what is obstructive sleep apnea?


SNORING – A LOUD BUT SILENT KILLER!!

Most of us know & understand that our blood carries vital oxygen to the cells throughout our bodies – without which we would simply die.
Yet so often when oxygen levels become dangerously low during sleep, there seems to be no recognition of the rebound effects on our day to day wellbeing.
Regular loud snoring, associated with repeated silences (cessations in breathing) & daytime fatigue or tiredness, are a fair indicator there may be an underlying problem.
Quite often, these events are associated with the tongue relaxing into the upper airway – to the point where there is limited airflow into the lungs, in turn resulting in little or no replenishment of fresh oxygen into the blood.
When this happens, a chain of events (too complex to detail here) causes often rapid increases in heart rate, which if left untreated, have been clearly identified as a precursor to heart attack or stroke.
Clearly, regular loud snoring & associated “gasping” during sleep, should be checked – if only for “peace of mind”.
Established in 2009, Western Sleep Clinic provides a unique low cost overnight ambulatory (at home) sleep study service, meaning there is no longer any need to sleep in the unfamiliar surroundings of a hospital or sleep lab.
Following each study, every outcome is reviewed personally (& confidentially), so as to ensure a clear understanding of results, which at very least provides peace of mind.
Should the need arise, Western Sleep Clinic are also able to facilitate fast & effective treatment protocols.
With over 250 local Doctors, now referring through Western Sleep Clinic, we stand proud of our uniquely successful reputation.
Founder & clinician Roger Osmond is also available to speak on such matters through community / employer awareness forums - at no charge (community group facilitators & employers are encouraged to enquire).
Take a close look at the cycle of symptoms on our home page. If you or any of your loved ones identify with four or more, it’s time to have it checked.

further reading from Health Central/Health Encyclopedia - Edited for clarity by Roger Osmond, Jan 2014

Introduction

Apnea is defined as a cessation of oronasal airflow (breathing normally- through your Nose or Mouth) for a period of at least 10 seconds.

When this occurs 30 or more times during a 7-hour period of sleep, it is viewed as (medically) abnormal.
This condition is called obstructive sleep apnea (OSA) and requires immediate (medical) intervention to prevent it from becoming life-threatening.

Description

In the most common form of the condition - obstructive apnea - air stops flowing through the nose and mouth, but throat and abdominal breathing efforts are uninterrupted. The snoring that results is produced when the upper rear of the mouth (the soft palate and the cone-shaped tissue - the uvula - that descends from it) relaxes and vibrates as air passes in and out. This sets up an air current between the palate and the base of the tongue, resulting in snoring.

Sleep apnea can be recognized by a number of symptoms. Loud and intermittent snoring is one major warning signal. Sleep apnea patients may also experience a choking sensation, early-morning headaches, dry throat, or extreme daytime sleepiness . His / Her bed partner or roommate may comment on excessive body movements or snorting or gasping for breath during sleep.
Typically, the individual will wake, emit a vigorous snort or grunt while gasping for air, then immediately fall back to sleep, only to repeat the cycle –again & again, throughout the night, & in many cases unaware of these events.

If the condition is suspected, it should be reported to a Doctor or Physician, who may recommend evaluation by a specialist in sleep disorders. Since sleeping pills may be harmful for people with sleep apnea, they should not be taken if the condition is suspected.

Causes

Sleep apnea is believed to affect at least 1 out of every 200 Americans - 70 to 90 percent are men, mostly middle-aged and usually overweight. But the condition can afflict both men or women at any age, or of any bodily shape or size.

Symptoms

People with this disorder may actually stop breathing while asleep - even hundreds of times - without being aware of the problem. During an apnea attack, the snorer may seem to gasp for breath, and the blood Oxygen level may become abnormally low.
In severe cases, a sleep apnea victim may actually spend more time not breathing than breathing and may be at risk for death.

Diagnosis

Polysomnography, a technique used to diagnose obstructive sleep apnea, records the number and duration of apnoeic episodes, determines the stage of sleep and oxygen saturation and observes when the patient awakens.

