About Sleep Apnea

Obstructive Sleep Apnea Syndrome (OSAS) is a disruption of breathing during sleep that can seriously threaten health and well-being. OSAS and snoring are related. Very simply, it’s snoring in its most dangerous form. Snoring happens when the muscles in the throat become so relaxed during sleep that they cannot hold the inner airway fully open. The airway then becomes narrow and its tissues vibrate with each breath. The tissue vibration causes the snoring sound.

Snoring in itself can be harmless, even if it’s very loud. But snoring that contains periods of silence, followed by choking or snorting sounds, might be a sign of OSAS. The silences happen when that vibrating airway becomes narrow enough to actually collapse, or obstruct. Because breath cannot pass through the obstructed airway, the tissue vibration and the snoring sounds stop. Apnea, or absence of breathing, results.

The apnea can last from a few seconds to a few minutes and during this time the body’s oxygen levels can fall. The apnea period ends only when the sleeper’s brain forces partial wakefulness in order to regain control of the airway muscles. The airway is then opened, usually with loud gasping or snorting sounds. Breathing is restored just long enough to bring oxygen levels back up toward normal, but in a few seconds or minutes the cycle of obstruction, apnea and partial awakening happens all over again. This cycle can be repeated from dozens to hundreds of times each night, and often the sleeper is not aware of any of it.

Click To Read More:
> OSAS Signs and Symptoms
> Health Risks of Untreated OSAS
> Diagnosing OSAS
> Treatment of OSAS

 

OSAS Signs and Symptoms

Sometimes people who have OSAS don’t recognize their symptoms, simply because the symptoms have slowly worsened over months or years rather than appearing suddenly. The symptoms can be divided into two groups:

  • those that occur during sleep and
  • those that are noticed during the daytime


Sleep symptoms

  • Snoring in OSAS is often but not always loud and usually has a distinctive pattern. It contains periods of silence as apneas occur. The silences are ended with noisy gulps of air.
     
  • Choking or gasping for air during sleep is sometimes noticed only by an alarmed bed partner, who may try to wake up the sleeper. In some cases, choking spells are severe enough to awaken the sleeper, who may or may not remember the spells in the morning.
     
  • Frequent Arousals to "lighter" levels of sleep occur even while the person may be unaware or only faintly aware of any sleep disruption. The arousals seldom result in full awakenings, but repeated arousal from deep sleep can lead to daytime sleepiness.
     
  • Restless Sleep is a common problem in people who have OSAS. This restlessness may range from occasional jerking leg movements to near continuous thrashing and changing of body position.
     
  • Heavy Sweating at night is often noticed. It is caused by the restlessness and distressed breathing of repeated airway obstruction.


Waking Symptoms

  • Daytime Sleepiness is caused by OSAS’s repeated disruption of nighttime sleep and ranges in severity. Some people with OSAS do not feel that they are sleepy. Other OSAS sufferers are unable to stay awake at work or school, while reading, watching television, or driving a vehicle.
  • Personality Changes, such as irritability, anxiety, depression or aggression, can result from sleep deprivation and daytime sleepiness. Memory, judgment, or concentration ability can also be affected. These changes can sometimes lead to relationship and work performance issues.
     
  • Morning Headache is a common problem of OSAS sufferers. It is caused by the unstable oxygen levels and other body disturbances that occur with repeated apneas.
     
  • Impotence and loss of interest in sex are problems sometimes related to OSAS.

Health Risks of Untreated OSAS

Untreated OSAS can cause a range of problems, from lifestyle interference to potentially life-threatening conditions. Low oxygen levels and sleep deprivation can lead to:

  • High Blood Pressure
  • Heart Attack
  • Heart Disease
  • Stroke
  • Sexual Dysfunction
  • Daytime Sleepiness
  • Accidental Death
  • Reduced Quality of Life
  • Anxiety
  • Depression

Daytime sleepiness is a very important problem. Affected people who operate heavy or delicate equipment, or even just drive a vehicle, can suddenly fall asleep and cause serious accidents with disastrous results. Ontario road accidents are caused every day by sober drivers who didn’t intend to doze off when they got behind the wheel. Of those who survive, many are found to be sleep-deprived due to untreated OSAS.

Treatment for OSAS is highly successful in reducing sleepiness and risk of accidents. It is extremely important to recognize the signs of sleepiness, to realize that it can be caused by OSAS, and to seek help before an accident occurs.

High blood pressure can be both caused and worsened by OSAS’s nightly disruptions of oxygen levels and other body functions. High blood pressure, in turn, is related to increased risk of stroke, heart attack, and other serious medical problems. Heart function can be affected by OSAS as oxygen-poor blood is pumped through the heart and the rest of the body. The combination of untreated OSAS and heart disease is a serious medical risk.

Diagnosing OSAS

If you suspect you may have OSAS, talk with your doctor. You may want to take your bed partner with you to provide more information about your sleep pattern. Answer any questions your doctor might have about your lifestyle, your medications, your health history, your family history. All of these factors can relate to sleep apnea and may be important clues to your individual case.

Your doctor may refer you to a specialist in sleep disorders for a polysomnogram (PSG) - an overnight test also referred to as a sleep study. Typically, a sleep study for OSAS is done during the night at a clinic. Before you go to sleep in the clinic’s private room, a technician applies several sensors to your body, using cream or tape to hold them in place against your skin. The sensors do not interfere with your movements in bed. While you sleep, these sensors send signals about your sleep levels, breathing, oxygen levels and other body systems to the technician’s station in a separate room. The technician monitors the signals and records them for the specialist to review. By examining the recorded signals, the specialist can determine if you have OSAS, and if needed, you will be given a prescription for treatment.

Treatment of OSAS

It's always important to talk to your doctor or a sleep specialist about the safety and success of the various treatments. In some cases, options may depend on the cause for OSAS.

Several options are currently available to treat OSAS. All are intended to improve sleep quality and daytime function, as well as reduce the risk or severity of related health problems. We encourage you to talk with your doctor about choosing the treatment that best suits your individual situation. Some people might choose one option as a relatively short-term measure to control their OSAS while they pursue a different measure for lifelong control. Treatments include:

Lifestyle changes
If you are overweight, or smoke, drink alcohol or use muscle relaxants or sleeping pills, these factors may be contributing to your OSAS. All of them can affect the airway or the brain’s control of the airway muscles during sleep. In some cases of mild OSAS, eliminating these lifestyle factors may be the only treatment needed. Even people who require additional OSAS treatment can improve by making these changes.

Oral Appliances
If you have mild to moderate OSAS, you may improve with a custom-made device that is worn in the mouth during sleep. These devices are designed to adjust the tongue or lower jaw position to keep the airway open. Their effectiveness in OSAS varies and their cost may not be covered by public or private health insurance plans. Your doctor can help you decide whether this option is a good one for you to consider.

Airway surgery
Surgical procedures, including laser surgery, may be used to treat OSAS. Various success rates are reported and generally the success rates are higher for snoring than for OSAS. It is difficult for doctors to predict which OSAS sufferers may improve after airway surgery and by how much. More than one procedure may be required and other treatments in addition to the surgery may be required. If you would like to know more about surgical options, ask your doctor.

CPAP Therapy
CPAP ("See-pap") is the acronym for Continuous Positive Airway Pressure. CPAP is the most common, most effective form of OSAS treatment. Thousands of Canadians use it every time they sleep. CPAP consists of a gentle stream of air that is directed through the airway during sleep. The pressure of the air stream holds the airway open and prevents apnea. Oxygen levels, blood pressure, heart function and sleep patterns are therefore stabilized, resulting in a more restful sleep.