At this point, your breathing may cease entirely while you’re sleeping. Millions of people worldwide suffer from a sleep ailment called apnea, also called sleep apnea. It is characterized by frequent breathing pauses during sleep, which results in shattered and subpar slumber. These pauses, also known as apnea events, can happen several times throughout the course of the night and last anything from a couple of seconds to a minute. An individual’s daily functioning, cardiovascular health, cognitive capacities, and emotional state are all susceptible to apnea, which has a considerable negative impact on one’s overall health and well-being. For correct diagnosis, intervention, and management of this breathing sleep situation, it is essential that one understands the causes, symptoms, effects, and available treatments for apnea. People can increase their general quality of life, lower health risks, and get more significant restful sleep by correctly treating their apnea.
Effects of Apnea
- Apnea disturbs the regular sleep cycle, resulting in fragmented and insufficient sleep, which contributes to excessive daytime sleepiness. It becomes challenging to focus and carry out everyday tasks as a result of excessive daytime sleepiness, weariness, and decreased awareness.
- Cardiovascular Complications: Untreated apnea raises the risk of high blood pressure, heart disease, stroke, and abnormal heart rhythms. The heart is stressed and oxygen to the body’s critical organs is disrupted when breathing is repeatedly interrupted during sleeping.
- Cognitive Impairment: Prolonged sleep loss brought on by apnea can harm cognitive abilities such as memory, focus, and problem-solving. It may also have an impact on creativity, judgment, and learning.
- Emotional and Psychological Impact: Apnea is linked to a higher risk of mental health issues like depression and anxiety. Anger, mood swings, and a lower quality of life can result from interrupted sleep patterns and physiological stress caused by apnea.
Causes of Apnea
- Obstructive Sleep Apnea (OSA):
- Obesity: OSA is significantly increased by being overweight or obese. Fat buildup around the neck and upper airway might cause airway blockage or narrowing while you’re sleeping.
- Anatomical anomalies or physical flaws can cause structural abnormalities, which might result in airway blockage. These could include a big tongue, a deviated septum, a narrow throat, swollen tonsils or adenoids, etc.
- Age: OSA becomes more prevalent as people age because their throat and tongue muscles may lose tone and become more prone to collapsing.
- Gender: Men are more likely to have OSA than women, while women are more at risk following menopause.
- Family history: Given that OSA tends to run in families, there may be a genetic component to the condition.
- Nasal Congestion: By preventing airflow, chronic nasal congestion brought on by allergies, sinus issues, or nasal blockages can exacerbate OSA.
- Use of alcohol and sedatives: These substances can relax the muscles in the throat, which can cause more airway collapse and obstruction as you sleep.
- Central Sleep Apnea (CSA):
- Medical Conditions: Heart failure, stroke, brainstem problems, and ailments affecting the brain’s respiratory control centers are a few of the conditions that are frequently linked to CSA.
- Prescription drugs: Some drugs, notably opioids or specific sedatives, can reduce the brain’s respiratory drive and cause CSA.
- High Altitude: Being exposed to high altitudes can mess with your breathing and make you more prone to developing CSA.
- Mixed Sleep Apnea:
When both obstructive and central factors contribute to the disruption of breathing while you sleep, you have mixed sleep apnea, which combines both OSA and CSA.
Symptoms of Apnea
- Apnea symptoms must be recognized in order to be detected early and treated effectively. Typical signs include:
- Loud, Chronic Snoring: In situations with OSA, snoring is a common sign of apnea. The snoring is frequently loud and obtrusive, and it occasionally includes gasping or choking noises.
- Intermittent Breathing Pauses: Partners or family members notice episodes of interrupted breathing that last anywhere from a few seconds to a minute. These pauses are typically followed by a sharp gasp or snort as breathing starts up again.
- Even after a night of sleep that seemed enough, people with apnea frequently complain of extreme daytime tiredness. They could have trouble staying awake when working, watching TV, or driving.
- Morning Headaches: Lack of oxygen during sleep may cause persistent morning headaches.
- Apnea can cause cognitive impairment generally, including memory issues, difficulties focusing, decreased attentiveness, and general cognitive impairment.
- Mood swings, melancholy, anxiety, and irritability can all occur in apnea sufferers.
- Reduced Libido: Apnea can lead to sexual dysfunction and a reduction in libido.
Natural remedies for Apnea
- Weight loss: Particularly in cases of OSA, losing excess weight might considerably alleviate apnea symptoms. A common risk factor for apnea is obesity, and losing weight helps lessen airway blockage.
- Instead of sleeping on your back, try sleeping on your side to avoid airway obstruction. It may be helpful to use pillows or other positioning aids that promote side sleeping.
- Regular Physical Activity: Being physically active on a regular basis can assist to enhance overall sleep quality and lessen the severity of apnea symptoms.
- Healthy Sleep Habits: Good sleep hygiene, which includes following a regular schedule, creating a sleep-friendly atmosphere, and avoiding stimulants like caffeine and technology before bed, will help you get a better night’s sleep.
- Avoiding Alcohol and Sedatives: Alcohol and sedatives can relax the throat muscles, making sleep apnea symptoms worse. It is best to avoid or consume them in moderation, especially before bed.
- Nasal Dilators and Strips: By keeping the nasal passageways open, nasal dilators like sticky strips or nasal cones can aid enhance airflow.
- Dental professionals can rearrange the jaw and tongue with the aid of oral appliances, which can assist maintain the airway open while you sleep.
