so that patient’s do not become discouraged and non-compliant.
Sleep Apnea affects millions of Americans and more people are being diagnosed with it every year. There are better treatments being developed for it. As for me, my wife and brother seem to be doing well with the best treatments that their doctors have described for them. After writing and researching this I hope you will have a greater understanding of Sleep Apnea. I know I do!
I’m an avid bike rider and I love all things healthy. When I’m not riding my bike you’ll see me driving the big yellow bus to school.