Sleep Apnea

Causes, Symptoms, and Treatment Remedies




Sleep Apnea Treatment Remedies

 

The contents of this app are provided for educational purposes only and are not intended to diagnose, treat, cure, or prevent any disease or health condition. The information provided should not be considered as a substitute for the advice of a medical doctor or other healthcare professional.

More about Sleep Apnea

In obstructive sleep apnea (OSA), airway collapse is eventually terminated by a brief awakening, at which point the airway reopens and the person resumes breathing.

In men, shirt size is a useful predictor, with the likelihood of OSA increasing with a collar greater than about 42 cm (16.5 inches).

Other causes of the condition include medical disorders, such as hypothyroidism or tonsillar enlargement.

The condition is also more common in patients with a set-back chin (retrognathia), and it may be for this reason that patients of East Asian heritage are more likely to have sleep apnea without being overweight.

The most common symptom of OSA is sleepiness, with many patients describing sleep as unrefreshing. Sleep disturbance may cause difficulty concentrating, worsen short-term memory, and increase irritability.

The bed partner is likely to describe heavy snoring (OSA is exceptionally unusual without snoring) and may have observed the apneic pauses, with the resumption of breathing usually described as a gasp or a snort.

Patients with OSA and sleepiness are at increased risk of motor vehicle accidents; the magnitude of the increased risk is the subject of some debate but is thought to be between three- and sevenfold. The risk returns to normal after treatment.

Patients with severe OSA—those who stop breathing more often than once every two minutes—are at risk of other diseases, including ischemic heart disease, hypertension, and insulin resistance. However, it is less certain that these diseases are caused by OSA; it is more likely that they are secondary consequences of obesity and a sedentary lifestyle.

Treatment typically involves continuous positive airway pressure (CPAP), which uses a mask (facial or nasal) during sleep to blow air into the upper airway.

Although CPAP does not treat the condition itself, which can be resolved only by weight loss or treatment of underlying conditions, it does prevent airway collapse and thus relieves daytime sleepiness.

Some patients with sleep apnea may be treated with a dental device to advance the lower jaw, though surgery is seldom recommended.

Sleep Apnea Symptoms

Sleepiness while driving.

Morning headaches.

Restless sleep.

Recurrent awakenings or insomnia.

Excessive daytime sleepiness.

Waking with an unrefreshed feeling after sleep, having problems with memory and concentration, feeling tired, and experiencing personality changes.

Morning or night headaches. About half of all people with sleep apnea report headaches.

Heartburn or a sour taste in the mouth at night.

Swelling of the legs.

Getting up during the night to urinate.

Sweating and chest pain while you are sleeping.

Episodes of not breathing (apnea), which may occur as few as 5 times an hour (mild apnea) to more than 50 times an hour (severe apnea). How many episodes you have determines how severe your sleep apnea is.

Restless tossing and turning during sleep.

Nighttime choking or gasping spells.

Children who have sleep apnea nearly always snore. But they may not appear to be excessively sleepy during the day (a key symptom in adults).

Not growing as quickly as they should for their age. This may be the only symptom in some children. These children may also have behavior problems and a short attention span.

In rare cases, sleep apnea in children can cause developmental delays and can cause failure of the right side of the heart (cor pulmonale).

Other conditions with symptoms similar to sleep apnea include other sleep disorders and an underactive thyroid.

Obstructive sleep apnea usually occurs when the throat muscles and tongue relax during sleep and partially or completely block the airway.

When you stop breathing or have reduced flow of air into your lungs during sleep, the amount of oxygen in your blood decreases briefly.

Obstructive sleep apnea can also occur if you have bone deformities or enlarged tissues in your nose, mouth, or throat.

For example, you may have enlarged tonsils. During the day when you are awake and standing up, this may not cause problems. But when you lie down at night, the tonsils can press down on your airway, narrowing it, and causing sleep apnea.

Drinking alcohol also causes sleep apnea by affecting the part of the brain that controls breathing. This may relax the breathing muscles and cause a narrowing of the airway and sleep apnea.

