What is sleep apnea?

Sleep apnea is a potentially fatal condition in which you stop breathing for a few moments during sleep.

Cessation of breathing is usually for a few moments, you miss one or more inhalation or exhalations. However, since our body requires a continuous supply of oxygen, sleep apnea may result in hypoxia, that is, low levels of oxygen in the blood stream.

All vital organs get less of oxygen, resulting in starvation of cells there. More sensitive cells may even die and permanent loss of function may result.

Why do you get it?

The mechanism how you get it may be different in different individuals, and hence the severity of the condition.

On the basis of the mechanism causing it, the condition can be broadly divided into the following types-

Obstructive Sleep Apnea

As the name suggest, something is obstructing the airway, not letting air go in smoothly. So, lesser air or sometimes, no air is able to go into the lungs, giving apnea.

The blockage is due to the muscles of the neck/ throat. They become flaccid or relaxed. Consequently, in the relaxed state, they appear longer and bigger, blocking the airway passage.

Commonly, the patient is obese and fat deposition may be seen around the neck region, adding up to narrowing of airway passage there.

Central Sleep Apnea

The center, that is, the brain is directly involved. For some reason, the brain is unable to send signals to the throat muscles during sleep. This may lead to relaxation of the throat muscles.

The resultant flaccid muscle mass blocks the throat from inside, leading to apnea during sleep.

Complex Sleep Apnea

A mixed type or complex sleep apnea may be seen in some individuals, where both the above factors partially play their roles.

What Makes You Prone to Getting Sleep Apnea?

Not everybody develops this problem. There are factors that make you prone to sleep apnea.

• The commonest among them is being overweight. It has been theorized that fatty tissues get deposited in your upper airways, leading to narrowing of the passage there. While you are awake and alert, you pull in air with effort. However, while sleeping, the brain signals to the throat muscles also slow down. All body muscles are naturally a bit relaxed during sleep. Fatty deposits plus the flaccid muscles may together block the air passage completely, leading to instant apnea state.
• Older people are more vulnerable to it, as their muscle control from the brain gradually becomes weak.
• Males are more vulnerable than females.
• People having thicker necks show more chances of developing this problem in their later lifes. Neck circumference of more than 17 inches in males and 15 inches in females may be taken as a threshold, beyond which the risk increases.
• If you are under any medications that relax the muscles or make you sleep, you may get sleep apnea. This is more relevant when the medication is prescribed for a long period of time. Some of the medications that need caution in this direction are sleeping pills, narcotics (strong pain killers), alcohol etc.
• Smokers inhale irritants that continuously irritate the airway. The inflamed airway may retain fluids of inflammations, narrowing the airway passage.
• Children showing enlarged tonsils on examination. These bunches of lymphoid tissues may block their narrow airways during sleep, leading to apnea.

What Happens When You Get Apnea or No Air?

As your sleep sets in, the air passage may start getting narrowed. You may start making a noise, often called snoring by people. You don’t know that you are snoring, but people sharing your bedroom would tell you. As the breathing stops, you may cough, roll over or transiently get disturbed, gradually resuming your sleep again.

Sleep disturbances are there. You may get a headache when you wake up in the morning. The following day may feel tiring and you may want to sleep in the day time.

Some times, as the breathing stops during sleep, the person arouses with severe shortness of breath. This indicates central sleep apnea, more serious form of the condition.

Making a diagnosis

If you are told that you snore during nights, or you get any shortness of breath while you sleep, go for a medical evaluation.

Your doctor would check your upper airway to see if any thing is evident, blocking your air passage. There may be tonsils, swelling, a paralyzed upper palate muscle or problems with your tongue.

If not, you may be told to undergo sleep tests. These are simple test performed while you sleep.

Sleep tests help diagnosing sleep apnea.

Management

Below mentioned steps may prove helpful in most cases-

• Lose weight, if you are obese. As you shed weight, fatty tissues from around the neck region get dissolved, reducing the narrowing of air passage.
• Quit smoking. Chronic smoking irritates and swells up the upper airways.
• Avoid taking too much of narcotics, sleeping pills or alcohol.
• If you have any nasal infection or allergy, get it treated. Any inflammation going on in this area may make you prone to sleep apnea.
• Sleep on your side, rather than sleeping on your back. This position helps in letting the airway stay open.

If your sleep apnea is severe, you may need help with oral appliances, that help in keeping the upper airway passage throughout night.

Your doctor may suggest you CPAP.

About CPAP

This is a machine designed to provide you continuous positive airway pressure throughout the night. You are made to wear a mask, through which, the machine delivers air at a pressure slightly higher than surrounding air. This pressure is just enough to let your upper airway stay open throughout your sleep, preventing sleep apnea.

If you find it cumbersome, try changing to a softer mask that fits you better. The machine is quite effective solving problems for most.