Sleep Apnea affects over 42,000,000 adults in the USA! A recent study showed that one in ten Australians suffer from diagnosed obstructive sleep apnea; 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, the air stops flowing to your lungs for 10 seconds or more when you’re sleeping. When you stop breathing, your blood oxygen levels drop, which triggers your brain to wake up out of sleep for a microsecond, so you can take a breath and then fall asleep again, and this cycle continues throughout the night.
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 and put your body in a very stressful environment when it’s supposed to be resting, relaxing, and recovering from the day’s activities.
Untreated sleep apnea can cause some pretty severe health consequences, including stroke, heart disease, heart attacks, high blood pressure, diabetes, depression, car accidents, and a list of other things.
So we must get tested for sleep apnea if we 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, you are in a relaxing status. Your muscles in your upper airway and your tongue, throat, and 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 noticeable 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, so the more weight you get when you lie there, the more pressure you put on those muscles, more weight on those muscles when they relax, and the more likely to 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 sent from our brain to our lungs.
Usually, your brain’s telling your lungs to breathe, and with central sleep apnea, there’s a bit of a signal fault. Your lungs aren’t getting told to breathe, so your airway can be open, but you’re just not getting to know that signal down to your lungs debris. Central sleep apnea can go undiagnosed quite often because there can sometimes be no snoring.
There’s usually a lot of noise and snoring with obstructive sleep apnea 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 more complex.
Unfortunately, without treatment, you’ll most likely have sleep apnea for life, so we must treat it.
Sleep Apnea Treatments
The older we get, the more severe the sleep apnea tends to become. If we have sleep apnea happening when we are young and do nothing about it, it generally worsens as we get older.
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’s hard to go and do exercise. So it can be quite a challenge which is why we tend to do CPAP therapy.
We need to stop smoking and avoid alcohol consumption in the evening regarding lifestyle changes. Alcohol is very enjoyable because it’s a muscle relaxant and makes us very relaxed. We want to avoid excessive muscle-relaxing when we’re sleeping because that’s what obstructs it from happening. So you really should avoid that glass of wine before bed and quit smoking.
The next one is positional therapy, which means staying 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 are several surgical options out there, but we must first exhaust our non-invasive treatment options which are a lot more enjoyable and far less painful than jumping down the surgical road.
Positive Airway Pressure Therapy
So let’s talk about the most favorite therapy, positive airway pressure therapy, which is the gold standard and the most common form of treating sleep apnea. You have a little device, a machine with some tubing, and you wear a small mask when you go to bed. The machine creates air pressure. When the outside pressure of your body is higher than the pressure in your lungs, the machine will force air in because the air travels from high pressure to low pressure. The machine treats sleep apnea brilliantly.
There are a few types of positive airway pressure therapy, and I’ll discuss them with you now because it can be confusing for someone, but it’s essential to understand the different forms of the therapy.
Continuous Positive Airway Pressure
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.
Automatic Positive Airway Pressure
Another form of continuous positive airway pressure is automatic positive airway pressure. There is still continuous pressure, 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 normal and the machine will automatically stay nice and low, but if you’re having obstructive sleep apnea events and snoring, the machine will pick up that information and gradually increase the pressure to treat the sleep apnea.
There is another form of therapy called BIPAP. BiPAP is usually used to treat people with complex or mixed sleep apnea. We sometimes use CPAPs and APAPs when we start. If it’s not working out, 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. Still, 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 that we can move them to a BiPAP. Generally, your physician will 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 sleep apnea and enjoy every breath easily.