What is Sleep Apnea

Woman Covers Her Ears with a Pillow Whild Husband Snores

Sleep apnea is the most common sleep disorder, affecting millions of Americans. There are basically three different types of sleep apnea, the most common being obstructive sleep apnea or OSA. Obstructive sleep apnea is the periodic cessation of breathing during sleep due the blockage of the airway.

The cessation of breathing caused by this blockage may be sudden and prolonged.  The result is a serious drop in oxygen levels and a significant rise in blood pressure.

Sufferers may have from a few to several hundred apneic episodes in one night.

Muscles in the back of the throat which support the soft palate, the uvula, the tonsils and the tongue over-relax. This makes it impossible to breathe properly for up to 10 or 20 seconds at a time. Your brain realizes that it needs oxygen and wakes you up until you start breathing normally again.

Most sleep apnea sufferers gasp, snort, or make a choking sound when this happens. This pattern may repeat itself all night long for as often as 30 or more times per hour. These episodes can be measured by sleep testing providing the patient with an AHI (Apnea-Hypopnea Index) rating. An AHI of more than 5 is abnormal and 30 is considered to be severe obstructive sleep apnea.

It’s common for people not to remember all these awakenings and believe they slept through the night. The problem is that normal sleep patterns are severely disrupted and sufferers don’t go through the stages of sleep as they should. The result is that most people with sleep apnea aren’t aware of it, so it continues untreated, posing quite a number of health risks.

Normal Airflow and Airflow During an Apnea

Sleep apnea is a potentially life-threatening condition causing a decreased oxygen supply to vital organs. The problem is usually recognized by loud, chronic snoring, though snoring does not necessarily mean one has sleep apnea.

Fortunately, sleep apnea can be diagnosed and treated by a qualified Sleep Physician. There are a number of treatment options available, and research into additional options is ongoing.

Types of Sleep Apnea

The main types of sleep apnea are called obstructive, central, mixed, and complex. In all cases, a person’s sleep is fragmented and repeatedly disrupted throughout the night.  This results in fatigue and a myriad of other health issues and concerns.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. The disruption of the ability to breathe normally due to this blockage is called an apnea.

Someone with obstructive sleep apnea usually begins to snore quite heavily after they fall asleep. It’s common for the snoring to become louder until it is interrupted by a long silent period during which they are not breathing. Usually this is followed by a choking sound, a gasp for breath, or a loud snort as the person attempts to breathe. This pattern will repeat itself throughout the night.

Many people wake up unrefreshed in the morning and feel sleepy or drowsy throughout the day. This is called Excessive Daytime Sleepiness (EDS).

Central Sleep Apnea 

Central sleep apnea or CSA is is due to the temporary absence of a signal from the brain’s respiratory center to the muscles that control breathing. The brain fails to send the proper signals to the muscles responsible for inhaling and exhaling. Carbon dioxide levels in the blood rise and oxygen levels fall. The person is aroused by the inability to breathe properly and then normal breathing resumes. Males, people with heart disorders, and those with brain tumors are more likely to experience central sleep apnea. Other causes are strokes, the use of opiates like morphine, oxycodone, and codeine. Sleeping at high altitudes, especially if your body is not used to it can also be a problem.

Mixed Apnea

Mixed apnea is a combination of central and obstructive apnea and is fairly common. It occurs most often in infants or young children who have abnormal control of their breathing. When the symptoms of obstructive sleep apnea are treated, the brain is still unable to control the patient’s breathing. Though treated for obstructive sleep apnea, the patient will still suffer from central sleep apnea.

Complex Sleep Apnea

Complex sleep apnea first presents itself as obstructive sleep apnea, but when treated with a CPAP or bilevel treatment, a patient still does not breathe normally. Complex sleep apnea consists of all or mostly obstructive apneas which turn into all or predominantly central apneas. Patients with this condition are often helped by adaptive servo ventilation (ASV or VPAP) treatment.

Causes of Sleep Apnea

Regardless of a particular cause, sleep apnea occurs when an individual is not getting enough oxygen into their lungs while sleeping. When one is awake, their airways are somewhat stiff, open, and free to let air flow into the lungs, but when sleeping, the throat muscles and tongue tend to relax. Relaxed muscles in your throat don’t normally block your airway, but with sleep apnea, your airway becomes more narrow or blocked.

One of the most common causes of sleep apnea is obesity. Excess weight, especially in the trunk and neck area presses down on the tissues surrounding the airway making it difficult to pass air into the lungs.

This becomes a vicious circle as the lack of good quality sleep reduces any motivation to get enough exercise to help maintain proper weight. The lack of exercise contributes to obesity, which in turn contributes to sleep apnea.

Obstructive Sleep Apnea is most common in obese middle-aged men, but can occur in men and women of any age.

Person Measuring their Waist

Another cause is