Sleep Apnea explained in layman's terms
Sleep Apnoea Definition
An apnea is just one occurrence. This can be repeated hundreds of times during your sleep period, and is nearly always accompanied by snoring, which is usually quite loud. You will not be aware of this happening to you, in normal circumstances.
- Obstructive - Fairly common
- Central - Rare
- Mixed - Extremely rare
Note: UK spelling is 'Apnoea' and sometimes 'Apneoa'.
Obstructive Sleep Apnea (OSA)
The oxygen level in the blood falls considerably, then the heart pumps faster trying to compensate for this. Blood pressure rises. Eventually, the brain kicks in and wakes you up momentarily. You breathe normally again for a short while as you fall back to sleep, totally unaware that anything has happened.
It is not uncommon for this to repeat every 15 minutes, thus interrupting a persons proper nightly sleep.
This obstructive sleep apnea cycle continues throughout the night, resulting in the patient having excessive daytime tiredness and a lack of concentration. This can be a danger when working with machinery, heavy equipment, or driving any type of vehicle. If you are unaware of the problem, you assume that you're just not getting enough quality sleep.
Central Sleep Apnea
Mixed Sleep Apnea
How Serious is Sleep Apnea?
The main risks include:
- Heart attacks
- Irregular heart beat
- High blood pressure
- Heart disease
Other known side-effects of sleep apnea are impotency and depression. (Well, I guess that's enough to make you depressed)
In addition, as sleep apnea causes daytime sleepiness, there is also a greater risk of accidents in the home, work or at leisure, caused by a loss of concentration and tiredness.
Important notes on driving:
It is especially important for anyone diagnosed with sleep apnea not to drive for any lengthy periods, or to drive at all when feeling tired. Your doctor or specialist must by law (and ethically) inform the DVLA about your condition. If it is severe, your driving licence is usually suspended. If you get treatment and this is working to the satisfaction of your specialist, you can apply for your licence back.
Who does it affect?
- Sleep apnea can affect anyone, but tends to be more common in men than in women
- It is said to affect 4 percent of adult males and only 2 percent of adult females
- Overweight people are more likely to suffer with it
- Anyone with a neck measurement above 17 inches is said to be more susceptible
- People with a very small or recessed jaw (retrognathia). This increases the chance of the tongue falling back and blocking the airway
- Abnormalities, such as a large uvula (the dangly bit at the back of your throat) or enlarged tonsils
- Much more common as people get older
- Some studies show that it may be hereditary, but this has yet to be verified
Sleep apnoea can also affect children, but thankfully it's rare. There are some that suspect there is a connection to infant cot deaths, but no evidence of this has been found as yet.
Symptoms of Sleep Apnea
- Loud snoring
- Morning headaches
- Dry mouth upon waking
- Excessive daytime fatigue
- Memory and concentration problems
- Falling asleep during lunch-time or tea-breaks
- If you're observed to hold your breath while sleeping
If you have some or all of the above symptoms (especially the last one), then it may be advisable to consult your doctor. Try taking the Epworth Sleepiness Test to see your score. You could then quote your Epworth Score, as they will know what this is.
There are other things that can cause significant daytime sleepiness, so your problem may not be sleep apnea. The most common of these is medications, particularly antihistamines, tranquillizers, and psychotropic drugs. Another is depression. Please note that with depression, some may be unable to sleep while others can't seem to get enough sleep.
Sleep Apnea Treatments
If you have been referred to a specialist, you will be given the standard Epworth Sleepiness Test. He may make arrangements for a comprehensive sleep-study.
The next step I went through was to try a Orthodontic dental appliance which looks rather like a gum shield. It draws the lower jaw forward, making more room at the back of the throat. Spacers are added each month to gradually increase the pressure pushing forward on lower jaw. These are usually made and fitted by a dentist or orthodontist. Try to image what it's like to sleep with this thing in your mouth all night, but I'm told it does work for some people. Didn't work for me.
The CPAP machine (Continuous Positive Airway Pressure) has proven to be the most successful treatment for severe sleep apnea sufferers, but there is a shortage of CPAP machines as they are extremely expensive. This is a medical air pump which is connected via plastic tubing to a nasal or full-face mask. The pressure on the pump is set just high enough to stop the airway collapsing.
Some people find they can't tolerate using a CPAP machine due to the strange experience of having air forced into the lungs. I have met some patients who couldn't bear to have the mask over their face, yet others don't seem to have a problem and some say the noise lulls then to sleep. The CPAP machine certainly does work for OSA and is also a complete cure for snoring (totally).
The Bi-PAP machine is similar to the above machine but is easier for the user to exhale, due to it's bi-level pressures. Bi-PAP machines are not issued very often, due to their excessive cost.
Surgical Treatments for Sleep Apnea
- Trimming the nasal passages and removing polyps and other growths, to generally improve nasal breathing.
- Straightening a deviated septum (that's the middle bit of your nose to you and me), also to aid easier nasal breathing.
- Laser-assisted uvulopalatoplasty (LAUP), using a laser to remove excessive tissue, and tightening the throat. Mainly, this operation is used to stop snoring, but not always successful and very painful.
- Uvulopalatopharyngoplasty, luckily there's an abbreviation for it (UPPP), which entails removing the uvula (the dangly thing at the back of your throat), plus excess tissue at the back of the throat, and part of the soft palate. This is a most unpleasant operation, and it didn't cure my OSA. You have to re-learn how to drink, as it can go down the wrong way.
A tracheostomy (alternative spelling tracheotomy) can be done in severe cases where all other treatments have failed. This is a guaranteed solution to obstructive sleep apnea, but don't consider this option without a great deal of thought. Some photos in the Tracheostomy page, if you're not squeamish!
Please Note:- Information on this website is not medical advice.
Always seek the advice of your doctor if you have a health problem.