Sleep Apnea in Adults | Warning Signs | Consequences of Obstructive Sleep Apnea
Treatment Options| Fast Facts
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Sleep Apnea in Adults
There are 2 primary types of sleep apnea: obstructive and central. Apnea is defined as not breathing for 10 seconds or longer. Central sleep apnea is a breathing disorder that causes your body to decrease or stop the effort of breathing during sleep. This occurs in an off-and-on cycle. It is a result of a problem in the brain or heart. It’s different from obstructive sleep apnea (OSA) because the problem is not caused by a blockage of the airway. There are a few different types of central sleep apnea, but they mainly occur in the following groups: middle-aged or elderly individuals, those with chronic congestive heart failure or stroke, people affected by heart or kidney problems, people in high altitudes (higher than 15,000 feet or about 5,000 meters), and those taking long-acting opioid drugs for longer than two months.
Obstructive sleep apnea, or OSA, is a sleep-related breathing disorder that causes your body to stop breathing during sleep. This is a very common sleep disorder. OSA occurs when the tissue in the back of the throat collapses and blocks the airway during sleep. This obstruction keeps air from getting in to the lungs. It happens because the muscles in the throat relax as you sleep. Gravity then causes the tongue to fall back and block the airway. Blockage of the airway can happen a few times a night or several hundred times per night.
- Loud snoring
- Snoring interrupted by pauses in breathing and then gasping
- Falling asleep at inappropriate times
- Trouble with concentration or memory, irritability, depression, loss of interest in sex, or impotence
- Headaches, dry mouth, sore throat or nausea upon awakening
- Frequent nighttime urination or even bedwetting
Sleep and Polynocturia
- Sleep apnea is present in about 80% of cases of polynocturia in both men and women
- Treatment of sleep apnea in people with polynocturia results in a substantial reduction in frequent awakenings to go the bathroom
- snore every night?
- wake up suddenly during the night perspiring, choking or gasping for air?
- wake up in the morning with headaches or a sore throat?
- fight falling asleep during the day, at work or while driving?
- feel irritable, have memory loss or a lack of concentration each day?
- suffer with obesity, gastric reflux, or high blood pressure?
If you answered “yes” to more than one of these questions, it’s likely you have OSA.
Almost all people with OSA snore loudly, and about half of the people who snore loudly have OSA. Snoring is a sign that your airway is being partially blocked. While you may not think you snore, ask the person who sleeps next to you. He or she can tell how often you snore and whether or not you stop breathing.
Many people with OSA are sleepy during the day. They find that they are still tired even after a nap. When you stop breathing, your body wakes up. It happens so quickly, you aren’t even aware of it. This event disrupts your sleep process. You can stop breathing hundreds of times in one night. This repetitive disruption of sleep will make you feel very tired the next day. As a matter of fact, a person with OSA has 3 times the likelihood of being involved in a car accident.
OSA and AFib
- People with severe sleep apnea are at four times increased risk for atrial fibrillation (AFib)
- The risk of recurrent AFib in people with untreated sleep apnea is 82%, but in people with AFib and treated sleep apnea the risk of recurrent AFib drops by 50%
Consequences of Obstructive Sleep Apnea
- Daytime sleepiness that affects work
and social activities
- Loss of interest in sex, or impotence
- Increased risk for automobile accidents
- Hypertension (high blood pressure)
- Heart attack
- Type 2 Diabetes
OSA and ED
In a recent study, 40% of males with untreated sleep apnea have Erectile Dysfunction (ED)
However, treatment of sleep apnea can reduce and possibly reverse the risks for these adverse outcomes. Early recognition and treatment of sleep apnea has been shown to reverse the symptoms and to prevent the occurrence or worsening of these consequences. It is important to talk to your doctor about problems with your sleep, as sleep disorders are readily treatable.
At Dallas Sleep, we provide you with the latest treatment options. We give you all the information you need, so you can make an informed decision. The Dallas Center for Sleep Disorders is truly a comprehensive medical center dedicated to the diagnosis and treatment of the complete array of sleep disorders.
There are different options available for the treatment of snoring and sleep apnea. For mild snoring, position therapy may help. Sleeping on your side instead of on your back will reduce symptoms. Also, raising the head of the bed may reduce symptoms. Many people with undiagnosed OSA naturally gravitate to sleeping on their side, as their body attempts to compensate for their sleep-related breathing disorder.
