Obstructive Sleep Apnea I How OSA affects your health?

 

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. You need to understand "How OSA affects your health?" While you're sleeping, it causes your breathing to stop and start repeatedly. In an effort to protect you, your brain tries to wake you up enough to breathe, but this keeps you from getting a good night's sleep. In either scenario, there may be a drop in blood oxygen saturation, a sleep disturbance, or both. When blood oxygenation is disturbed and apneas or hypopneas occur regularly while you sleep, it may affect the quality of your sleep and have an adverse effect on your health and quality of life. This condition can develop into serious complications over time. However, with strict adherence to the recommended treatments, this condition is frequently very manageable.

This article reviews obstructive sleep apnea, its signs and symptoms, causes, and treatment to manage to sleep apnea.

Obstructive Sleep Apnea I How OSA affects your health?

What is sleep apnea?

You stop breathing while you're sleeping, which causes sleep apnea. Obstructive sleep apnea, which causes airway obstruction, or central apnea, due to which brain control inadequate breathing control. It typically occurs when your throat becomes too narrow due to excessive airway control muscle relaxation. You briefly awaken in order to reopen your airway, but you most likely won't recall doing so. Each hour, this could occur dozens of times. Obesity, swollen tonsils, and medical conditions like endocrine disorders or heart failure are a few other things that can block your throat and lead to obstructive sleep apnea.

 

What are types of obstructive sleep apnea?

#1. Obstructive Sleep Apnea (OSA):

• During sleep, the airway can become partially or totally blocked.
• Most typical kind.
• Caused by negligent throat muscles, a throat soft tissue collapse, structural abnormalities, etc. Results in frequent breathing pauses and brief waking up during sleep.

#2. Central Sleep Apnea (CSA):

• Is less frequent than OSA.
• Not brought on by airway obstruction.
• The brain fails to communicate properly with the breathing muscles.
• Frequently linked to diseases like heart failure, stroke, or damage to the brainstem.

#3. Complex Sleep Apnea Syndrome (CompSA):

• Combination of central and obstructive sleep apnea.
• Begins as OSA but may progress to central apneas with CPAP therapy.

 

What is moderate sleep apnea?

The classification of moderate sleep apnea indicates a moderate degree of severity, with a moderate number of breathing interruptions while sleeping, frequently accompanied by symptoms like snoring and drowsiness during the day.

 

What is sleep disordered breathing?

The term "sleep disordered breathing" refers to a range of breathing irregularities that occur while a person is asleep, including respiratory conditions like sleep apnea, snoring, and others that can impair the quality and consistency of sleep.

What are sign and symptoms of obstructive sleep apnea?

Sleep apnea has many symptoms, some of which are easier to spot than others. The symptoms include:

• High blood pressure
• Mood changes, such as depression or irritability
• Daytime sleepiness or fatigue
• Dry mouth or sore throat when you wake up
• Headaches in the morning
• Pauses in breathing while asleep that others witness.
• Trouble concentrating, forgetfulness, depression, or crankiness
• Unusual breathing patterns.
• Restlessness during sleep
• Loud snoring
• Insomnia.
• Sexual dysfunction.
• Night sweats
• Waking up suddenly and feeling like you're gasping or choking
• Trouble getting up in the mornings
• Waking up often in the middle of the night to pee
• Gastroesophageal reflux disease (GERD)

 

Symptoms in children may include:

• Bed-wetting
• Snoring
• Teeth grinding
• Restlessness in bed
• Sluggishness or sleepiness (often seen as laziness)
• Breathing that pauses or stops
• Ribcage moves inward when they breathe out
• Learning and behavior problems
• Choking or drooling
• Sweating a lot at night Problems at school
• Unusual sleeping positions, such as sleeping on their hands and knees, or with their neck bent far back

 

How sleep apnea disrupts your sleep cycle, or severe obstructive sleep apnea?

Your brain adjusts your breathing, heart rate, blood pressure, and other bodily functions as needed. Apnea or hypopnea can cause your blood oxygen levels to fall when you stop breathing.

• Apnea: This is when you stop breathing while asleep or have almost no airflow.
• Hypopnea: This means you aren’t breathing enough to maintain oxygen levels in your blood.

Your brain responds to blood oxygen levels dropping due to either apnea or hypopnea by inducing a response that is similar to a failsafe, and waking you up long enough to breathe normally again. Your brain automatically tries to restart your sleep cycle as soon as you start breathing again. These interruptions will occur more frequently the more severe your sleep apnea is. 

The primary factor determining the severity of sleep apnea is the apnea/hypopnea index (AHI). The severity is as follows:

• Mild sleep apnea: An individual at this level has an AHI of 5 to 15 events per hour. If you don't show any additional symptoms, it might not reflect it's serious enough to treat.
• Moderate sleep apnea: Between 15 and 29 events happen every hour in people with moderate sleep apnea. That indicates that a person who sleeps for eight hours either stops breathing or awakens between 120 and 239 times.
• Severe sleep apnea: Severe sleep apnea patients awaken 30 or more times per hour. That indicates that during an entire eight hours of sleep, they stop breathing and/or wake up 240 or more times.

