How Do You Know if You Have Apnea

Overview

Normal airway and obstructed airway due to sleep apnea — Obstructive sleep apnea occurs when the tongue and soft palate block the airway while you lot're sleeping.

What is slumber apnea?

Sleep apnea is a serious sleep disorder that happens when a person's breathing is interrupted during slumber. People with untreated slumber apnea stop animate repeatedly during their slumber, sometimes hundreds of times during the night.

If it's not treated, sleep apnea can cause a number of health issues, including hypertension (loftier blood pressure), stroke, cardiomyopathy (enlargement of the muscle tissue of the eye), heart failure, diabetes and eye attacks. Untreated sleep apnea can also be responsible for job impairment, work-related accidents and motor vehicle crashes, as well as underachievement in school in children and adolescents.

In that location are two types of slumber apnea, obstructive and cardinal:

Obstructive sleep apnea is the more than mutual of the two. Obstructive sleep apnea occurs as repetitive episodes of complete or fractional upper airway blockage during sleep. During an apneic episode, the diaphragm and chest muscles piece of work harder equally the pressure increases to open the airway. Breathing ordinarily resumes with a loud gasp or body jerk. These episodes can interfere with sound sleep, reduce the menstruum of oxygen to vital organs, and cause heart rhythm irregularities.
In primal slumber apnea, the airway is non blocked but the brain fails to signal the muscles to breathe due to instability in the respiratory control center. Key apnea is related to the function of the key nervous arrangement.

Who gets slumber apnea?

Sleep apnea occurs in nigh 25% of men and about 10% of women. Sleep apnea can affect people of all ages, including babies and children and particularly people over the age of 50 and those who are overweight.

Certain physical traits and clinical features are common in patients with obstructive sleep apnea. These include excessive weight, large neck and structural abnormalities reducing the diameter of the upper airway, such as nasal obstruction, a low-hanging soft palate, enlarged tonsils or a pocket-sized jaw with an overbite.

What happens when you cease breathing?

When y'all cease breathing, your heart rate also tends to drop the longer your body is deprived of oxygen. And then, your involuntary reflexes crusade yous to startle awake at the end of that catamenia of not breathing. When this occurs, your middle rate tends to accelerate quickly and your blood pressure rises.

These are changes that take place acutely when yous stop breathing. However, your body starts to experience chronic effects if you feel frequent apnea. Data suggests increased take chances, particularly when you finish breathing roughly thirty times or more per hour. But there is likely a take chances at fifty-fifty lower frequency rates.

For case, your claret force per unit area tends to go up, your heart walls thicken due to increased workload and the construction of your eye changes. Information technology tends to become stiffer and less flexible because there are more fibrous cells growing in between the muscle cells.

All of those things increase the risk that you can have either atrial or ventricular arrhythmias. They also tend to reduce the function of the heart then that information technology'due south less efficient at pumping blood.

Symptoms and Causes

What causes sleep apnea?

Obstructive slumber apnea is caused past a blockage of the airway, unremarkably when the soft tissue in the rear of the throat collapses during sleep. Central sleep apnea is normally observed in patients with central nervous system dysfunction, such as following a stroke or in patients with neuromuscular diseases like amyotrophic lateral sclerosis (ALS, Lou Gehrig'south disease). Information technology is also common in patients with heart failure and other forms of heart, kidney or lung disease.

What are the symptoms of sleep apnea?

Often the first signs of OSA are recognized not by the patient, merely by the bed partner. Many of those affected have no sleep complaints. The about common signs and symptoms of OSA include:

Snoring.
Daytime sleepiness or fatigue.
Restlessness during sleep, frequent nighttime awakenings.
Sudden awakenings with a sensation of gasping or choking.
Dry mouth or sore throat upon awakening.
Cerebral impairment, such as trouble concentrating, forgetfulness or irritability.
Mood disturbances (depression or anxiety).
Nighttime sweats.
Frequent nighttime urination.
Sexual dysfunction.
Headaches.

People with key sleep apnea more often report recurrent awakenings or insomnia, although they may also feel a choking or gasping sensation upon enkindling.

Symptoms in children may not be equally obvious and include:

Poor school performance.
Sluggishness or sleepiness, often misinterpreted as laziness in the classroom.
Daytime oral fissure breathing and swallowing difficulty.
In movement of the ribcage when inhaling.
Unusual sleeping positions, such every bit sleeping on the hands and knees, or with the neck hyper-extended.
Excessive sweating at dark.
Learning and behavioral disorders (hyperactivity, attention deficits).
Bedwetting.

Diagnosis and Tests

How is sleep apnea diagnosed?

If your doctor determines that you have symptoms suggestive of sleep apnea, you may be asked to have a sleep evaluation with a slumber specialist or may order an overnight sleep study to objectively evaluate for sleep apnea.

Testing includes an overnight slumber study chosen a polysomnogram (PSG). A PSG is performed in a slumber laboratory under the direct supervision of a trained technologist. During the examination, a multifariousness of trunk functions, such as the electric action of the brain, eye movements, muscle action, eye rate, animate patterns, air menstruation, and blood oxygen levels are recorded at night during sleep. After the report is completed, the number of times breathing is impaired during sleep is tallied and the severity of the sleep apnea is graded.
For adults, a Dwelling Slumber Test (HST) tin sometimes be performed instead. This is a modified type of slumber study that can exist done in the condolement of home. It records fewer body functions than PSG, including airflow, animate effort, claret oxygen levels and snoring to confirm a diagnosis of moderate to severe obstructive sleep apnea.

