Simone Lawson
Sleep apnea is a common sleep disorder that affects your breathing while you sleep. It is characterized by recurrent pauses in breathing, which can last from 10 seconds to several minutes, and can occur many times an hour. These breathing disruptions can lead to serious health complications, including heart problems and high blood pressure. The severity of sleep apnea is typically assessed through a sleep study, which measures the apnea-hypopnea index (AHI) to determine the number of apnea and hypopnea episodes per hour of sleep. While sleep apnea itself is not fatal, it can increase the risk of sudden death, especially if left untreated. Therefore, it is important to seek medical evaluation and explore treatment options to manage the condition effectively.
| Characteristics | Values |
|---|---|
| Definition | Sleep apnea is a sleep disorder in which a person briefly stops breathing while asleep, causing them to wake up repeatedly during the night. |
| Cause | Blockage of the airway (obstructive sleep apnea) or the brain not controlling breathing as expected (central sleep apnea). |
| Diagnosis | A sleep study is the most effective way to diagnose sleep apnea. |
| Mild sleep apnea | Up to five pauses in breathing per hour in adults and once per hour in children. |
| Moderate sleep apnea | Between 15 and 30 pauses in breathing per hour. |
| Severe sleep apnea | More than 30 pauses in breathing per hour. |
| Treatment | Positive airway pressure (PAP) machine, medication, surgery, or a continuous positive airway pressure (CPAP) machine. |
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What You'll Learn
- Sleep apnea is a common condition that affects breathing during sleep
- Obstructive sleep apnea (OSA) is caused by a blocked airway
- Central sleep apnea (CSA) occurs when the brain doesn't signal breathing muscles
- Mixed/complex sleep apnea combines CSA and OSA
- Sleep studies are the most effective way to diagnose sleep apnea
Sleep apnea is a common condition that affects breathing during sleep
There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA is the more common form, affecting approximately 1 billion people worldwide between the ages of 30 and 69. It occurs when the airway is blocked, interrupting breathing. CSA, on the other hand, is caused by the brain failing to send signals to the breathing-related muscles during sleep. While CSA is less common than OSA, it is still a significant condition.
The severity of sleep apnea can range from mild to severe. This classification is based on the apnea-hypopnea index (AHI), which measures the average number of apnea and hypopnea episodes per hour of sleep. Severe OSA is defined as an AHI greater than 30, while moderate OSA corresponds to an AHI between 15 and 30. Mild sleep apnea may be treated with lifestyle changes such as weight loss, smoking cessation, or addressing respiratory allergies.
Untreated sleep apnea can lead to serious health problems, including heart failure, high blood pressure, diabetes, and an increased risk of sudden death. However, effective treatments are available, including the use of continuous positive airway pressure (CPAP) machines and oral appliances. These treatments can help manage symptoms and reduce the risk of long-term complications. Therefore, it is important for individuals experiencing recurrent pauses in breathing during sleep to seek medical evaluation and treatment.
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Obstructive sleep apnea (OSA) is caused by a blocked airway
Sleep apnea is a condition that affects your breathing while you sleep, preventing you from getting a restful night's sleep. This can have serious implications for your physical and mental health over time. There are two main types of sleep apnea: central sleep apnea (CSA) and obstructive sleep apnea (OSA). Obstructive sleep apnea (OSA) is caused by a blocked airway. During OSA, the airway is blocked, preventing breathing. The brain responds by waking the person up to breathe, but this disrupts their sleep.
OSA is the more common form of sleep apnea, affecting around 1 billion people worldwide between the ages of 30 and 69. It can affect anyone, including children, but the risk increases with age. The condition can often go unnoticed unless a sleeping partner notices abnormal breathing patterns. OSA can be effectively managed, and in some cases, treated.
There are several treatment options for OSA. Continuous positive airway pressure (CPAP) therapy is the most common and effective treatment for adults with OSA. It involves using a machine to deliver air through a mask, creating positive pressure and keeping the airway open. However, adherence to CPAP can be challenging, as many patients find it uncomfortable or struggle to sleep with the mask.
For those who cannot tolerate CPAP, custom-fitted oral appliances or mandibular advancement devices (MAD) are an alternative. These devices gently advance the lower jaw to alleviate airway obstruction. This treatment option is typically recommended for patients with mild-to-moderate OSA and good dental health. Surgery is another option for some patients, and it can help address the underlying causes of OSA.
The diagnosis of OSA is typically made through a polysomnography (PSG) test, which is considered the gold standard. This involves monitoring various physiological parameters during sleep, including brain activity, breathing patterns, muscle movements, and heart rate. Accurate diagnosis is crucial for initiating appropriate management and treatment strategies, which can vary depending on the patient's preferences and clinical presentation.
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Central sleep apnea (CSA) occurs when the brain doesn't signal breathing muscles
Sleep apnea is a condition that affects your breathing while you sleep, preventing restful sleep. Central sleep apnea (CSA) occurs when the brain temporarily stops sending signals to the muscles that control breathing. This is different from obstructive sleep apnea, where something physically blocks your breathing, although it is possible to have both types at the same time, known as mixed sleep apnea.