Obesity. Fat in the neck area can press down on the tissues around the airways. This narrows the airways and can cause sleep apnea. About 7 out of 10 people who have sleep apnea are obese.

Some medicines that are taken for conditions such as allergies, long-term pain, insomnia, or anxiety. These medicines, such as narcotics, can also relax the muscles and tissues in the throat, causing it to narrow.

Sleep Apnea Treatment

You may be able to treat mild cases of sleep apnea by losing weight, avoiding alcohol and sleeping pills, changing sleep positions to improve breathing, and stopping smoking.

Smoking can increase the swelling in the upper airway, which may worsen both snoring and apnea.

Avoiding sleeping on your back.

Continuous positive airway pressure, also called CPAP, is a treatment in which a mask is worn over the nose and/or mouth while you sleep. The mask is hooked up to a machine that delivers a continuous flow of air into the nose. This air flow helps keep the airways open so that breathing is regular.

CPAP is considered by many experts to be the most effective treatment for sleep apnea.

Dental devices can be made that help keep the airway open during sleep. Such devices can be specifically designed by dentists with special expertise in treating sleep apnea.

If you have a deviated nasal septum, enlarged tonsils, or a small lower jaw with an overbite causing the throat to be too narrow, surgery may be needed to correct sleep apnea.

Nasal surgery: Correction of nasal problems such as a deviated septum.

Uvulopalatopharyngoplasty (UPPP): A procedure that removes soft tissue on the back of the throat and palate, increasing the width of the airway at the opening of throat.

Mandibular maxillar advancement surgery: Surgery to correct certain facial problems or throat obstructions that contribute to sleep apnea.

There are minimally invasive office procedures that reduce and stiffen the soft tissue of the soft palate. While these procedures have been effective in treating snoring, their effectiveness in treating sleep apnea in the long term isn't known.

Adjustable airway pressure devices. If CPAP continues to be a problem for you, you may be able to use a different type of airway pressure device that automatically adjusts the pressure while you're sleeping. For example, units that supply bilevel positive airway pressure (BPAP) are available. These provide more pressure when you inhale and less when you exhale.

Expiratory positive airway pressure (EPAP). This is the most recent treatment approved by the Food and Drug Administration (FDA). These small, single-use devices are placed over each nostril before you go to sleep. The device is a valve that allows air to move freely in, but when you exhale, air must go through small holes in the valve. This increases pressure in the airway and keeps it open. The device helped reduce snoring and daytime sleepiness when compared to a sham device. And, it may be an option for some who can't tolerate CPAP.

Supplemental oxygen. Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs.

Oral appliances. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances may be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.

A number of devices are available from your dentist. You may need to try different devices before finding one that works for you. Once you find the right fit, you'll still need to follow up with your dentist at least every six months during the first year and then at least once a year after that to ensure that the fit is still good and to reassess your signs and symptoms.

A dentist or orthodontist can make a custom-fit plastic mouthpiece for treating sleep apnea. (An orthodontist specializes in correcting teeth or jaw problems.) The mouthpiece will adjust your lower jaw and your tongue to help keep your airways open while you sleep.

If you use a mouthpiece, tell your doctor if you have discomfort or pain while using the device. You may need periodic office visits so your doctor can adjust your mouthpiece to fit better.

Breathing device called CPAP. The machine gently blows air into your throat. The pressure from the air helps keep your airway open while you sleep.

Treating sleep apnea may help you stop snoring. But not snoring doesn't mean that you no longer have sleep apnea or can stop using CPAP. Your sleep apnea will return if you stop using your CPAP machine or don’t use it correctly.

Usually, a technician will come to your home to bring the CPAP equipment. The technician will set up the CPAP machine and adjust it based on your doctor's prescription. After the initial setup, you may need to have the CPAP adjusted from time to time for the best results.