Diagnosis of Apnea
- Polysomnography, a thorough sleep study, is regarded as the gold standard for identifying apnea. It entails tracking a variety of physiological indicators over the course of a night’s sleep, such as brain activity, heart rate, oxygen levels, and breathing patterns.
- The number of apnea and hypopnea occurrences per hour of sleep is determined by the Apnea-Hypopnea Index (AHI). It aids in assessing apnea severity and directs therapy choices.
- Medical History: The healthcare professional will start by interviewing you in-depth about your medical history. Your symptoms, sleeping habits, medical issues, and any prescription drugs you might be taking will all be questioned. To aid in the diagnosis, it is crucial to offer correct and complete information.
- Physical Exam: A physical exam may be performed to evaluate your general health and check for any physical symptoms or apnea risk factors. The examination could involve a throat, neck, and airway assessment.
- extra Examinations: In some circumstances, extra examinations may be advised to further assess the underlying causes or aggravating elements of apnea. These may consist of:
- The Multiple Sleep Latency Test (MSLT) gauges how sleepy you are during the day by gauging how quickly you nod off in a peaceful setting. It aids in evaluating how apnea affects daytime functioning.
- Home Sleep Apnea Test (HSAT): Using portable monitoring equipment, a streamlined sleep study may occasionally be carried out at home. With no substantial comorbidities and a high possibility of having moderate to severe obstructive sleep apnea (OSA), patients frequently choose this option.
Treatment options for Apnea
- Changes in Lifestyle:
Weight loss: Losing weight can considerably reduce symptoms in those with obstructive sleep apnea (OSA) who are overweight or obese. Even a small amount of weight loss can assist to lessen apnea severity and enhance general health.
- Regular Physical Activity: Being physically active on a regular basis can assist to enhance overall sleep quality and lessen the severity of apnea symptoms. For individualized advice, it’s critical to discuss workout regimens with a healthcare practitioner.
- Instead of sleeping on your back, try sleeping on your side to avoid airway obstruction. Techniques that promote side sleeping, such as the use of cushions or positioning devices, can be helpful.
- Avoidance of Alcohol and Sedatives: Sedatives and alcohol should be avoided since they relax the muscles in the throat and make apnea symptoms worse. It can be beneficial to restrict or prevent their consumption, particularly just before bed.
- Continuous Positive Airway Pressure (CPAP):
Treatment for moderate to severe OSA frequently involves CPAP. It entails using a mask over the nose or mouth as you sleep that provides a steady stream of air to keep your airway open. The air pressure is changed to the ideal setting advised by a medical expert.
- Oral devices:
Oral appliances are made-to-measure tools that assist in realigning the jaw and tongue to maintain an unobstructed airway as you sleep. They are especially beneficial for people with mild to moderate OSA who cannot tolerate CPAP or would rather utilize an alternative form of treatment. A dentist with expertise in sleep apnea should fit and maintain these devices.
- Positive airway pressure at two levels (BiPAP):
A higher pressure is delivered by BiPAP machines during breathing and a lower pressure is delivered during expiration. For people with certain respiratory disorders or those who have trouble tolerating CPAP, BiPAP is frequently given.
- Adaptive Servo-Ventilation:
For the treatment of central sleep apnea (CSA) or mixed sleep apnea, a specialized type of positive airway pressure therapy called ASV is employed. For the purpose of stabilizing breathing as you sleep, ASV devices track your breathing patterns and offer pressure support as necessary.
To treat anatomical defects that lead to airway obstruction in some circumstances, surgical operations may be advised. There are a number of surgical treatments, including maxillomandibular advancement (MMA) surgery, adenoidectomy, uvulopalatopharyngoplasty, and tonsillectomy. When alternative treatment options have failed or are inappropriate, these treatments are often considered.
- Various Therapies:
For some people with apnea, there are a number of alternative therapies that could offer symptomatic alleviation. They include acupuncture, a variety of mouth exercises, and positional therapy. It is crucial to discuss these therapies with a healthcare provider because the efficacy of these methods can differ.
Prevention of Apnea
- Obesity is a major risk factor for obstructive sleep apnea (OSA), so keep your weight in check. Maintaining a healthy weight through a balanced diet and consistent exercise can lower the risk of having OSA or help people who have the condition to feel better.
- Practice Good Sleep Hygiene: Creating healthy sleep routines can improve sleep quality and lessen the risk of apnea. Maintaining a regular sleep schedule, providing a cozy sleeping environment (cold, dark, and quiet), and staying away from stimulants like caffeine and nicotine as well as electronic gadgets in the hours before bedtime are just a few suggestions for good sleep hygiene.
- void Alcohol and sedatives can relax the muscles in the throat, which increases the chance of airway collapse and obstruction while you’re sleeping. Alcohol and sedative use should be restricted or avoided, especially before night, as this might lead to apnea episodes.
- In people who are prone to apnea, sleeping on the side rather than the back can assist prevent airway obstruction. It may be helpful to use pillows or other positioning aids that promote side sleeping. The airway may be kept open by slightly raising the bed’s head.
- Maintain Nasal Health: The onset or worsening of apnea can be influenced by chronic nasal congestion brought on by allergies, sinus issues, or anatomical abnormalities. Airflow can be improved by properly treating nasal congestion, such as with nasal sprays or allergy drugs.
*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.
Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician, and Rajeshwar Rao, Pharm D.