Sleep Apnea and Your Sleep

By Yash Pal Mehndiratta, MD, DABSM

Sleep Services of Maryland

. http://www.sleepservicesmd.com/

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Sleep Apnea and Your Sleep

Obstructive sleep apnea (OSA) is a disorder in which breathing is briefly and repeatedly interrupted during sleep. The “apnea” in sleep apnea refers to a breathing pause that lasts at least 10 seconds. Obstructive sleep apnea occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. Another form of sleep apnea is central sleep apnea, in which the brain fails to properly control breathing during sleep. Obstructive sleep apnea is far more common than central sleep apnea.

Obstructive sleep apnea, or simply sleep apnea, can cause fragmented sleep and low blood oxygen levels. For people with sleep apnea, the combination of disturbed sleep and oxygen starvation may lead to hypertension, heart disease and mood and memory problems. Sleep apnea also increases the risk of automobile crashes. Sleep apnea can be life-threatening and you should consult your doctor immediately if you feel you may suffer from it.

More than 18 million American adults have sleep apnea. OSA occurs in all age groups and both sexes, but there are a number of factors that increase risk, including having a small upper airway, being overweight, having a recessed chin, small jaw or a large overbite, a large neck size, smoking and alcohol use, being age 40 or older, and ethnicity (African-Americans, Pacific-Islanders and Hispanics). Also, OSA seems to run in some families, suggesting a possible genetic basis.

Chronic snoring is a strong indicator of sleep apnea and should be evaluated by a health professional. Since people with sleep apnea tend to be sleep deprived, they may suffer from sleeplessness and a wide range of other symptoms such as difficulty concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep while at work, on the phone, or driving. Left untreated, symptoms of sleep apnea can include disturbed sleep, excessive sleepiness during the day, high blood pressure, heart attack, congestive heart failure, cardiac arrhythmia, stroke or depression.

If you suspect you may have sleep apnea, the first thing to do is see your doctor. Bring with you a record of your sleep, fatigue levels throughout the day, and any other symptoms you might be having. Ask your bed partner if he or she notices that you snore heavily, choke, gasp, or stop breathing during sleep. Be sure to take an updated list of medications, including over the counter medications, with you any time you visit a doctor for the first time. You may want to call your medical insurance provider to find out if a referral is needed for a visit to a sleep center.

One of the most common methods used to diagnose sleep apnea is a sleep study, which may require an overnight stay at a sleep center. The sleep study monitors a variety of functions during sleep including sleep state, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels. This test is used both to diagnose sleep apnea and to determine its severity. Sometimes, treatment can be started during the first night in the sleep center.

The treatment of choice for obstructive sleep apnea is continuous positive airway pressure device (CPAP). CPAP is a mask that fits over the nose and/or mouth, and gently blows air into the airway to help keep it open during sleep. This method of treatment is highly effective. Using the CPAP as recommended by your doctor is very important.

The most important part of treatment for people with OSA is using the CPAP whenever they sleep. The health benefits of this therapy can be enormous, but only if used correctly. If you are having problems adjusting your CPAP or you're experiencing side effects of wearing the appliance, talk to the doctor who prescribed it and ask for assistance.

Getting adequate sleep is essential to maintaining health in OSA patients. If you have symptoms of insomnia such as difficulty falling asleep, staying asleep, or waking up unrefreshed, talk to your doctor about treatment options.