Treament

A physician can diagnose sleep apnea and suggest treatment based on the patient's complaints of daytime sleepiness, insomnia, awareness of obstructed breathing during sleep, snoring, and headache or dry mouth on waking.
The physician examines the bones of the face and jaw and throat structures such as palates, uvula and tonsils while the patient is in various positions, to see the sizes of spaces through which inhaled air can pass. X-rays may help envision how these structures lie.
Definitive diagnosis of sleep apnea depends upon the results of a number of polysomnography signals recorded throughout a sleep study. A diagnosis of sleep apnea is made when polysomnography indicates more than five apneoc episodes, of 10 seconds or longer occur per hour of sleep, associated with an irregular heartbeat, frequent arousal during sleep, and / or dips in arterial oxygen saturation.
For mild obstructive sleep apnea, treatment often consists of avoiding sleep on one's back. Other people have a significant problem when the nose is congested, so decongestant therapy may be helpful for them. A more drastic treatment if the patient is overweight, is bariatric (surgical) weight reduction. It is also recommended to avoid central nervous system depressants, such as alcoholic beverages, or hypnotic or sedative drugs.
Most serious sleep apnea cases can be remedied by a treatment called Continuous Positive Airway Pressure (CPAP). CPAP uses a small mask secured over the nose or small “pillows” that insert into the nostrils. These are connected to a small air pump that regulates the amount and pressure of air sent into the nose, so as to remain comfortable but sufficient to keep the respiratory passages open.

Benefits

Effective CPAP treatment usually brings immediate relief. Snoring is greatly reduced and in many cases stops altogether. A smooth regular breathing pattern is restored, abnormal heart rate (cardio vascular stress and risk of heart attack) is minimised, and blood oxygen levels stabilize and are restored to normal.
Don’t expect miracles. During the first week of CPAP therapy, the sleep pattern may still be grossly abnormal, but with peaceful stretches of sleep gradually growing (almost as if the body is trying to catch up). Over the following weeks and as the user becomes more comfortable with treatment, sleep eventually returns to a more normal pattern (often for the first time in several years).
Apart from the obvious health aspects, subsequent benefits frequently manifest as:- Feeling refreshed and the absence of morning tiredness and headaches, reduction in the need to urinate overnight, relief from daytime fatigue & tiredness, ability to concentrate with improved clarity of thinking, and increased libido.

SLEEP DISORDERS & DEPRESSION

Feeling sad every now and then is a fundamental part of the human experience, especially during difficult or trying times. In contrast, persistent feelings of sadness, anxiety, hopelessness and disinterest in things that were once enjoyed are symptoms of depression, an illness that affects at least 20 million Americans. Depression is not something that a person can ignore or simply will away. Rather, it is a serious disorder that affects the way a person eats, sleeps, feels and thinks. The cause of depression is not known, but it can be effectively controlled with treatment.

The relationship between sleep and depressive illness is complex – depression may cause sleep problems and sleep problems may cause or contribute to depressive disorders. For some people, symptoms of depression occur before the onset of sleep problems. For others, sleep problems appear first. Sleep problems and depression may also share risk factors and biological features and the two conditions may respond to some of the same treatment strategies. Sleep problems are also associated with more severe depressive illness.

Research suggests that the risk of developing depression is highest among people with both sleep onset and sleep maintenance Issues. However, because symptoms of depression overlap with symptoms of sleep disorders, there is a risk of misdiagnosis. For example, depressed mood can be a sign of insomnia, OSA or narcolepsy.

Obstructive sleep apnea (OSA) is also linked with depression. In a study of 18,980 people in Europe conducted by Stanford researcher Maurice Ohayon, MD, PhD , people with depression were found to be five times more likely to suffer from sleep-disordered breathing (OSA is the most common form of sleep disordered breathing). The good news is that treating OSA with continuous positive airway pressure (CPAP) may improve depression; a 2007 study of OSA patients who used CPAP for one year showed that improvements in symptoms of depression were significant and lasting.