An HST is not advisable to exist used every bit a screening tool for patients without symptoms. Information technology'southward not used for patients with significant medical problems (such as center failure, moderate to severe cardiac disease, neuromuscular illness or moderate to severe pulmonary affliction). It's also not used for patients who have other slumber disorders (such as key sleep apnea, restless legs syndrome, insomnia, cyclic rhythm disorders, parasomnias or narcolepsy) in improver to the suspected obstructive slumber apnea.

Management and Treatment

Sympathize Pap Therapy for Your Sleep Apnea

What are the treatments for sleep apnea?

Conservative treatments: In mild cases of obstructive sleep apnea, conservative therapy may be all that is needed.

Overweight persons can benefit from losing weight. Even a x% weight loss can reduce the number of apneic events for most patients. Even so, losing weight can exist difficult to do with untreated obstructive sleep apnea due to increased ambition and metabolism changes that tin happen with obstructive sleep apnea.
Individuals with obstructive sleep apnea should avoid the utilize of alcohol and sure sleeping pills, which brand the airway more probable to plummet during sleep and prolong the apneic periods.
In some patients with balmy obstructive slumber apnea, animate pauses occur just when they sleep on their backs. In such cases, using a wedge pillow or other devices that help them sleep in a side position may assistance.
People with sinus problems or nasal congestion should employ nasal sprays or breathing strips to reduce snoring and improve airflow for more comfortable nighttime breathing. Avoiding sleep deprivation is important for all patients with sleep disorders.

Mechanical therapy: Positive Airway Pressure (PAP) therapy is the preferred initial handling for most people with obstructive sleep apnea. With PAP therapy, patients article of clothing a mask over their olfactory organ and/or rima oris. An air blower gently forces air through the olfactory organ and/or mouth. The air pressure is adapted and so that information technology is just enough to preclude the upper airway tissues from collapsing during slumber. PAP therapy prevents airway closure while in use, but apnea episodes return when PAP is stopped or if information technology is used improperly. There are several styles, and types of positive airway pressure devices depending on specific needs of patients. Styles and types include:

CPAP (Continuous Positive Airway Pressure) is the most widely used of the PAP devices. The motorcar is fix at one single pressure level.
Bi-Level PAP uses one pressure during inhalation (breathing in), and a lower pressure during exhalation (animate out). At that place is a criterion that must be met before health insurance will encompass the bi-level. This usually ways that the CPAP machine must be tried first with no success and these results documented earlier insurance will pay for a bi-level.
Car CPAP or Automobile Bi-Level PAP uses a range of pressures that cocky-regulates during utilise depending on force per unit area requirements detected by the motorcar.
Adaptive Servo-Ventilation (ASV) is a blazon of non-invasive ventilation that is used for patients with central slumber apnea, which acts to go along the airway open up and delivers a mandatory breath when needed.

Mandibular advancement devices: These are devices for patients with mild to moderate obstructive slumber apnea. Dental appliances or oral mandibular advocacy devices that assistance to prevent the tongue from blocking the throat and/or advance the lower jaw frontward tin can be made. These devices help keep the airway open up during sleep. A sleep specialist and dentist (with expertise in oral appliances for this purpose) should jointly determine if this treatment is all-time for you.

Hypoglossal nervus stimulator: A stimulator is implanted nether the skin on the right side of the chest with electrodes tunneled under the skin to the hypoglossal nerve in the neck and to intercostal muscles (betwixt two ribs) in the chest. The device is turned on at bedtime with a remote command. With each jiff, the hypoglossal nerve is stimulated, the tongue moves forrad out of the airway and the airway is opened.

Surgery: Surgical procedures may help people with obstructive slumber apnea and others who snore merely don't take sleep apnea. Among the many types of surgeries done are outpatient procedures. Surgery is for people who accept excessive or malformed tissue obstructing airflow through the nose or pharynx, such as a deviated nasal septum, markedly enlarged tonsils or small lower jaw with an overbite that causes the throat to be abnormally narrow. These procedures are typically performed later sleep apnea has failed to answer to conservative measures and a trial of CPAP. Types of surgery include:

Somnoplasty is a minimally invasive procedure that uses radiofrequency energy to reduce the soft tissue in the upper airway.
Tonsillectomy is a process that removes the tonsillar tissue in the dorsum of the throat which is a common cause of obstruction in children with sleep apnea.
Uvulopalatopharyngoplasty (UPPP) is a process that removes soft tissue on the back of the throat and palate, increasing the width of the airway at the pharynx opening.
Mandibular/maxillary advancement surgery is a surgical correction of certain facial abnormalities or throat obstructions that contribute to obstructive sleep apnea. This is an invasive procedure that is reserved for patients with severe obstructive slumber apnea with head-face abnormalities.
Nasal surgery includes correction of nasal obstructions, such equally a deviated septum.

Living With

What are the effects of sleep apnea?

If left untreated, sleep apnea tin result in a number of health issues including hypertension, stroke, arrhythmias, cardiomyopathy (enlargement of the muscle tissue of the heart), eye failure, diabetes, obesity and heart attacks.

Information technology's probable that sleep apnea tin cause arrhythmias and heart failure because if you have slumber apnea, y'all tend to have higher claret pressure. In fact, sleep apnea occurs in about 50% of people with heart failure or atrial fibrillation.

This is because sleep apnea can cause:

Repeated episodes of oxygen lowering (what doctors telephone call hypoxia).
Changes in carbon dioxide levels.
Direct effects on the eye due to pressure level changes within the chest.
Increased levels of markers of inflammation.

With the loftier prevalence of sleep apnea in cardiac arrhythmias and centre failure (essentially a coin flip as to whether the patient has it), experts recommend that you lot don't filibuster in seeking the advice of your dr..

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Source: https://my.clevelandclinic.org/health/diseases/8718-sleep-apnea