• Second Opinion Magazine

What You Need to Know About Sleep Apnea

Sleep apnea is a relatively common, chronic condition that can affect anyone. The National Sleep Foundation estimates that more than 18 million Americans suffer from some degree of sleep apnea, but that number could be much higher; many cases are undiagnosed. This is an unconscious process and most people who have sleep apnea are not aware of it. Sleep apnea can be mild, moderate or severe.

There are two different kinds of sleep apnea. The first is central sleep apnea, which occurs when the part of the brain responsible for breathing doesn’t send the right signals. Breathing stops for a period of time. Central sleep apnea is the least common form of sleep apnea and often occurs because of certain medications or diseases/disorders such as head injuries, stroke or heart failure.

The second, more common type of sleep apnea is obstructive sleep apnea. It occurs when the airway becomes constricted or blocked during sleep, which causes a period of shallow breathing or stops breathing all together for up to ten seconds. With no oxygen coming into the lungs, blood oxygen levels decrease. The brain is then alerted, which wakes the person just enough to resume breathing. When the pause of breath, or apnea, ends, the person usually gasps, snores, snorts or coughs as the lungs refill with air. This cycle occurs repeatedly over the course of a night. Apnea disrupts sleep and leads to excessive sleepiness during the day because of this constant cycle of waking and sleeping. Daytime tiredness is often the first sign of sleep apnea.

Causes

Sleep apnea is caused by genetics, lifestyle choices or other medical conditions, such as menopause, excessive growth hormone, hypothyroidism or muscle diseases such as dystrophy. Those with abnormal jaw structures, large tongues, constricted nasal passages, excess airway tissues, large necks, recessed chins and large overbites have an increased likelihood of sleep apnea. Apnea can also be brought on by medications such as sleeping pills, pain medications containing narcotics, sedatives and alcohol. Apnea gets worse with age and is more common in men, older people and African Americans.

Sleep apnea is difficult to diagnose because often, no real symptoms exist. Many people experience tiredness during the day or their sleeping partners alert them to their snoring or disrupted sleep patterns. Even when this is identified, sleep apnea is difficult to diagnose. Beyond sleep tests, there are no tests to diagnose sleep apnea.


Although sleep apnea seems like a simple sleeping issue, it can create serious problems. Left untreated, sleep apnea increases the likelihood of high blood pressure, heart attack, stroke, heart failure, heart arrhythmias, obesity, diabetes, sexual dysfunction and premature death.  It also leads to excessive tiredness during the day, reduced quality of life, lost productivity, relationship strain, daytime accidents and car accidents. In addition, apnea increases blood pressure and heart rate, which can put extra strain on the heart and cardiovascular system. This increased strain increases the production of chemicals as the body tries to regulate, which can cause inflammation in the body. Low blood oxygen caused by apnea activates the nervous system and can also lead to inflammation in the body. Inflammation is hard on the body and often leads to cardiovascular issues and premature death.  Furthermore, the combination of low blood oxygen and poor sleep quality can lead to memory problems, personality changes, morning headaches, dry mouth in morning, irritability, depression, difficulty concentrating, heartburn, insomnia, nighttime urinating, restless sleep and confusion upon waking.

Treatment

The most common treatments for sleep apnea include lifestyle change, machines and surgery. Often, the first step in treatment is lifestyle changes including the following:  learn to sleep on your side, lose weight, quit smoking, avoid alcohol, sedatives, sleeping pills and heavy meals before bed and get plenty of exercise. For those with sleep apnea caused by obstructed nasal passages, a saline nasal solution may help. If the lifestyle solutions don’t provide relief, your doctor may suggest mouthpieces, oxygen masks or devices to help you breathe while sleeping. Surgery is often recommended in severe cases. There are several different surgical procedures to help sleep apnea, depending on the causes, severity and your medical history. In cases of facial structure issues, the solution may be to remove tonsils or adenoids, restructure the jaw or repair a deviated septum.

Outside of the lifestyle changes mentioned above, there is not much talk of holistic therapies for sleep apnea. The American Sleep Apnea Association does suggest acupuncture as a potential solution, however other sources make note of little to no empirical evidence supporting the use of acupuncture for this reason. The American Sleep Apnea Association also suggests playing the didgeridoo or other wind instruments to improve respiratory effectiveness as a way to improve sleep apnea. Other options include various styles of breathing exercises, reducing stress and meditation. There is anecdotal evidence that the herbs valerian, lobelia, thyme, cramp bark and chamomile may be beneficial.

Sleep apnea is a serious condition with potentially severe complications. If you or your significant other thinks you may have a form of sleep apnea, talk to your doctor right away.

Resources: http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/ http://www.stanford.edu/~dement/apnea.html http://www.sleepfoundation.org/article/sleep-related-problems/obstructive-sleep-apnea-and-sleep http://healthysleep.med.harvard.edu/sleep-apnea/treating-osa/impact http://www.sleepapnea.org/diagnosis-and-treatment/treatment-options.html http://www.mayoclinic.com/health/sleep-apnea/DS00148/DSECTION=alternative-medicine

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