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Understanting Sleep Apnea

July 4, 2014

Sleep apnea (SA) is one of the major health problems people around the world experience. Yet, many of us has not fully recognize the harm done by this illness. Most even do not know the term. Sleep apnea comes from the Greek word apnea (pronounced, AP-nee-yuh) that literally means without breath, breathless, or no breath. It is the cessation of breathing during sleep.

People who have this sleeping disorder experience pauses in breathing during their sleep that may last for several seconds to minutes. These pauses can occur many times during their sleep, making the person lose valuable restorative sleep that he needs throughout the day. This sleeping disorder has been identified to be a possible cause of various health problems such as high blood pressure, diabetes, heart attack, stroke and many other serious illnesses.

Diagnosis of the illness can be done by polysomnogram (PSG) or an overnight sleep test. One can also diagnose by simply observing your sleeping partner while asleep. Snoring with frequent long pauses should be evaluated by a sleep specialist and given successful treatment.

There are three types of SA that can be determined by having the patient undergo an overnight sleeping test.

Obstructive sleep apnea (OSA) – occurs when there are repeated airway obstructions during sleep. This is the most common type of SA that is experienced by 80% of the SA population. In OSA, one’s muscles and soft tissue in the back of the throat, behind the tongue or sometimes the tongue, are sucked into the upper airway when we inhale.

Central sleep apnea (CSA) – happens when the nerve cells in one’s brain fail to activate automatic breathing. This is a rare type of SA that is experienced by only 1% of the population.

Complex sleep apnea syndrome is a combination of both OSA and CSAS. This is experienced by 15% of the people with SA.


Sleep Apnea Treatments

Sleep apnea treatment can prevent and even reverse the complications brought by this condition.  It can also restore vitality, energy level, mood and positive outlook in life. The sooner a patient is treated, the better are the results.

Sleep apnea treatment includes the use of breathing devices.  Since sleep apnea is caused by the blockage of airway passages, these devices can help keep the air passages of people with sleep apnea open while they are sleeping.

Continuous positive airway pressure (CPAP)  – this is the most common type of breathing device that is used to treat sleep apnea.  The device has a special mask worn over a person’s nose and mouth.  Air is then gently blown into the throat, easing passage into the airways. The pressure is also set in the right amount so it would be enough to stop blockages and the narrowing of airways during sleep.

Expiratory positive airway pressure (EPAP) – this treatmentuses small single-use devises that are placed over each nostril before going to sleep. It allows air to enter freely and when one exhales, it goes out through the holes in the valve. This device also reduces snoring and daytime sleepiness.

Surgery is done for people who have severe sleep apnea and when all other sleep apnea treatment have failed. In the surgery, doctors enlarge the airway passage of one’s nose or throat. There are also several kinds of surgery that can be done such as tissue removal, implants, repositioning of the jaws, and tracheotomy (creating a new airway).


Symptoms of Sleep Apnea

Eighty to ninety percent of individuals who experience this sleeping disorder are undiagnosed. Lots of victims suffer for more than ten years before they were correctly treated after diagnosis.

Here are some signs [symptoms] of sleep apnea:

  • Loud and irregular snoring
  • Unusual breathing sounds when asleep
  • Long pauses in breathing while asleep
  • Excessive daytime drowsiness
  • Difficulty of going back to sleep after waking up, Insomnia
  • Hyper-arousal
  • Obesity
  • Morning headaches, Chronic headache
  • Heartburn
  • Sudden weight gain and difficulty losing weight
  • Waking up sweaty
  • Waking up with a feeling of drowning
  • Waking with a sore throat or dry mouth
  • Fatigue, physical exhaustion
  • Depression
  • Clumsiness
  • Sleepwalking
  • Mood swings, irritability
  • Poor decision making
  • Libido decline
  • Forgetfulness
  • Bed wetting

In some cases, patients do not show symptoms at all but they still have this sleeping disorder. Furthermore, the first symptom of sleep apnea can appear years after the start of the disorder. One can look normal when awake but deadly ill when asleep.


Sleep Apnea Surgery

If you are tired of wearing uncomfy and awkward breathing devices every night and no matter what your sleep apnea just keeps getting back, it’s probably best to opt for surgery. Sleep apnea surgery is a one-time procedure that has a good success rates for patients with sleep apnea but still doctors can never promise permanent results.

Sleep apnea surgery is usually done when all other treatments have failed and for some people with jaw structure problems.  Surgeries for sleep apnea enlarge the air passage that is blocked when the person with this condition sleeps. There are different kinds of sleep apnea surgery and it is best to consult with your surgeon to know what is best for you.

Types of Surgery

  • Tracheostomy – in this kind of surgery, your doctor makes an incision on the neck and opens a direct airway in the windpipe [trachea] where a tracheostomy tube is inserted to allow a person breathe through his nose or mouth.
  • Tissue Removal or Uvulopalatopharyngoplasty (UPPP) – in this surgery, your surgeon removes tissues from your mouth and your throat.  This surgery is successful in helping people stop snoring and only a slim chance in curing sleep apnea since tissue from far down your throat still blocks air passage.
  • Implants – some snorers and people with mild sleep apnea ask their surgeons for implants to cure their loud sleeping sounds. Doctors surgically implant plastic rods into their soft palate in the operation.
  • Jaw repositioning – the jaw is moved further forward from your facial bones. By doing this, the space behind one’s tongue and palates are enlarged preventing obstructions when breathing during sleep.

There are also sleep specialist that believe surgery for sleep apnea is not for everyone. It is recommended that obese people with sleep apnea use breathing devices and see a nutritionist while thin people with severe apnea should opt for surgery.


Sleep Apnea Machine

Treatments for sleep apnea include using sleep apnea machinesuch as the CPAP, VPAP and AutoPAP masks.

  • Continuous Positive Air Pressure or CPAP is a sleep apnea machine used for people who suffer from sleep apnea.  The CPAP works by forcing air into the air passages of a person’s throat to prevent it from closing and depleting the oxygen supply.  CPAP helps to deliver same level of pressure through the airway during inhalation and exhalation.
  • Variable/Bi-level Positive Airway Pressure or VPAP/BiPap provides two kinds of pressure. These are the inspiratory airway pressure and the lower expiratory positive airway pressure. This device is used just like the CPAP to provide easier breathing and exhalation during sleep.
  • AutoPAP are auto adjusting PAP devices that can automatically vary PAP pressures throughout the night to the lowest levels that is required to treat sleep apnea. These devices are comparably expensive than the previous and are more comfortable to use.

There are also different styles of PAP masks. The first kind delivers the air via the nose only, the second kinds delivers air both by the nose and mouth.  It is important to also assure the comfort of the person who’s going to be fitted with the mask so as there can be no air leak. People who use these devices often complain of nasal congestion, excessive noise, irritation of skin over the mask, too much pressure and even claustrophobia. Doctors would always advice patients to use the sleep apnea machine that they are comfortable wearing.