Another recommended treatment for snoring and OSA is weight reduction. Weight reduction is very helpful as this decreases the amount of obstruction in the throat. A significant amount of weight loss may reduce the symptoms. However, most people who are overweight have great difficulty in losing weight because several factors are working against them. One of these factors is fatigue and feeling totally exhausted all the time. Without the energy and motivation to exercise and eat right, it's tough to lose weight. Another factor is physiology. Research has proven that people who don't sleep well or get enough sleep are more likely to have a slowed metabolism, which makes it difficult to lose weight. This may be in part related to elevated levels of cortisol due to poor sleep. Finally, we now also know that the hormones that control appetite (see Leptin and Ghrelin) are completely thrown out of whack as an effect of poor quality or insufficient sleep, resulting in increased cravings for higher carb foods and unhealthy snacks.
Continuous positive airway pressure (CPAP) is the treatment most often used to treat OSA in adults. It is a device which blows air through your nose into the back of your throat to help maintain the airway while you sleep. It basically allows you to breathe like you normally do during the day. Snoring is completely eliminated. The air is delivered through a small hose attached to a mask worn over or under the nose. The right amount of air pressure necessary is different for each person. An overnight CPAP study will determine what level is right for you. CPAP masks and devices have greatly improved over the years, and most people get adjusted to treatment within 1-2 weeks. However, we work very closely with our patients during this process at Dallas Sleep. After a careful observation period over the first month, most patients are comfortable sleeping with CPAP. In fact, many patients notice sleeping better and feeling much better after just 2-3 weeks of treatment. The feelings of unrefreshing sleep, fatigue, irritability, headaches and dry mouth can be reversed very quickly. We initially recommend a trial of CPAP for just 2 months. If it works well for you, both you and we will know it. If it doesn't seem to help much, we will gladly help you find a different alternative for treatment.
Another viable sleep apnea treatment option that's growing in popularity is oral appliance therapy. An oral appliance looks a little like a mouthguard or retainer, but works to open the airway by advancing the mandible (jaw) during sleep. This adjustment can help treat patients with mild to moderate sleep apnea by preventing the tongue and soft tissues from obstructing the airway.
The American Academy of Sleep Medicine does not recommend over the counter oral devices to treat sleep apnea. Oral appliances must be custom fitted to suit the needs of individual patients. OAT is most beneficial and effective when your sleep health physician and team collaborates with a dental health expert to fit your device.
Upper airway surgery is another option that may help someone with OSA. The size of the upper airway is increased to prevent collapse of the airway and to make breathing easier during sleep. Increasing the size of the upper airway can be done in two different ways: 1) by removal of redundant soft tissues in the back of the throat or 2) by expansion of the jaw structures that restrict the space in the throat. Because the airway pattern and the severity of obstruction vary greatly between individuals, the success rate of a given surgical procedure also varies greatly. In general, as the severity of OSA increases, the chances of successful elimination of OSA with surgical treatment decreases. Most patients that are referred for surgical treatment of OSA are those that are young adults or have mild OSA, so the chance of a successful outcome is improved. Since CPAP is essentially 100% effective if used properly, most surgeons agree that a trial of CPAP is the first step in treatment. At Dallas Sleep, we can refer you to a well-trained ENT surgeon who is skilled in the surgical treatment of sleep apnea.
- Research suggests that adults require an average of 7 to 8 hours of sleep each night
- More than 18 million Americans suffer from sleep apnea
- It is conservatively estimated that 10 million Americans with sleep apnea remain undiagnosed
- For people suffering with untreated sleep apnea, their sleep is disrupted up to hundreds of times each night, causing daytime fatigue, sleepiness, and irritability
- A study conducted on 72,000 nurses reported that snoring alone increases the risk of developing high blood pressure
- People who snore have a higher rate of heart disease
- OSA increases a person’s risk for high blood pressure, heart disease, stroke, type 2 diabetes, erectile dysfunction and depression
- Treatment of OSA can reverse symptoms of daytime fatigue and sleepiness and it can reverse or reduce the risk for high blood pressure, heart attack, stroke, type 2 diabetes, depression and erectile dysfunction
- For OSA in adults, the most common treatment options are CPAP, surgery, and oral appliances