SLEEP APNEA & SNORING
Everyone knows a good night’s sleep can make or break his or her day. What most people don’t know is that sleep apnea ignored for long period of time can lead to complications of severe nature like high blood pressure, stroke, heart failure, irregular heartbeats, heart attacks, diabetes, depression and headaches.
People who suffer from sleep disorders frequently don’t even know it is happening to them. They wake up in the morning without feeling rested or have head and ear-aches and don’t even know why. Sleep apnea is a total blockage of the airway during sleep, causing the patient to stop breathing for 10 seconds or longer which causes tissues in the throat to vibrate when the patient breathes.
Types of Sleep Apnea:
- Obstructive Sleep Apnea (OSA)
- Central Sleep Apnea (CSA)
- Mixed Sleep Apnea
OBSTRUCTIVE SLEEP APNEA (OSA)
Symptoms of Obstructive Sleep Apnea
It can affect anyone at any age, even children. Obstructive sleep apnea is as common as adult asthma. Warning signs to look out for sleep apnea can be:
- Loud snoring
- Breath holding at night (apnoea)
- Daytime fatigue
- Short term memory loss
- Multiple trips to urinate through the night
- Early morning headaches
- Trouble concentrating
- Memory or learning problems
- Moodiness, irritability or depression
Causes of Obstructive Sleep Apnea
- Blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep.
- People who have smaller airways in their nose, throat or mouth. People with deviated septum in the nose might also experience OSA. Also common among people with thick or large necks.
- People who have larger than average tongue have higher chances of sleep apnea. Here the tongue blocks the airway causing OSA.
Treatment of Obstructive Sleep Apnea
Although continuous positive airway pressure (CPAP) therapy is the first line of treatment for sleep apnea, there are two main methods of treatment of OSA (obstructive sleep apnea) in patients who have been diagnosed using an overnight sleep study. These are:
Oral Appliance Therapy
An oral appliance is a small plastic device that fits in the mouth like a sports mouth guard or orthodontic retainer. Oral appliances help prevent the collapse of the tongue and soft tissues in the back of the throat, keeping the airway open during sleep and promoting adequate air intake.
Oral appliance therapy involves the selection, fitting and use of a specially designed oral appliance that maintains an open, unobstructed airway in the throat when worn during sleep. Nearly all appliances fall into one of two categories & can be classified by mode of action or design variation.
Mandibular Repositioning Appliances
Tongue Retaining Appliances - Tongue retaining appliances hold the tongue in a forward position using a suction bulb. When the tongue is in a forward position, it serves to keep the back of the tongue from collapsing during sleep and obstructing the airway in the throat.
- Mandibular repositioning appliances reposition and maintain the lower jaw in a protruded position during sleep. The device serves to open the airway by indirectly pulling the tongue forward, stimulating activity of the muscles in the tongue and making it more rigid, it also holds the lower jaw and other structures in a stable position to prevent the mouth from .
Treatment of snoring and obstructive sleep apnea with oral appliance therapy requires ongoing care which includes short- and long-term follow-up. Many patients prefer an oral appliance to CPAP which may be used alone or in combination with other treatments for sleep-related breathing disorders such as weight management, surgery or CPAP
Upper Airway Surgery. Surgery is site-specific meaning it requires the identification of specific anatomic areas contributing to airway obstruction. Depending on the location and nature of the airway obstruction the procedure may be minimally invasive or more complex.
Other options for managing OSA are weight loss, smoking cessation, decreased alcohol use, more exercise, and an attempt to better regulate the sleep/wake time.
CENTRAL SLEEP APNEA (CSA)
In CSA, airway is not blocked but the brain fails to signal the muscles to breathe. CSA occurs when the brain does not send the signal to the muscles to take a breath and there is no muscular effort to take a breath.
CSA usually occurs in adults with other medical problems. In infants, it usually occurs with prematurity or other congenital disorders. In both patient groups it is usually suspected by the primary care doctor.
CSA can be diagnosed with a sleep study or overnight monitoring while the patient is in the hospital. In infants, central sleep apnea is treated with an apnea alarm, in adults with central sleep apnea the treatment involves treating the underlying heart disease, medication interaction or other primary problem.
MIXED SLEEP APNEA
Mixed sleep apnea occurs when there is both central sleep apnea and obstructive sleep apnea, the brain rouses the person usually only partially to signal breathing to resume. As a result, the sleep is extremely fragmented and of poor quality.
Cures and preventive measures for sleep apnea range from the psychological (antidepressants) to the extreme (laser surgery to remove soft tissue). If you have severe sleep apnea, it usually won't get better on its own, so it's important to get treatment.