Sleep apnea is a sleep disorder which causes irregular breathing
and snoring patterns that can ultimately cause apnea, which is where a person momentarily
stops breathing altogether. The inability to get restful sleep can also lead to severe
exhaustion.
Individuals can have obstructive sleep apnea, central sleep apnea, or features of both.
Obstructive sleep apnea is the most common form, and it develops when there’s a blockage
of the airways. Air has to go from the nose through the nasopharynx into the laryngopharynx,
through the larynx and then into the trachea. Somewhere along that path, there might be
a blockage in the flow of air. Allergies might cause swelling of the tissue in the nasopharynx,
or there might be swollen adenoid glands or tonsils because of an infection. There might
be a severe overbite which pulls the jaw back and blocks the airway. In individuals that
are overweight, there could be too much weight in the soft tissues of the neck, which can
weigh down the airway especially when a person is lying down. These problems are most obvious
at night because hormonal changes at night cause the muscles around the airway to becomes
slightly less stiff while sleeping. This means that they are less able to keep the airway
open, making it more likely to get a bit squashed or obstructed.
Central sleep apnea refers to the fact that the problem is “central” or related to
the central nervous system. This is where the brain intermittently stops making an effort
to breathe for 10 to 30 seconds. The apnea can persist for several seconds even after
waking up, triggering feelings of panic and further disrupting the sleep cycle. Central
sleep apnea starts with an initial episode of hyperpnea, which is when the brain directs
the lungs to start hyperventilating during sleep by increasing the respiratory rate.
This rapid breathing causes hypocapnia, a drop in the blood’s carbon dioxide levels.
When the carbon dioxide falls below a certain threshold, the body slips into a state of
apnea, making no effort to breathe and taking in no oxygen. This causes the carbon dioxide
levels to rise back to normal levels and then, as the apnea persists, they keep rising to
which is called hypercapnia. The really high carbon dioxide levels triggers hyperpnea again,
and the cycle starts all over. Essentially, the respiratory system is going rapidly back
and forth between two states, first making no effort to breathe and then hyperventilating,
with no in-between.
The most common symptom of sleep apnea is severe sleep deprivation. Interrupted sleep
can cause nocturia, the excessive need to urinate during the night and stress-induced
insomnia. The effects are also apparent during the day, because the loss of restful sleep
leads to difficulty concentrating, headaches, and fatigue. Apneic episodes are usually preceded
by loud snoring, which can interrupt the sleep of other people as well. Sleep apnea on its
own is rarely fatal, but it can worsen other health problems. For example, drops in oxygen
levels can trigger anginal chest pain, and can irritate heart cells leading to an arrhythmia—an
irregular heartbeat. Broadly speaking, individuals with sleep apnea have a higher risk for heart
failure, respiratory failure, diabetes, and certain types of cancer.
Diagnosing sleep apnea requires a sleep study to help identify episodes of sleep apnea,
the more episodes the more severe the sleep apnea. A sleep study usually involves getting
monitored overnight with a polysomnogram. A polysomnogram tracks things like brain movement,
oxygen and carbon dioxide blood levels, vital signs, and outward symptoms like snoring and
movement.
Treating sleep apnea starts with avoiding things like sleeping pills, alcohol, and other
depressant medications because they can relax the throat muscles around the airway and make
the airways more likely to collapse during sleep. In addition, sleeping on the side instead
of on the back can also help because it creates better airflow into the lungs. For severe
sleep apnea, individuals can use a continuous positive airway pressure device or CPAP device
for short. This machine forces the airways open with a steady stream of pressurized air
delivered through a plastic facemask or nasal prongs. Used properly, This is very effective,
but it requires continuous use. Many people eventually stop using it, finding it annoying
or difficult to wear, and the problem persists. Some people with obstructive sleep apnea can
benefit from custom made oral mouthpieces that help improve airflow during sleep. Sometimes,
obstructive sleep apnea can be managed surgically, for example removing large adenoid tissue
or realigning the jawbone, however, procedures can be complicated because the anaesthesia
and surgical swelling can both worsen sleep apnea in the short term.
All right, as a quick recap - sleep apnea can be due to physical obstruction of the
airway or from a neurological malfunction initiated by imbalances in the blood’s oxygen
and carbon dioxide levels, which regulate breathing cycles. Left untreated, the condition
can interact negatively with other underlying health conditions, leading to serious complications.