Sleep Apnea: Causes, symptoms and treatments

Sleep apnea is the most common sleep disorder, but it often goes undiagnosed. Aside from creating ongoing disruptions to restful sleep resulting in chronic fatigue, if left untreated, apnea can have a long term effect on overall health.

“It’s raining, it’s pouring. The old man is snoring. And he couldn’t get up in the morning.”- Mother Goose

That nursery rhyme may seem innocent enough, however it sounds as if the poor old man may have possibly suffered from sleep apnea. This disorder affects as many as 22 million Americans alone.

What is obstructive sleep apnea?

Obstructive sleep apnea is the most common, often undiagnosed sleep-related disorder that occurs when you have abnormal reductions in your breathing while you are sleeping.^[1] This is a serious disorder as it may cause you to stop breathing for 20 to 30 seconds numerous times throughout the night, on average 5 times per hour.^[1][2] These disruptions can not only reduce the quality of your restful phases of sleep, but can also lead to potentially serious health conditions if left untreated.^[3]

Sleep & obstructive sleep apnea

Obstructive sleep apnea occurs when the upper airway is blocked or constricted while the individual is sleeping, preventing air from passing through normally and contributing to a buildup of carbon dioxide.^[1][5][6] The person suffering from this disorder awakens due to the blocked airway, gasps for air or takes deep breaths and is often heard snorting or choking.^[1] If this disorder is left untreated it increases the individuals risk to diseases such as heart disease, stroke, diabetes, headache syndromes, high blood pressure, congestive heart failure, and can cause heart rhythm problems.^[3][5] Obstructive sleep apnea may also be the cause for job impairment, work-related accidents, motor vehicle crashes, as well as poor school performance in children and adolescents. ^[5]

Symptoms of sleep apnea

• Loud snoring that is often accompanied with grasping, snorting, or choking sounds.^[1][2]
• Restless sleep that has you kicking, thrashing, jerking often accompanied with periods of insomnia throughout the night.^[1][2]
• Irritability, frustration, or difficulty focusing. (1).^[1]
• Dry mouth or a sore throat upon awakening.^[1][5]
• Excessive tiredness, daytime sleepiness, or fatigue.^[1][2][5]
• Headaches.^[5]
• Sexual dysfunction or decreased libido.^[6]
• Bad breath that won’t go away.^[4]
• High blood pressure.^[6]

Risk Factors

• Age: Sleep apnea can occur at any age even amongst infants and children, however the risk increases with age throughout adulthood especially amongst people over the age of forty. ^[1][5]
• Body weight: Research has shown a correlation between individuals who have a higher body mass index, are overweight, or are obese.^[1][3]
• Sleeping position: People who sleep on their back are more prone to the disorder due to how the sleeping position affects the airways shape and positioning of the tissue supporting the airway.^[1]
• Medications: Chronic prolonged use of opioid drugs and some prescription medications increase one’s risk.
• Structural Abnormalities: Individuals who have large necks, enlarged tonsils, small jaw with an overbite, or nasal obstruction have and increased risk.^[5]
• Smoking.^[6]
• A family history of sleep apnea.^[6]
• Asthma.^[6]

Treatment:

One of the most common ways to treat obstructive sleep apnea is to sleep with a CPAP (continuous positive airway pressure) machine and mask.(1) The machine keeps the airway open and delivers constant steady pressure to help you breathe while you sleep.^[1]

Your dentist might discuss with you the option of getting a custom-fitted oral appliance therapy made. Dental appliances help prevent the tongue from blocking the throat and can advance the lower jaw forward, thus helping to keep the airway open while sleeping.^[5]

Surgery might be suggested that removes excess tissue in the throat and expands the airway.^[1] This might prove helpful to individuals who have tissue that is obstructing their airway. Another option it to have a surgical treatment that implants a device that stimulated a nerve to help control your breathing.^[1][5] Other surgery options are to repair abnormalities that cause obstructions when you breath, removal of adenoids and tonsils, or repairing the defects in facial structures.^[3]

Many have found that making lifestyle changes such as: losing weight, exercising regularly, alternating sleep positions, and reducing alcohol consumption has helped them to manage their symptoms.^[5]

It is important to discuss any symptoms you have with your medical doctor or your dentists so that you can avoid the risk of major health problems.^[3] They will probably recommend a sleep study that will determine your breathing patterns and help the doctor develop a customized treatment plan for you to treat and manage your condition.^[3]

References

1. Sleep Foundation. https://www.sleepfoundation.org/sleep-apnea
2. John Hopkins Medicine. 4 Signs You Might Have Sleep Apnea. https://www.hopkinsmedicine.org/health/wellness-and-prevention/4-signs-you-might-have-sleep-apnea
3. John Hopkins Medicine. Obstructive Sleep Apnea. https://www.hopkinsmedicine.org/health/conditions-and-diseases/obstructive-sleep-apnea
4. Mayo Clinic. CPAP machines: Tips for avoiding 10 common problems. 2021, October 27. ://www.mayoclinic.org/diseases-conditions/sleep-apnea/in-depth/cpap/art-20044164
5. Cleveland Clinic. Oral Appliance Therapy for Obstructive Sleep Apnea. https://my.clevelandclinic.org/health/treatments/21129-oral-appliance-therapy-for-sleep-apnea
6. Mayo Clinic. 2021, October 27. Sleep Apnea. ://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090