Obstructive events, which are very short-lived, can affect any stage of sleep.

How to take care of myself/manage symptoms, or sleep apnea self-care?

With sleep apnea, you run the risk of experiencing events and complications that could endanger your life. You shouldn't attempt to self-diagnose or self-treat it as a result. You should speak with a sleep expert if you suspect that you have sleep apnea.

 

How does sleep apnea affect the body?

To understand how sleep apnea works, it helps to know a little bit about the human sleep cycle. Sleep happens in multiple stages:

Stage 1: Light sleep. This brief phase starts immediately after you nod off, and it takes up about 5% of the time you spend sleeping overall.

Stage 2: Deeper sleep. This stage is deeper and makes up about 45% to 50% of all the time you spend sleeping.

Stage 3: Slow wave sleep. This is the deepest sleep stage, making up about 25% of the time you spend sleeping. Parasomnias like sleepwalking and sleep talking happen in this stage.

Rapid eye movement (REM) sleep: In this phase, dreams occur, and you can observe a person's eyes moving just below their eyelids.

When you fall asleep, you typically enter Stage 1, and then move into and various cycle.

Who does sleep apnea affect?

Anyone can develop sleep apnea, from young children and infants to elderly people. Certain situations and populations are more likely to experience obstructive sleep apnea than others:

• Males and those who were assigned male at birth (AMAB) have a higher occurrence of it before age 50. After age 50, it impacts both women and those who were born with the gender assigned to them (AFAB) equally.
• Getting older makes people more likely to develop it;
• Being overweight or obese significantly raises the risk of getting it.

 

There are some demographics where central sleep apnea is more prevalent:

• Those who use opioid painkillers.
• People older than 60.
• Those who suffer from congestive heart failure or atrial fibrillation, both of which are heart conditions.
• This may cause the emergence of central events known as treatment-emergent central sleep apnea in some CPAP users or those with obstructive sleep apnea. Living at a high altitude can result in central apneas.

What are sleep apnea causes?

Some of the illnesses connected to OSA include:

• Obesity hypoventilation syndrome, which affects how people breathe when they are obese.
• Chronic lung disease, like asthma, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis.
• Endocrine conditions, such as hypothyroidism, acromegaly, and polycystic ovary syndrome, which may affect your breathing while you're asleep.
• Neuromuscular conditions, such as a stroke, which can affect brain signals to your chest muscles and airway.
• Heart failure or kidney failure, which could lead to fluid retention in your neck and an obstruction of your upper airway.
• Maternity

How sleep apnea test conducted?

The most common tests for sleep apnea include:

# Overnight sleep study (polysomnogram):

In this overnight test, you'll spend the night in a hospital setting that has been specially designed to be as comfortable as possible while still keeping an eye on your sleep. Sensors used in this test keep an eye on your breathing, heart rate, blood oxygen levels, brain waves, and more. This test is regarded as the gold standard by professionals for identifying sleep apnea.

# Home sleep apnea testing:

This kind of testing enables someone to carry out a sleep study at home. It is comparable to an overnight sleep study, but it excludes the use of a brain wave monitor. When doctors suspect more severe sleep apnea or if you have other sleep disorders or medical conditions, they usually won't recommend this test because it can't identify central sleep apnea. Experts frequently advise doing an overnight sleep study to confirm results from a home study that don't indicate sleep apnea.

What are treatment options to cure sleep apnea?

Possible treatment options for obstructive sleep apnea include:

#1. Weight loss:

People with obesity who also have OSA are typically advised to manage their weight and exercise, and even a 10% weight loss makes a difference.

#2. Not drinking alcohol or taking sleeping pills:

These increase the likelihood that your airway will close while you sleep and prevent you from breathing normally for longer periods of time.

#3. Sleeping on your side:

This can help if you get mild sleep apnea only when you sleep on your back.

#4. Nasal sprays:

These can help if sinus problems or nasal congestion make it harder to breathe while you sleep.

#5. Continuous positive airway pressure (CPAP) machine:

The first line of treatment for OSA is this therapy. A mask is included with this device, which you can wear over your mouth, nose, or both. Your mouth or nose will be continually blown with air by an air blower. Just enough air pressure is present to prevent excessive relaxation of the tissues lining your upper airways while you sleep.

#6. Bilevel positive airway pressure (BPAP):

In some cases, these devices are used to treat OSA when CPAP therapy fails to work. The settings on BPAP machines, allow them to respond to your breathing by delivering two pressures: an inhaled pressure and an exhaled pressure. This indicates that the difference in pressure between inhaling and exhaling.

#7. Oral devices:

Dental appliances or oral "mandibular advancement" devices that move your lower jaw forward or prevent your tongue from obstructing your airway may be prescribed if you have mild sleep apnea. That might assist in maintaining an open airway while you sleep.

