Sleep Apnea: The Hidden Danger While You Sleep

Understanding Sleep Apnea

Sleep apnea is the most common sleep disorder and can affect people of any age or gender.

Sleep apnea or obstructive sleep apnea (OSA) is a condition in which breathing is disrupted during sleep. These breathing pauses (called apneas) prevent air from flowing into the lungs. 

Sleep apnea happens when upper airway muscles (throat) relax during sleep and close off the airway, which prevents you from getting enough air. This causes the blood oxygen to drop, which then triggers the person to wake up just enough to start breathing again.

The majority of the time, there is no one cause for sleep apnea, and the condition is multifactorial for almost all patients.

Risk Factors for Sleep Apnea

Potential risk factors for sleep apnea are:

• Being overweight or obese
• Family history of sleep apnea
• Having a large/fat neck
• Smoking
• Alcohol consumption 
• Inflamed or enlarged tonsils
• Certain medications (sedatives or muscle relaxants)
• Certain medical conditions (hypothyroidism or goitre)

Symptoms of Sleep Apnoea

Sleep apnea symptoms include:

• Loud snoring – the most common symptom
• Gasping or choking sounds during sleep
• Pauses in breathing
• Dry mouth after waking up
• Excessive daytime sleepiness
• Feeling tired in spite of getting many hours of sleep
• Irritable mood
• Headaches upon waking
• Depression and anxiety

Degrees of Severity of Sleep Apnoea

Sleep apnea can be classified as mild, moderate, or severe.

• Normal sleep: < 5 events of breathing pauses per hour
• Mild sleep apnea: 5 – 14 events of breathing pauses per hour
• Moderate sleep apnea:  15 – 29 events of breathing pauses per hour
• Severe sleep apnea: > 30 events of breathing pauses per hour

The Dangers of Uncontrolled Sleep Apnea

Obstructive sleep apnea is a chronic disease with serious health consequences if left untreated. 

Several studies have shown an association between sleep apnea and health issues. People with sleep apnea face an increased risk for high blood pressure, type 2 diabetes, and other health issues. Timely sleep apnea treatment can help reduce the risk of these complications.

Diagnostic Tests for Sleep Apnea

Sleep apnea is diagnosed using a combination of medical history, physical examination, and sleep studies. 

1. Medical history and physical examination: The doctor will ask about the symptoms and conduct a physical examination, looking for signs of sleep apnea such as enlarged tonsils or a narrow airway. 
2. In-lab sleep study: A Sleep study uses equipment to monitor your breathing and oxygen levels while you sleep. Sleep studies measure things such as brain activity, heart rate, oxygen levels, and breathing patterns.  It is usually done in a laboratory where you will spend the night for monitoring. 
3. Drug-induced sleep endoscopy (DISE): In this test, after sedation, an endoscope (thin tube with a light and camera) is inserted down the throat to find the exact location of blockages in your upper airway. DISE helps us select the right surgical treatment for your needs.
4. Home sleep apnea test: Home sleep apnea testing is possible as well, using a portable monitor. 

Common Treatments for Sleep Apnea

Sleep apnea is treatable with both medical and surgical options, depending on the severity of the condition.

1. CPAP machine:
   • The most common treatment for sleep apnea. 
   • It is a non-invasive machine that blows air through tubing into a mask that is worn on the nose and/or mouth. This air pressure goes into the back of the throat, holding it open.
   • This prevents pauses in breathing.
2. Bilevel Positive Airway Pressure (BiPAP)
   • The BiPAP machine operates similarly to a CPAP machine, with a connected tube that pushes air into a mask to keep the airway open. However, it uses two kinds of pressure: higher pressure during inhalation and lower pressure during exhalation.
   • Used when a person with sleep apnea cannot tolerate CPAP. 
3. Oral Appliances: If you have mild to moderate sleep apnoea, another possible treatment is by use of oral appliances. Oral appliances are designed to reduce symptoms by opening up the airway.
   • Mandibular advanced splints (MAS): This is a kind of mouthguard designed to pull the lower jaw forward to create more room in the throat. It needs to be worn whenever the patient sleeps.
   • Tongue-retaining devices: These devices work by keeping the tongue positioned forward using suction. It keeps the airway clear and prevents its blockage by the tongue.
4. Medication: Other options to treat sleep apnea include medications (Tirzepatide). These are used to treat moderate to severe obstructive sleep apnea in patients with obesity. 
5. Sleep apnea surgery: Surgery is often only considered after non-invasive treatments have been tried. It is done to remove excess tissue from the airway or to widen the nasal passage.
   • Turbinate surgery: This is a procedure that removes or shrinks some of the tiny bones in the nose. It is done when the structure of a person’s nose and nasal passage contributes to sleep apnea symptoms. 
   • Transoral robotic surgery (TORS): This is a minimally invasive robotic surgical technique to treat mouth and throat tumors and conditions that obstruct the upper airway.
   • Endoscopic sinus surgery: This is another minimally invasive procedure used to clear blocked sinuses. Using a thin, flexible tube with a camera called an endoscope, surgeons can see inside the sinuses and remove blockages such as polyps, infected tissue, or bone fragments.
   • Maxillomandibular advancement (MMA): In this procedure, the upper and lower jaw bones are surgically moved forward to create more space in the airway. MMA is generally combined with other procedures, such as soft tissue surgery, to achieve the best results.

Lifestyle Changes to Treat Sleep Apnea

For mild sleep apnea syndrome, lifestyle changes may be enough to alleviate the symptoms. 

1. Weight loss: For people who are overweight or obese, weight loss is key for treating or avoiding sleep apnea. There are many research studies showing that losing weight can either completely cure you of sleep apnea or at least make it less severe. Experts recommend diet and exercise for weight management.
2. Changing sleep position: Positional therapy can reduce OSA symptom severity in some people. Back sleeping is associated with more severe symptoms for many people with sleep apnea so sleeping position may be changed..
3. Improve sleep hygiene: It’s ideal to maintain a consistent sleep schedule as much as possible. Creating a calm and soothing sleep environment may help you get more restorative sleep. Avoid activities that may interfere with your sleep routine, such as eating a large meal, consuming caffeine or alcohol, exercising, and using digital devices.
4. Avoiding alcohol and certain medications: People with sleep apnea should avoid alcohol and sedatives at least 2-3 hours before sleeping. This is because they increase sleep apnea symptoms by relaxing muscles associated with the airway, thereby causing blockages.
5. Quitting smoking: Cigarette smoking increases a person’s risk of having sleep apnea, so doctors often recommend that smokers with sleep apnea quit smoking.

Why Choose Arpit Medi for Sleep Apnea Treatment

1. State-of-the-art sleep centre for sleep apnea diagnosis and treatment: Understanding the causes of your sleep breathing issues is important for choosing the right treatment.
2. Individualized sleep apnea care: At Arpit Medi, we offer a wide variety of surgical and medical treatment options for adults and children with sleep apnea, depending on the severity and the patient’s preferences.
3. Patient-Centered outcomes: We help you understand your sleep issues and create a personalized treatment plan that helps you feel your best. Our focus is on your overall health, sleep quality, and quality of life.

Key Takeaways

Sleep apnea is a common sleep disorder in which breathing is disrupted during sleep. There are several symptoms of sleep apnea, including snoring, gasping, dry mouth, fatigue, and irritability. Sleep apnea can have serious health consequences if left untreated. It is treatable with lifestyle changes as well as medical and surgical options.

Frequently Asked Questions