Obstructive Sleep Apnea or Sleep Apnea
- Sleep Apnea is when you stop breathing during your sleep
- Your oxygen levels are affected in your body
- Signs and Symptoms of Sleep Apnea can include: Heavy snoring, witnessed pauses in your breathing, going to the toilet a lot at night, high blood pressure, daytime tiredness and headaches.
- A range of treatments are available, athough CPAP still remains the gold standard.
What causes Obstructive Sleep Apnea (OSA)?
Obstructive Sleep Apnea is a common and serious sleep disorder that causes you to stop breathing during sleep. The airway repeatedly becomes blocked, limiting the amount of air that reaches your lungs. When this happens, you may snore loudly or make choking noises as you try to breathe. Your brain and body become oxygen deprived and you may wake up. This may happen a few times a night, or in more severe cases, several hundred times a night.
In many cases, an apnea, or temporary pause in breathing, is caused by the tissue in the back of the throat collapsing. The muscles of the upper airway relax when you fall asleep. If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in back of the throat vibrate as you breathe.
There are many people with Sleep Apnea who have not been diagnosed or received treatment. A Sleep Specialist can diagnose Obstructive Sleep Apnea using an easy, one night only home sleep test. Sleep Apnea is generally treated using Continuous Positive Airway Pressure (CPAP). There are other remedies and treatments available however our patients advise they have tried many different options and CPAP remains the gold standard as far as treating sleep apnea..
Obstructive sleep apnea in adults is considered a sleep-related breathing disorder. Causes and symptoms differ for Obstructive Sleep Apnea in Children, and Central Sleep Apnea.
What are the Symptoms of Sleep Apnea?
The symptom most commonly associated with Sleep Apnea is snoring. Not everyone who snores has Sleep Apnea. If snoring is combined with choking or gasping sounds, it is likely to be Sleep Apnea.
Daytime fatigue is another common symptom.
The many symptoms of Sleep Apnea include:
- Loud or frequent snoring
- Choking or gasping while you sleep
- Pauses in breathing
- Morning headaches
- Excessive daytime sleepiness
- Insomnia due to difficulty staying asleep
- Waking up with dry mouth or a sore throat
- Frequent need to urinate during the night
- Trouble concentrating
- Memory or learning problems
- Moodiness, irritability or depression
What are the Risk Factors of Sleep Apnea?
A common misconception is that Sleep Apnea only affects older, overweight men. This widely-held assumption is wrong: anyone can have Sleep Apnea, regardless of gender, age or body type.
If you have any of the following traits you may be at higher risk:
- Excess weight – An adult with a BMI of 25 or higher is considered to be overweight. Your risk of Sleep Apnea increases with the amount of excess body weight.
- Large neck size (>43 cm for men, > 40 cm inches for women) – A large neck will have more fatty tissue that can block your airway.
- Older age (40+ for men, 50+ for women) – Sleep Apnea occurs more often in older adults, especially people older than 60.
- Male – Men have twice the risk of having Sleep Apnea compared to women
- Smoker – Smokers have a higher risk of Sleep Apnea
- Hypertensive – High blood pressure is very common in people with Sleep Apnea
- Family history – Sleep Apnea can appear more often among family members.
What tests are available to investigate snoring and OSA?
The first step is for you to discuss your snoring or sleep problem with your own doctor. It is a good idea to take your sleeping partner, if you have one, to the doctor with you, because it is your sleep partner that notices that in addition to snoring, there are periods of Apnea (ie obstructed breathing) during sleep, and a very restless sleep pattern. This can be a cause of great concern to the partner who lies awake fearful that breathing might not start again.
Following a thorough history and examination by your doctor, you may be referred to a specialist in sleep disorders.
If necessary, the advice of a surgeon may be sought regarding any nasal or throat problems.
It is generally accepted by those working in the area that a sleep study or polysomnogram should be performed to make a diagnosis. In addition, breathing tests and blood tests (to test oxygen levels, haemoglobin levels, and thyroid gland function) can be performed.
