Sleep Apnea And Sleep Studies - February 28, 2017 Newsletter

Sleep Apnea And Sleep Studies

EHE Newsletter, Volume 17, Number 46
February 28, 2017

When you sleep well, you feel refreshed, alert and ready to face the day’s challenges. When you do not sleep well, every aspect of life can suffer; work, relationships, productivity, health and safety. Individuals who feel sleepy or unrefreshed in spite of a seemingly sufficient night of sleep, may have sleep apnea. Undiagnosed and untreated sleep apnea can lead to chronic disease, poor quality of life and dangerous accidents. Fortunately, a sleep study can determine if sleep apnea is present and there are effective treatments that can improve the condition.

What is Sleep Apnea?

There are two main types of sleep apnea, Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). Both types are sleep disorders characterized by the brief, repeated and involuntary interruption of an individual’s breathing during sleep. According to the American Sleep Apnea Association (ASAA) , the pauses in breathing (each of which is called an "apnea") can last anywhere from a few seconds to over a minute and can occur up to 30 or more times an hour.

OSA: OSA is the most common type of sleep apnea. According to a report commissioned by the American Academy of Sleep Medicine (AASM), almost 30 million adults in the United Sates have OSA, and approximately 23.5 million of those adults don’t know they have it. OSA occurs when the airway is narrowed or blocked, usually because the soft tissue in the rear of the throat collapses during sleep.

CSA: CSA is less common then OSA. It occurs when the brain does not send the proper signals to the muscles that control breathing.

A third type is ‘mixed’ or ‘complex sleep apnea’ which is a combination of OSA and CSA.

When breathing stops or becomes very shallow, oxygen levels in the blood decrease. The brain responds to the lack of oxygen by alerting the body and causing a brief arousal from sleep that restores normal breathing. In many cases, individuals are unaware of being awakened at all and the only indication of the presence of this condition is excessive daytime fatigue. Unfortunately, for many people who have been living with undiagnosed sleep apnea for an extended period of time, this fatigue is “normal” to them and they don’t recognize that there is cause for concern.

According to the AASM , when the body doesn’t receive enough oxygen, negative long term health consequences may occur, such as:

  • High Blood Pressure
  • Heart Disease
  • Stroke
  • Pre-diabetes and Diabetes
  • Depression

What are the Symptoms of Sleep Apnea?

While snoring and daytime fatigue are the most common symptoms of sleep apnea, other symptoms may include:

  • Pauses in breathing
  • Choking or gasping sounds
  • Restless and unrefreshing sleep or insomnia
  • Morning headaches
  • Waking up frequently at night to go to the bathroom
  • Forgetfulness and difficulty concentrating
  • Decreased sexual desire
  • Moodiness and irritability

What are the Risk Factors?

Overweight and obesity are the primary risk factors for sleep apnea. Other risk factors that increase an individual’s risk for sleep apnea include:

  • Neck Size: A neck size of 17 inches or more for men and 16 inches or more for women increases the risk for sleep apnea.
  • Family History: According to the AASM , individuals with a family history of sleep apnea are at increased risk of developing it themselves
  • Age: Sleep apnea can occur at any age, but it most common in middle and older age adults.
  • Gender: According to UpToDate , sleep apnea is twice as common in men then in women. For women, the risk of sleep apnea increases after menopause.
  • Certain medications and alcohol: When individuals are sedated from medication or alcohol it can relax the muscles in the throat making it more likely that the soft tissue in the back of the throat will collapse and block the airway.
  • Facial structure abnormalities: Abnormalities that reduce the diameter of the upper airway increase an individual’s risk of developing sleep apnea. Such abnormalities include nasal obstruction, a low–hanging soft palate, enlarged tonsils, or a small jaw with an overbite.
  • Smoking: Smoking can cause inflammation and fluid retention in the upper airway and throat which may increase the risk for sleep apnea.

Diagnosis

According to the ASAA, “Only a sleep study in a sleep laboratory or a home sleep study can show definitively that sleep apnea is present and how severe it is.” A sleep study, also called a polysomnogram, is a method of testing for sleep apnea that monitors and records an individual’s sleep stages and cycles during his or her normal sleeping hours. It is usually performed at a sleep laboratory or sleep center. Using sensors placed on the head, chest and legs, the PSG records brain wave activity, eye movement, muscle movement, oxygen levels in the blood, air flow, respiratory effort, heart rate, heart rhythm and blood pressure. Direct observation is also noted. After a full period of sleep is recorded, the information will be interpreted by a physician who is trained in sleep medicine so that a diagnosis can be made.

While a sleep study conducted in a sleep lab is regarded as the best method for diagnosis of sleep apnea, it may be determined that results of a home sleep study will suit an individual better and be sufficient to make an accurate diagnosis. A home study is almost always self-administered and is becoming more widely used.

Treatment

If sleep apnea is present, it can be treated successfully in a variety of ways depending on an individual’s medical history and the cause and severity of the disorder. For mild cases, lifestyle and behavioral changes such as losing weight, changing sleeping position to sleep on one’s side rather than the back, avoiding alcohol, not smoking, using a dental or oral device that enlarges the airway and avoiding sedative medications may be all that is necessary. For more severe cases or when these lifestyle changes do not improve the condition, a Continuous Positive Airway Pressure (CPAP) device is the most widely–used form of treatment.

A CPAP device is almost always the first line of treatment recommended by healthcare professionals when lifestyle changes are unsuccessful. During sleep, the CPAP sends a constant, low-pressure stream of air through a mask into an individual’s nose and/or mouth in order to keep the airway open. There are many kinds of CPAP machines and masks; some masks fit over the nose and others cover both the nose and mouth. It is important that the device fits well and is comfortable. The mask must make a seal that prevents air leaks and maintains the appropriate level of pressure in order to keep the airway open throughout the night. It is also important that individuals who use a CPAP use it consistently and correctly. According to the AACM, consistent use of a CPAP device “can prevent or reverse serious consequences of obstructive sleep apnea,” including congestive heart failure, coronary artery disease, Irregular heartbeat, stroke, diabetes, and accidents caused by daytime sleepiness.

What is the Bottom Line?

Adequate sleep is vital to an individual’s health and well–being. When you don’t sleep well it can have devastating short and long–term consequences involving nearly every aspect of your life including work performance, relationships, productivity, health, and safety (and the safety of others). Unfortunately, sleep apnea often goes unrecognized for years, and can lead to unnecessary suffering and poor quality of life. If you are not sleeping well, consult with your health care professional or a sleep specialist. Fortunately, there are many sleep center facilities throughout U.S. where you can be evaluated for a sleep disorder. A sleep study will provide you with an invaluable assessment of your sleeping habits and can lead to diagnosis and treatment if you have sleep apnea. Most importantly, a sleep study can help you to get back on the path to restful sleep.


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MEDICAL DISCLAIMER: The information is not intended to constitute medical advice and is not a substitute for consultation with a physician or other healthcare provider. Individuals with specific complaints should seek immediate consultation from their personal physicians.

Source - EHE

EHE International