CPAP treatment may cause side effects in some people. These side effects include a dry or stuffy nose, irritated skin on your face, dry mouth, and headaches. If your CPAP isn't adjusted properly, you may get stomach bloating and discomfort while wearing the mask.

If you're having trouble with CPAP side effects, work with your sleep specialist, his or her nursing staff, and the CPAP technician. Together, you can take steps to reduce the side effects.

For example, the CPAP settings or size/fit of the mask might need to be adjusted. Adding moisture to the air as it flows through the mask or using nasal spray can help relieve a dry, stuffy, or runny nose.

There are many types of CPAP machines and masks. Tell your doctor if you're not happy with the type you're using. He or she may suggest switching to a different type that might work better for you.

People who have severe sleep apnea symptoms generally feel much better once they begin treatment with CPAP.

Bilevel positive airway pressure (BPAP). Unlike CPAP, which supplies steady, constant pressure to your upper airway as you breathe in and out, BPAP builds to a higher pressure when you inhale and decreases to a lower pressure when you exhale. The goal of this treatment is to assist the weak breathing pattern of central sleep apnea. Some BPAP devices can be set to automatically deliver a breath if the device detects you haven't taken one after so many seconds.

Adaptive servo-ventilation (ASV). This more recently approved airflow device learns your normal breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to normalize your breathing pattern and prevent pauses in your breathing. ASV appears to be more successful than other forms of positive airway pressure at treating central sleep apnea in some people.

Surgery is usually only an option after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery.

Surgery is done to widen breathing passages. It usually involves shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw.

Surgery to shrink or stiffen excess tissue is done in a doctor's office or a hospital. Shrinking tissue may involve small shots or other treatments to the tissue. You may need a series of treatments to shrink the excess tissue. To stiffen excess tissue, the doctor makes a small cut in the tissue and inserts a piece of stiff plastic.

Surgery to remove excess tissue is done in a hospital. You're given medicine to help you sleep during the surgery. After surgery, you may have throat pain that lasts for 1 to 2 weeks.

Surgery to remove the tonsils, if they're blocking the airway, might be helpful for some children. Your child's doctor may suggest waiting some time to see whether these tissues shrink on their own. This is common as small children grow.

Tissue removal. During this procedure, which is called uvulopalatopharyngoplasty (UPPP), your doctor removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well. This type of surgery may be successful in stopping throat structures from vibrating and causing snoring. However, it may be less successful in treating sleep apnea because tissue farther down your throat may still block your air passage. UPPP usually is performed in a hospital and requires a general anesthetic.

Removing tissues in the back of your throat with a laser (laser-assisted uvulopalatoplasty) isn't a recommended treatment for sleep apnea. Radiofrequency energy (radiofrequency ablation) may be an option for people who can't tolerate CPAP or oral appliances.

Jaw repositioning. In this procedure, your jaw is moved forward from the remainder of your face bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely. This procedure, which is known as maxillomandibular advancement, may require the cooperation of an oral surgeon and an orthodontist, and at times may be combined with another procedure to improve the likelihood of success.

Implants. Plastic rods are surgically implanted into the soft palate while you're under local anesthetic. This procedure may be an option for those with snoring or milder sleep apnea who can't tolerate CPAP.

Creating a new air passageway (tracheostomy). You may need this form of surgery if other treatments have failed and you have severe, life-threatening sleep apnea. In this procedure, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe. You keep the opening covered during the day. But at night you uncover it to allow air to pass in and out of your lungs, bypassing the blocked air passage in your throat.

Nasal surgery to remove polyps or straighten a crooked partition between your nostrils (deviated nasal septum)

Surgery to remove enlarged tonsils or adenoids.

Sleep Apnea Prevention

In many situations, sleep apnea is not preventable.

Many people experience sleep apnea because of heredity and environmental risk factors. Sleep apnea also tends to run in the family, so a genetic link might be a possibility for some patients.

You may experience sleep apnea for a variety of reasons, including the shape of your air passageways, bones, and nasal passages.

