Simple Explanation Of sleep Apnea
Sleep Apnea affects over 42,000,000 adults in the USA! A recent study showed that one in ten Australians suffer from undiagnosed obstructive sleep apnoea; in the males aged 40–69 years, this could be as high as 49 % and in males aged over 70 years, as high as 62 %! So what is sleep apnea? What causes it and how do you treat it?
What is sleep apnea?
Apnea literally means stopping breathing. So if you suffer from sleep apnea, when you're sleeping, the air stops flowing to your lungs for 10 seconds or more. When you stop breathing, your blood oxygen levels drop and this triggers your brain to just wake up out of sleep for a microsecond, so you can take a breath and then you fall asleep again, and this cycle continues throughout the night.
Now this stopping of your breathing can happen many times an hour night after night and it can not only affect the quality of your sleep and your sleep cycle, but it also puts your body in a very stressful environment at a time when it's supposed to be resting relaxing and recovering from the day's activities.
Left untreated sleep apnea can cause some pretty severe health consequences, these include stroke, heart disease, heart attacks, high blood pressure, diabetes, depression, car accidents as well as a list of other things.
So it's very important that we do get tested for sleep apnea if we do think there might be something going on with our sleep.
There are three main types of sleep apnea: obstructive sleep apnea, central sleep apnea, and mixed sleep apnea.
Obstructive sleep apnea
Obstructive sleep apnea is the most common one. When you fall asleep and you are relaxing, your muscles in your upper airway, your tongue, your throat, your mouth are relaxing a bit too much and they're falling back and just obstructing your upper airway there so they're closing off your trachea where the air comes in and causes of obstructive sleep apnea.
If you suffer from OSA, the most obvious change is probably being overweight. So if you are carrying a bit more weight, you're more prone to having sleep apnea. There's no doubt about that. We carry a lot of weight in our neck here, and so the more weight you got, when you lie there, it's putting more pressure on those muscles, more weight on those muscles when they relax it's more likely to just close over sinus issues.
Central sleep apnea
Central sleep apnea is far less common. With central sleep apnea, there's not an actual obstruction. The fact is that there is a fault happening between the signal that's sent from our brain to our lungs.
Normally your brain's telling your lungs to breathe, and with central sleep apnea there's a bit of a signal fault happening there, and so your lungs just aren't getting told to breathe, so your airway can be open but you're just not getting you to know that signal down to your lungs debris and central sleep apnea can go undiagnosed quite often because there can sometimes be no snoring associated with it.
With obstructive sleep apnea, there's normally a lot of noise and snoring that goes along with it, because of the restriction. So generally people are aware that something is going on, but with central sleep apnea, you might not get those noises.
Mixed sleep apnea
Mixed sleep apnea is just a combination. So you've got a combination of both obstructive sleep apnea and central sleep apnea happening in one person, which is a little bit more complex.
Without treatment, you'll most likely have sleep apnea for life, unfortunately, so we must treat it.
The older we get, the more severe the sleep apnea tends to become. If we have sleep apnea happening when we are young and we do anything about it, as we get older, it generally gets a bit worse.
There are several ways we treat sleep apnea and sometimes we use a combination approach to help reduce the severity of that sleep apnea.
Usually, we need to do some weight loss and lifestyle changes, while the truth is that when you have sleep apnea, you're generally pretty tired during the day and you don't feel very energetic, so it' hard to go and do exercise. So it can be quite a challenge which is why we sort of tend to do CPAP therapy.
About lifestyle change, we need to stop smoking and avoid alcohol consumption in the evening. Alcohol is very enjoyable because it's a muscle relaxant and makes us very relaxed but what we want to avoid when we're sleeping is excessive muscle relaxing, because that's what causing the obstruction to happen. So you really should avoid that glass of wine before bed and quit smoking.
The next one is positional therapy, which means you just stay off your back when you're sleeping. So just sleeping on your side. This doesn't work for everyone obviously but these are just some of the treatment options.
There is a number of surgical options out there but it's important that we sort of first exhaust our non-invasive treatment options which are a lot more enjoyable and far less painful than jumping down the surgical road.
So let's talk about the most favorite therapy, which is positive airway pressure therapy. This is the gold standard and also the most common form of treating sleep apnea. If you know nothing about it, it's basically you have a little device, a machine with some tubing and you wear a small mask when you go yo bed. The machine creates air pressure. When the pressure on the outside of your body is higher than the pressure in your lungs, it forces air in. Because the air travels from high pressure to low pressure. This treats the sleep apnea brilliantly.
There are a few types of positive airway pressure therapy and I'll just discuss them with you now because it can be a little bit confusing for someone, but it's important to understand the different forms of the therapy.
The first one is continuous positive airway pressure which is CPAP. CPAP is a word that many of you have heard. With continuous positive airway pressure, your device is set to one preset level of therapy pressure, so when you're breathing in and out, there's just one level of pressure.
Another form of continuous positive airway pressure is what we call automatic positive airway pressure. There is still continuous pressure coming in, but it's not preset to one fixed level. The machine itself will monitor your breathing and then it will regulate that pressure up and down minute by minute. This we call APAP.
If your airway is nice and the machine will automatic to stay nice and low, but if you're having obstructive sleep apnea events and snoring, the machine will pick up that information and it will gradually increase the pressure to treat the sleep apnea.
There is another form of therapy called BIPAP. BiPAP, that's normally used to treat either people with complex or mixed sleep apnea. We do sometimes use CPAPs and APAPs when we start and if it's not working out, then we'll use the BIPAPs which are a bit more technologically advanced than the other forms of therapy and also sometimes we use BiPAP for people who might have obstructive sleep apnea but they're not coping with CPAP or APAP. They may find it too hard to breathe out against the pressure and they can't quite get it, so we can move them to a BiPAP. Generally, your physician will sort of work out the best to set the values.
We all know that the BIPAP therapy devices usually cost a lot, but I believe that with the development of technology, these machines will become cheaper and more affordable.
Just stay safe and monitor your sleep health. You will finally get rid of the sleep apnea and enjoy every breathe easily.