Sleep studies can be performed as a home sleep test using simple non-invasive equipment used to monitor brain, heart, lung and other organ activity during sleep.
Some patients with high risk factors for Sleep Apnea and no other medical disorders may be appropriate for a home sleep test. This type of sleep study lets you sleep in the comfort of your own home while a machine collects information. The testing equipment is similar to what is used in an overnight sleep study. Lullaby has a very easy process for you to undergo a home sleep study. You will be given a detailed video to show you how to apply the device and instructions on how to use it..
While there are other types of screening that claim to detect Sleep Apnea many cannot accurately detect and diagnose Sleep Apnea. Beware of devices that have not been recommended by a Sleep Specialist.
Once you have completed your sleep test, our Sleep Specialist will schedule a follow-up appointment to discuss your diagnosis. If you are diagnosed with Sleep Apnea, the Specialist will discuss your treatment options with you.
What is the treatment for OSA?
Sleep Apnea is a serious sleep disorder that needs to be treated. Our Sleep Specialist can help you select a treatment plan that is right for you. Depending on the treatment, he or she may work in collaboration with other members of the sleep team, including dentists, dieticians, exercise physiologists, psychologists, and technologists. Your plan may include any combination of these treatments:
CPAP (Continuous Positive Airway Pressure)
CPAP is a machine that uses a steady stream of air to gently keep your airway open throughout the night so you are able to breathe. You sleep with a mask with tubing that is attached to a machine kept at the bedside. Masks and machines may vary depending on your treatment and comfort needs.
Oral Appliance Therapy
An oral appliance or Mandibular Advancement Splint (MAS) is a device that fits in your mouth over your teeth while you sleep. It may resemble a sports mouth guard or an orthodontic retainer. The device prevents the airway from collapsing by holding the tongue in position or by sliding your jaw forward so that you can breathe when you are asleep. Some patients prefer sleeping with an oral appliance to a CPAP machine. A dentist trained in dental sleep medicine can fit you with an oral appliance after you are diagnosed with Sleep Apnea.
Surgical therapies are not as effective in treating Sleep Apnea as CPAP and oral appliances. There are a variety of surgical options you can elect to have if CPAP or oral appliance therapy does not work for you. The most common options reduce or eliminate the extra tissue in your throat that collapses and blocks your airway during sleep. More complex procedures can adjust your bone structures including the jaw, nose and facial bones.
Weight loss can help improve or eliminate your Sleep Apnea symptoms if you are overweight or obese. Overweight people often have thick necks with extra tissue in the throat that may block the airway.
If you have mild Sleep Apnea or you only snore when you sleep on your back, you may be able to improve or eliminate your symptoms by changing your sleep position. Your airway may open if you sleep on your side instead of your back. There are a variety of products that you can wear when you go to sleep that prevent you from sleeping on your back. You can also attach a tennis ball to the back of your shirt or night clothes.
There are a variety of lifestyle changes that you can make to help you reduce your snoring and improve your Sleep Apnea symptoms. Behavioural changes such as quitting smoking or not drinking alcohol may improve Sleep Apnea symptoms.
As patients with Sleep Apnea already have disrupted sleep, it is important that it is not made any worse. Therefore, it is important for patients with OSA to have regular bed times and rising times, preferably allowing 8 hours of sleep per night
If you have difficulty staying with your treatment plan or cannot sleep even with treatment, our doctor will recommend alternatives for you.
Things to avoid if you have OSA
- Alcohol may worsen Sleep Apnea because it relaxes your muscles. Mild Sleep Apnea can become severe after a few drinks.
- Smoking – this damages the upper airway and makes it more collapsible
- Sleeping tablets can reduce the drive to breathe
- Sleep deprivation – this can compound the sleepiness already present because of Sleep Apnea.
What to do next…
Step 1 – Find out if you have Sleep Apnea. Having a Sleep Test to rule out breathing disorders.
Step 2 – Consult with a Sleep Physician to discuss Sleep Test results and findings and work out a treatment plan.