Even though you may not be able to prevent sleep apnea, measures can be taken to reduce the impact of problems related to sleep apnea.

If you keep your symptoms under control, and if you catch the condition early, you should be able to treat your sleep apnea with success.

To prevent sleep apnea, you need to maintain a healthy body weight. When a person is overweight, their windpipes can become constricted. Maintaining a healthy body weight reduces this risk.

If you are overweight, you should work with a dietician or doctor to find a plan that can help you get your weight under control.

You can also prevent symptoms of sleep apnea by keeping your allergies under control. Many people experience sleep apnea because of inflammation and problems related to allergies.

Talk to your doctor about options that are available to kept you control your allergies, especially if you notice them becoming worse in the day time.

Lifestyle changes can be sufficient in regulating mild sleep apnea. Avoid alcohol and medications than cause drowsiness. These substances can interfere with the throat's ability to stay open when a person is sleeping.

Sleep apnea patients should also avoid smoking.

If you have central sleep apnea, you should avoid taking sleep aids. These medications can be fatal for people with neurological conditions.

If you have obstructive sleep apnea, you should get it under control as soon as possible. Sometimes, obstructive sleep apnea can cause central sleep apnea.

By catching obstructive sleep apnea early, you can eliminate the possibility that you will develop more serious conditions in addition to the one that you already have.

If you think that you might have sleep apnea, or if you feel unexplained fatigue, you should talk to a doctor about undergoing a sleep test to monitor your sleeping cycle. You will benefit from a conclusive diagnosis for your sleep apnea or other sleep disorder.

Obesity is a major cause of sleep apnea. When a person is overweight, their windpipe can become constricted, reducing air flow to the lungs. For this reason, it is important to maintain a healthy weight and balanced diet.

If you are overweight, you can prevent and treat sleep apnea by getting in shape and losing weight. A dietician can work with you to create a diet plan that can help you lose weight.

A continuous positive airway pressure (CPAP) device is the most common treatment for sleep apnea. Sleep apnea patients must wear this device whenever they sleep in order to regulate air pressure in the throat. The CPAP machine is portable, so it can be used at home and during travel.

Some patients with mild sleep apnea do not need CPAP treatments at all. Nasal sprays and allergy medicines can help keep breathing passages open.

A mouthpiece can help people keep their airways open by regulating the jaw and tongue. Mouthpieces may require frequent adjustments.

If sleep apnea is a result of an underlying neurological condition, the patient may need to take medication that facilitates breathing. These kinds of patients should avoid taking sleeping pills or sedatives.

Some sleep apnea patients need surgery to widen the airways. These surgical procedures generally involve removing, shrinking, and stiffening excess tissue. Surgical procedures for sleep apnea result in painful side effects.

Sleep Apnea Statistics & Facts

Sleep is increasingly recognized as important to public health, with sleep insufficiency linked to motor vehicle crashes, industrial disasters, and medical and other occupational errors.

Unintentionally falling asleep, nodding off while driving, and having difficulty performing daily tasks because of sleepiness all may contribute to these hazardous outcomes.

Persons experiencing sleep insufficiency are also more likely to suffer from chronic diseases such as hypertension, diabetes, depression, and obesity, as well as from cancer, increased mortality, and reduced quality of life and productivity.

Sleep insufficiency may be caused by broad scale societal factors such as round-the-clock access to technology and work schedules, but sleep disorders such as insomnia or obstructive sleep apnea also play an important role.

An estimated 50-70 million US adults have sleep or wakefulness disorder1. Notably, snoring is a major indicator of obstructive sleep apnea.

Sleep modules were used to assess the prevalence of unhealthy/sleep behaviors by selected sociodemographic factors and geographic variations in 12 states. The analysis determined that, among 74,571 adult respondents in 12 states, 35.3% reported less than 7 hours of sleep during a typical 24-hour period, 48.0% reported snoring, 37.9% reported unintentionally falling asleep during the day at least once in the preceding month, and 4.7% reported nodding off or falling asleep while driving at least once in the preceding month.

