Chest and Pulmonolgy

Sleep Apnea

DESCRIPTION:

Sleep Apnea is a sleeping disorder where breathing stops for a short period of time during sleep. The air usually flows from the mouth and the nose into the lungs, but air repeatedly stops while sleeping due to the narrowness of the airway space in the throat that also results in snoring, which occurs when airflow is squeezed while passing through that narrow space. If the condition went untreated for long, it can create many health related issues that include stroke, diabetes, heart disease and hypertension.

Types of sleep apnea

  • Obstructive sleep apnea

  • Central sleep apnea

  • Mixed sleep apnea

Causes and symptoms

There are many risk factors associated with sleep apnea, which are being overweight, obesity, women with large collar size, large tonsils and adenoids, large tongue that may block the airway, shorter lower jaw, also known as retrognathia and a narrow palate.

Symptoms of sleep apnea include:

  • Persistent headache

  • Feeling grumpy and disgruntled

  • Drowsiness

  • Forgetfulness

  • Depression

  • Leg swelling

  • Weakness and fatigue

  • Loss of interest in sex

Diagnosis

Diagnosis of sleep apnea is done by examining the symptoms and medical history of the patient. The doctor will examine the head and neck in order to identify physical factors that are causing this condition. Several tests will be performed pinpoint the exact issue, which are:

  • Polysomnogram

  • EEG or EOM

  • EMG

  • EKG

  • Pulse Oximetry

  • Arterial Blood Gas (ABG)

Treatment

Treatment of sleep apnea can be done by ensuring an obstacle free airflow during the sleep. In order to make sure this happen, the doctor can several treatment methods depending on the severity of the condition. Below are given some usual treatment methods for sleep apnea:

  • Surgery: Surgical operation known as Uvulopalatopharyngoplasty (UPPP) can be performed to cure sleep apnea where extra tissues from the back of the throat is removed, which provides relief from snoring.

    • Another surgery known as tracheostomy is done where the surgeon makes an opening in the windpipe that allows the air to flow through the throat easily. It is performed as the last resort when UPPP can’t be done.

    • Other surgical procedure involves changing the structural issues of the face such as enlarged tonsils or adenoids, which is quite common in children with sleep disorders.

    • Implants can be done where a plastic rod is inserted into the palate that provide free air flow.

    • Nasal Surgery is another option where the removal of polyps between the nostrils is done to ensure in-obstructive air flow.

  • Weight Loss: Excess of weight or obesity is one common cause associated with sleep apnea. In order to get relief from the condition, weight loss can be an appropriate option.

  • Nasal Decongestants: A kind of pharmaceutical drug that provide aid from nasal congestion in the respiratory tract.

  • Continuous Positive Airway Pressure (CPAP): CPAP is the foremost treatment option for sleep apnea where a face mask is worn at night that delivers positive airflow in the throat by keeping the passage open at night. It may also be used with a dental device that positions the lower jaw forward. It is a highly effective treatment method of sleep apnea.

  • Bilevel Positive Airway Pressure (BPAP): In a few of the cases, BPAP machines are also utilized if CPAP isn’t effective. This machine provides pressure in response to your breathing.

  • Positional therapy: Supine position or sleeping on the back can worsen the sleep apnea, hence positional therapy is employed to learn various sleeping positions that provide relief from symptoms.

Complications

Sleep apnea treatment contains some mild or severe side effects that may include:

  • Discomfort wearing CPAP mask

  • Trouble breathing during night

  • Difficulty tolerating air

  • Stuff or dry nose

  • Feeling claustrophobic

  • Restless sleep

  • Nose irritation

  • Headaches

  • Bloating or tiredness

  • Nasal congestion

Post operative care

Post treatment, consult your doctor if you experience any serious or mild complications such as drowsiness and trouble sleeping.

Do not stop using the CPAP mask if you experience some issues. Notify your doctor for some modification in the mask.

You will require to lose weight and go for regular exercise and avoid alcohol and sleeping medications.

Try sleeping on your abdomen or sides instead on your back.

Use saline nasal spray to keep your nasal passage open at night.

Quit smoking as it can worsen the sleep apnea.