#8. Surgery:

This is for those who have extra or uneven tissue in their throat or nose that prevents airflow. For instance, surgery might be beneficial if you have a deviated nasal septum, enlarged tonsils and adenoids, or a small lower jaw that makes your throat too narrow. The norm for doctors is to first try other treatments.

Types of surgery for obstructive sleep apnea include:

• Upper airway stimulator-

Your surgeon will insert a tiny pulse generator with this device, in your upper chest, and your natural breathing pattern is traced by a wire that goes to your lung. Another wire that runs up to your neck sends gentle signals to the nerves that control the muscles in your airways to keep them open. It can be turned on and off with a remote control at night and in the morning.

• Somnoplasty- 

      Doctor uses radiofrequency energy to tighten the tissue at the back of your throat.

• UPPP (uvulopalatopharyngoplasty), or UP3-

By removing soft tissue from the back of your throat and palate, this procedure widens the airway at the opening of your throat.

• Nasal surgery- 

    These operations correct obstructions in your nose, such as a deviated septum, when the wall between your nostrils is off-center.

• Mandibular/maxillary advancement surgery-

To create more space in the back of your throat, your doctor will move your jawbone and face bones forward. Only those with severe sleep apnea and issues with their head or face are candidates for this complicated procedure.

What are complications/side effects of the treatment?

Many factors, mainly the treatments themselves, influence the complications and side effects of the treatments. The best person to ask for advice on how to reduce or, ideally, avoid side effects is your healthcare provider.

 

What are risk factors of obstructive sleep apnea?

Anyone can have obstructive sleep apnea. It’s more likely if you:

• Are male and older
• Have a family history of sleep apnea
• Have asthma, smoke, and have diabetes
• Have high blood pressure, and have a higher risk of heart failure or stroke
• Are overweight or obese, and have a large or thick neck
• Have slighter airways in your nose, throat, or mouth
• Have excessively tissue at the back of your throat that hangs down to block your airway
• Have a large tongue, and large tonsils
• Retrognathia, which is when your lower jaw is shorter than your upper jaw

 

What are obstructive sleep apnea problems?

• Eye problems such as glaucoma and dry eye
• Metabolic disorders like type 2 diabetes
• Problems with pregnancy like gestational diabetes or low-birth-weight babies
• Drowsiness during the day and worry concentrating. 
• Cardiovascular difficulties such as heart attack, high blood pressure, unusual heart rhythms, or stroke
• Complications after surgery

 

Is sleep apnea dangerous?

Yes, if untreated, sleep apnea poses a number of health risks, including daytime sleepiness, exhaustion, cognitive decline, cardiovascular issues, and an elevated risk of accidents.

How sleep apnea pregnancy affects?

Pregnancy-related sleep apnea can put the mother and the unborn child at risk for complications like preeclampsia, gestational diabetes, preterm birth, and lower birth weight. Therefore, it's important to receive appropriate care while pregnant.

Is sleep apnea affects infants or children?

Yes, sleep apnea in children can happen in slightly different ways. The symptoms of sleep apnea in children include:

• Sleeping in unusual positions or sleeping with their neck extended.
• Hyperactivity or trouble focusing or performing poorly in school. This can look like symptoms of attention-deficit/hyperactivity disorder (ADHD).
• Loud snoring.
• Bedwetting.
• Frequent arm or leg movements while asleep.
• Reflux (heartburn) or night sweats.

How can I reduce my risk or prevent sleep apnea?

Sometimes sleep apnea can be avoided, particularly when it develops as a result of obesity or excess body weight. Even so, some people who are underweight or who maintain a healthy body weight can still develop sleep apnea. For those people, a structural problem is typically what causes their apnea, making it impossible for them to prevent it.

The best things you can do to reduce your risk of sleep apnea include, try to maintain a healthy weight, and practice good sleep hygiene. Further, you can manage any existing health conditions, such as high cholesterol, high blood pressure and Type 2 diabetes.

See your healthcare provider at least once a year for a checkup.

 

Conclusion

Numerous factors influence how sleep apnea is viewed. It depends on the type and severity of the sleep apnea. The biggest determining factor in how this condition affects your life, though, is typically how well you follow your treatment plan. It's essential to closely follow the treatment plan. Utilizing and maintaining treatments, particularly ongoing ones like positive airway pressure devices, can significantly improve health.

If you consistently have trouble falling asleep or experience daytime sleepiness, you should always consult your doctor. To help you manage symptoms, OSA has a variety of treatment options. Your doctor will develop a treatment strategy that combines other therapies and lifestyle modifications.

 

Reference used:  

https://my.clevelandclinic.org/health/diseases/8718-sleep-apnea

https://www.webmd.com/sleep-disorders/sleep-apnea/understanding-obstructive-sleep-apnea-syndrome

https://en.wikipedia.org/wiki/Obstructive_sleep_apnea