This is the first CDC surveillance report to include estimates of drowsy driving and unintentionally falling asleep during the day. The National Department of Transportation estimates drowsy driving to be responsible for 1,550 fatalities and 40,000 nonfatal injuries annually in the United States.2

A short sleep duration was found to be more common among adults ages 20–39 years (37.0%) or 40–59 years (40.3%) than among adults aged ≥60 years (32.0%), and among non-Hispanic blacks (53.0%) compared to non-Hispanic whites (34.5%), Mexican-Americans (35.2%), or those of other race/ethnicity (41.7%).

Adults who reported sleeping less than the recommended 7–9 hours per night were more likely to have difficulty performing many daily tasks.

How much sleep we need varies between individuals but generally changes as we age. The National Institutes of Health suggests that school-age children need at least 10 hours of sleep daily, teens need 9-10 hours, and adults need 7-8 hours.

According to data from the National Health Interview Survey, nearly 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007.3 In 2009, only 31% of high school students reported getting at least 8 hours of sleep on an average school night.



Sleep Apnea Treatment Remedies plus




The contents of this app are provided for educational purposes only and are not intended to diagnose, treat, cure, or prevent any disease or health condition. The information provided should not be considered as a substitute for the advice of a medical doctor or other healthcare professional.

What is Sleep Apnea?

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

Sleep apnea is a respiratory condition characterized by pauses in breathing during sleep. The word apnea is derived from the Greek apnoia, meaning “without breath.”

There are three types of sleep apnea: obstructive, which is the most common form and involves the collapse of tissues of the upper airway; central, which is very rare and results from failure of the central nervous system to activate breathing mechanisms; and mixed, which involves characteristics of both obstructive and central apneas.

In severe cases this may occur once every minute during sleep and in turn may lead to profound sleep disruption. In addition, repetitive interruption of normal breathing can lead to a reduction in oxygen levels in the blood.

Obstructive sleep apnea is most often caused by excessive fat in the neck area. Thus, the condition has a strong association with certain measures of obesity, such as neck size, body weight, or body-mass index.

Sleep Apnea Symptoms

Waking up with a very sore or dry throat.

Loud snoring. Almost all people who have sleep apnea snore. But not all people who snore have sleep apnea.

Occasionally waking up with a choking or gasping sensation

Sleepiness or lack of energy during the day

Forgetfulness, mood changes, and a decreased interest in sex.

Sleep Apnea Causes

Your throat muscles and tongue relax more than normal.

Your tongue and tonsils (tissue masses in the back of your mouth) are large compared with the opening into your windpipe.

You're overweight. The extra soft fat tissue can thicken the wall of the windpipe. This narrows the inside of the windpipe, which makes it harder to keep open.

The shape of your head and neck (bony structure) may cause a smaller airway size in the mouth and throat area.

The aging process limits your brain signals' ability to keep your throat muscles stiff during sleep. Thus, your airway is more likely to narrow or collapse.

Sleep Apnea Treatment

Avoid alcohol and medicines that make you sleepy. They make it harder for your throat to stay open while you sleep.

Lose weight if you're overweight or obese. Even a little weight loss can improve your symptoms.

Sleep on your side instead of your back to help keep your throat open. You can sleep with special pillows or shirts that prevent you from sleeping on your back.

Keep your nasal passages open at night with nasal sprays or allergy medicines, if needed. Talk with your doctor about whether these treatments might help you.

If you smoke, quit. Talk with your doctor about programs and products that can help you quit smoking.

A mouthpiece, sometimes called an oral appliance, may help some people who have mild sleep apnea. Your doctor also may recommend a mouthpiece if you snore loudly but don't have sleep apnea.

CPAP (continuous positive airway pressure) is the most common treatment for moderate to severe sleep apnea in adults. A CPAP machine uses a mask that fits over your mouth and nose, or just over your nose.

Some people who have sleep apnea might benefit from surgery. The type of surgery and how well it works depend on the cause of the sleep apnea.



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