Sleep Apnea

• Are you a loud, habitual snorer, disturbing your bedroom companion?
• Do you feel tired and unrefreshed on awakening? 
• Do you have a dry mouth, sore throat or headache in the morning?
• Do you experience sleepiness and fatigue during waking hours?
• Are you overweight?
• Have you been observed to choke, gasp or hold your breath during sleep?

If you answered yes to any of these questions, then you should discuss your symptoms with your physician.

• What is sleep apnea?
  The Greek word apnea literally means ‘want of breath’. Sleep apnea is the medical name for interruptions in breathing during sleep. There are two types of sleep apnea. The most common and most severe form is obstructive or upper airway sleep apnea. This is caused by the obstruction of the airway resulting from the relaxation of tissue in the airway.
  
  The consequent difficulty in breathing causes the blood oxygen levels to fall, which in turn causes the brain to arouse and briefly wake up the person to breathe. The usual response is a big breath in, often a snore, and then to fall back to sleep again. This cycle repeats itself, sometimes hundreds of times a night. The same breathing difficulties during sleep are observed in central sleep apnea, but in this rarer form the difficulty is a consequence of the brain failing to send the appropriate messages to the diaphragm and chest muscles to inhale.

• What are the symptoms of sleep apnea? 
  The symptoms of sleep apnea are more likely to be noticed by the partner than by the person with sleep apnea. It is usually indicated by snoring and accompanied pauses in breathing which may last between 10 – 60 seconds. Each pause ends with a very deep gasping or snoring noise and a brief awakening as the person struggles to breathe. Mostly these brief arousals are not remembered, but some may remember waking with the sensation of choking.
  
  Often the person with untreated sleep apnea wakes up feeling like they are hungover, possibly with a headache, a dry mouth and a sore throat. The daytime sleepiness that may result from poor quality sleep can give rise to difficulty in concentrating and functioning during the day, forgetfulness, irritability, anxiety, depression and other personality changes. It can also have dangerous consequences if you fall asleep or lose concentration while driving or using heavy machinery. Research has shown that people with sleep apnea are 2 – 5 times more likely to have a motor vehicle accident.
  
  Other symptoms that can occur in untreated sleep apnea are impotence or reduced libido, high blood pressure, heart disease, stroke, excessive perspiration during sleep, increased frequency of urination at night and a dry mouth and sore throat upon awakening.
  
  
  
• Who gets sleep apnea?  
  Sleep apnea can occur in people of all ages. It is most common, though, in middle aged males who are overweight, particularly with excessive fatty tissue around the neck. In people who are not overweight, it is likely that they have been born with a narrow airway or a facial structure which leads to a narrow airway. The incidence of sleep apnea in women increases after menopause. In childhood, apnea most commonly occurs as a result of enlarged tonsils or adenoids, or from some facial bone abnormality. 
  
  
  
• Diagnosis of sleep apnea:
  Symptoms such as snoring, obesity, observed apnea and sleepiness in the day may suggest that a person has sleep apnea. The diagnosis is confirmed by an overnight sleep study where brain waves, muscle activity, leg and arm movements, heart rhythms, eye movement, respiration, and blood oxygen levels are monitored in the sleeping individual. These monitoring devices are comfortable and will not restrict your ability to move while asleep. Please refer to the Sleep study page on this site for more information regarding what is involved in a sleep study.
  
  
• Treatment of sleep apnea:
  Behavioural changes such as losing weight or sleeping on your side may help. In more moderate to severe forms of sleep apnea, treatment may take the form of nasal continuous positive airway pressure (CPAP). This consists of a pump that blows air through a mask worn over the nose. The air pressure keeps the airway open by preventing the collapse of soft tissue into the upper airway. The pump only needs to be used during sleeping hours and the treatment is immediately effective at controlling the symptoms and the long term consequences of sleep apnea. The noise of the pump is generally much less intrusive than the snoring that preceded it.
  
  Surgical treatments that attempt to remove excess tissue to clear the airway, moving the tongue forward, and moving the upper and lower jaw forward have been tried but they may not be effective in everyone. Devices that fit in the mouth and hold the jaw forward, elevate the soft palate or retain the tongue from falling back into the airway may also reduce the severity of sleep apnea, but these also will not work for everyone. There is no effective drug for treating sleep apnea.
  
  
• Things to avoid if you have sleep apnea

• Alcohol and its muscle relaxing properties may worsen this condition. Mild sleep apnea can become severe after three to four standard drinks.
• Sleeping tablets may also worsen sleep apnea by depressing the drive to breathe.
• Sleep deprivation
• Caffeine
• Eating late at night

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