Every Breath You Take I’ll Be Stopping You – Sleep Apnea
How difficult can it be to catch those few zzzs we all so desperately need? Considering our stressful lifestyles, one will probably say - very difficult. And if you add an annoying, but potentially serious, sleep disorder to the mix, your answer will surely be impossible.
Like millions of other people, you too could be suffering from sleep apnea (sa), one of the leading forms of sleep disorders. But fear not, “dear Sleepless in Seattle”, there are plenty of treatment options, and some of them are amazingly simple.
Everybody’s talking about sleep apnea...but what is it?
Sleep apnea is a chronic disorder characterized by repeated interruptions in breathing during sleep. These pauses raise the carbon dioxide level, triggering a signal from the chemoreceptors to the brain to wake us up. (In general, chemoreceptors or chemosensors detect chemical in their surroundings. Since carbon dioxide in blood exists in the form of hydrogen cations and bicarbonate anions, these chemoreceptors actually monitor the concentration of hydrogen ions.) When we wake up and start breathing again, normal oxygen levels are restored and eventually, we fall back to sleep.
There are two main types of sleep apnea:
Obstructive Sleep Apnea (OSA)
This most prevalent form occurs when throat muscles are relaxed for a prolonged amount of time, and there are obstructions in the airway (i.e. bone deformations in the nose or tissue inflammation).
Central Sleep Apnea (CSA)
This is best described as a failure of the brain to properly communicate with the breathing muscles. This form of sleep apnea is usually associated with alcohol consumption and certain types of medications.
What are the risk factors & How does SA affect you?
Large neck size, narrowed airways, being overweight, being a smoker, being male or your age.
Furthermore, recently published data shows an increased number of OSA in pregnant women, and overweight children. Alcohol and sedatives relax your muscles and can be a serious contributing factor. Although it may seem more like a nuisance than a real health threat, if left untreated, OSA may increase your risk of cardiovascular problems, stroke and type 2 diabetes.
Yikes! Do I have It? What Are The Symptoms?
OSA can be a real drag! Most of us are completely unaware of our behavior while we’re asleep. So, if you’re potentially facing the OSA, this will be one of the rare occasions when you’ll appreciate your partner’s relentless nagging about your snoring. However, snoring is not the only symptom. There are, in fact, a myriad of signs, but most resemble those of poor sleep quality or nasal congestion. Symptoms of sleep apnea include: sleepiness during the day, waking up with the shortness of breath, dry mouth and sore throat after waking up, chest pain upon waking up, insomnia, hypertension and snoring.
Also, if you or your partner snore loudly and wake up gasping for air, you can be pretty sure something funky is going on and should consider checking it out. A full and complete assessment of your condition is required for a reliable diagnosis. This usually involves a series of sophisticated tests, or sleep study, in sleep clinics or labs. Beforehand, your doctor may issue you a home sleep apnea test, which is essentially a small monitor that records all the data related to your sleep patterns.
Everybody’s Talking About It, But Who’s Doing Something About It ? Treatments for Sleep Apnea
The treatment usually starts with simple behavioral and lifestyle changes, like quitting smoking or losing weight. If those changes don’t show any improvement, there are still a number of options available, depending on the severity of your symptoms. Generally, the treatment options for sleep apnea are: lifestyle changes (quit smoking, losing weight, etc.), use of continuous positive airway pressure device (CPAP), oral appliances and surgical procedures.
Continuous Positive Airway Pressure Devices
Most often, doctors opt for continuous positive airway pressure (CPAP) devices, which are worn like a mask and generate a steady stream of pressurized air to prevent apneas from occurring. While these machines are proven to be highly effective, many patients find them discomforting.
If you are looking for a more suave or wearable solution, oral appliances should be your number one choice. Moreover, a recent study, carried out at the Netherlands’ University of Groningen, shows that this therapy can be superior to CPAP for treating both OSA and snoring. Similar to mouth guards and orthodontic retainers, these custom-made dental devices keep your lower jaw and your tongue in a fixed position so that they can’t block the airway in your mouth.
Currently, there are around 100 different FDA approved oral appliances, and some of them are over-the-counter items. However, you must be cautious with these and consult your doctor before you make any purchases.
Lastly, some patients might benefit from surgical procedures. But be aware that surgeries are almost always done after an extensive sleep study, and when other treatments are insufficient. The main purpose of any surgery for OSA is to expand the airways in your throat and nose. Depending on the specific cause of the sleep apnea, there are several surgeries that are nowadays performed routinely.
The procedure to remove the tissue from your mouth and throat (and occasionally your tonsils) is called uvulopalatopharyngoplasty. It is arguably less effective than CPAP, but a great number of patients have effectively beaten OSA with this intervention alone. Rhinoplasty, or “a nose job” in lay language, is pretty self-explanatory. Aside from its proven aesthetic benefits, rhinoplasty is a corrective procedure and a go-to option for any patient with a deviated septum or other nasal structural defects.
It's not all bad
Treatments and resources are aplenty, and there is nothing stopping you on your insatiable quest for a good night’s sleep. You can start with baby steps - talking to your nutritionist or GP about changing your diet and being more active. Quit smoking? (I don’t even want to go there.) During your next visit to the dentist, feel free to ask about those fancy customizable retainers. Consider improvising a home sleep test using your fitness tracker, as many fitness trackers are feature-packed gizmos with highly reliable sleep monitors. In addition to helping you monitor and record your sleep patterns, your tracker can be an excellent asset on your transformation journey.