Sleep apnea is a significant and dangerous sleeping condition in which breathing is paused or interrupted. People experiencing symptoms stop breathing fully (apnea) or partially (hypopnea), then resume breathing multiple times per hour during sleep. Snoring commonly suggests apnea but it is not required to make the diagnosis; the absence of snoring does not exclude apnea.
When breathing decreases, the brain does not receive sufficient oxygen. This condition causes the brain to move from DEEP sleep in which the brain rests and recovers and forces it into SUPERFICIAL sleep (or awake gasping for air). When the brain is punished this way every night, consequences are severe. They include:
To easily visualize a single apnea event, picture a person shoving a pillow over your face while in a deep sleep. The pillow stays until just before you wake up. This occurs 10, 20, 50 or even 100 times per hour depending on apnea severity. The brain simply cannot handle such repetitive lack of oxygen without harsh consequences.
There are three types of sleep apnea:
1. Obstructive sleep apnea (OSA)
This is the most common type. In obstructive sleep apnea, the airway narrows and blocks off when the throat muscles relax, and the tongue falls back in the throat. It occurs more frequently in people who are overweight but can occur in thin individuals based on body build. Large tonsils will also cause obstructive sleep apnea, especially in children.
2. Central sleep apnea
In this type of apnea, airway blockages are not involved. Instead, the brain fails to transmit signals telling the body to continue breathing. It is a result of a failure in the respiratory control area of the brain.
3. Complex (Mixed) sleep apnea
It is a combination of both obstructive sleep apnea and central sleep apnea.
Common signs of sleep apnea include:
Sleep studies diagnose sleep apnea. Health professionals record the apnea events per hour to determine the gravity of the condition. Oxygen levels in the blood are also an indicator of the severity of sleep apnea. Although the oxygen levels may drop to worrisome levels for many minutes or even hours each night, treating sleep apnea will often fix the oxygen deficit without needing to add oxygen overnight.
Home Sleep Apnea Test (HSAT)
This version of testing is commonly preferred by patients and insurance payers, given the convenience and cost (typically 75% cheaper than the PSG). With HSAT, a patient receives a small kit and easy to follow instructions.
Testing is done at home for three nights – in your own bed. Three sensors are placed to detect oxygen and apnea events, 1) nasal cannula, 2) respiratory elastic strap around the chest, and 3) fingertip cover for pulse oximetry. After completing 3 nights, the kit is returned. Two sample videos are available here: https://www.youtube.com/watch?v=Aw8ZwXHzpg4 or https://www.youtube.com/watch?v=awa4z2fFn7A.
It involves spending the night in a medical facility in a sleep lab bed. The polysomnogram measures the activity of the body functions associated with sleep. While disadvantages include only obtaining one night of data, increased cost, and sleeping in a strange bed, advantages include having a sleep technician monitor your sleep to reattach any dislodged cables and additional test modalities such as measurement of abnormal limb movements (kicking) or brain activity (EEG). The PSG may be preferred for people with significant COPD, heart failure, or prior stroke.
Treatment of sleep apnea will have a positive impact on the life of a person. The person may enjoy the following benefits:
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