CSA usually occurs when a person has a serious illness, especially one that affects the lower brainstem, which controls breathing. Conditions that can lead to CSA include neurological diseases such as Parkinson's, Alzheimer's, and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). Brainstem damage caused by swelling (encephalitis), stroke, or injury can also lead to CSA. In some cases, CSA can be caused by severe heart failure, resulting in a breathing pattern known as Cheyne-Stokes respiration, which involves alternating deep and heavy breathing with shallow or no breathing.
The main symptom of CSA is pauses in breathing, which can last up to 20 seconds in very young babies. Unlike obstructive sleep apnea, CSA usually doesn't cause snoring. Other symptoms may occur if the apnea is due to a problem with the nervous system. These symptoms depend on which part of the nervous system is affected.
To diagnose CSA, a healthcare provider will perform a physical exam and recommend tests to identify any underlying medical conditions. A sleep study (polysomnography) can also be conducted to confirm sleep apnea. During this study, specialists will monitor and record information about the patient's sleep, including how many times they stopped breathing, to grade the severity of the apnea.
Treatment for CSA aims to address the underlying cause. Devices used during sleep to aid breathing may be recommended, such as nasal continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), or adaptive servo-ventilation (ASV). In some cases, medications like acetazolamide (Diamox) and theophylline (Theochron) may be used to stimulate breathing. For moderate to severe CSA, a medical device called the Remede System can be implanted in the chest to stimulate the nerve controlling the breathing muscles and restore regular breathing patterns.
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Mixed/complex sleep apnea combines CSA and OSA
Sleep apnea is a condition that affects your breathing while you sleep, preventing you from getting restful sleep. This can have an impact on both your physical and mental health. Obstructive sleep apnea (OSA) occurs when the upper airway becomes blocked or collapses during sleep, causing temporary pauses in breathing. Central sleep apnea (CSA), on the other hand, occurs when the brain fails to send the proper signals to the muscles that control breathing.
Mixed/complex sleep apnea is a combination of both OSA and CSA. In some cases, one type of sleep apnea may be more predominant than the other. This form of sleep apnea is less common than OSA but still affects a significant number of people. Complex sleep apnea often arises when individuals with OSA undergo treatments such as continuous positive airway pressure (CPAP) therapy and begin to develop CSA symptoms. This can complicate the diagnosis and treatment process, requiring a more tailored approach.
CPAP therapy is typically used to treat OSA by keeping the airways open. However, in rare cases, CPAP treatment can trigger the development of complex sleep apnea. This occurs when individuals with OSA develop CSA as a result of the CPAP therapy, requiring additional treatments. The mechanisms behind this are not yet fully understood, but it presents a challenge in managing OSA effectively.
Certain factors can increase the risk of developing complex sleep apnea. These include male sex, older age, obesity, opioid use, and heart failure. Individuals with these risk factors should be particularly vigilant about monitoring their breathing during sleep and seeking medical advice if they notice any abnormal breathing patterns.
While complex sleep apnea can resolve on its own in some cases, it often requires a more nuanced approach to treatment. Healthcare providers may need to adjust the CPAP settings, transition to a different device, or explore alternative treatments. It is important for individuals with sleep apnea to work closely with their healthcare providers to find the most effective treatment plan for their specific needs.
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Sleep studies are the most effective way to diagnose sleep apnea
Sleep apnea is a condition that affects your breathing while you sleep. It can prevent you from getting restful sleep, which can impact your physical and mental health. Those with sleep apnea may experience unusual breathing patterns, with breathing getting faster and deeper, then shallower until it stops, before starting again.
A sleep study involves the use of multiple sensors that track specific body systems and processes to provide an in-depth analysis of your sleep. Sensors used include electroencephalography (EEG) sensors, which detect and record electrical activity in the brain, as well as sensors that monitor heart rate, breathing, and blood oxygen levels. This data is then interpreted by a healthcare provider to determine if there is a medical issue and to make a diagnosis.
Polysomnography is an overnight sleep study that can be conducted in a sleep lab or at home. The at-home version does not involve brain wave monitoring and cannot diagnose central sleep apnea. Video and audio recordings of a person sleeping can also provide key evidence to help speed up the diagnostic process.
While sleep studies are very common, some people may experience side effects such as irritation from adhesives used to attach sensors or difficulty sleeping in an unfamiliar place. However, healthcare providers who specialize in sleep studies can help you relax and rest easy during the test.
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Frequently asked questions
Sleep apnea causes breathing to stop intermittently, with pauses lasting at least 10 seconds, but sometimes longer. The severity of sleep apnea is classified according to the apnea-hypopnea index (AHI), which measures the average number of apnea and hypopnea episodes per hour of sleep. Mild sleep apnea is classified as an AHI score of 15-30, while severe sleep apnea is an AHI score of over 30.
Mild sleep apnea is characterised by 15-30 episodes of interrupted breathing per hour of sleep.
Severe sleep apnea is characterised by more than 30 episodes of interrupted breathing per hour of sleep.
Sleep apnea is diagnosed through a sleep study, which can be conducted at a hospital, sleep clinic, or at home. This involves wearing a breathing monitor to track breathing patterns, blood oxygen levels, and heart rate.
Untreated sleep apnea can lead to serious health complications, including heart failure, high blood pressure, diabetes, and stroke. People with sleep apnea are also twice as likely to die suddenly than those without the condition.
