Sleep apnea is a sleep disorder that can lead to pauses in breathing or shallow breathing during sleep, resulting from complete or partial obstruction of the airway. There can be multiple time breathing interruptions at night. Sleep apnea can lead to a reduction in the amount of oxygen that the body and brain receive, which can result in health issues. It triggers the possibility of serious health conditions such as heart disease, diabetes, stroke, and high blood pressure as well. Additionally, sleep apnea can also cause high blood pressure, which can further elevate the risk of heart disease and stroke.People with sleep apnea are more likely to develop heart disease, including heart failure, atrial fibrillation, and coronary artery disease. Less amount of peaceful sleep can initiate depression. Sleep apnea can significantly impact an individual’s quality of life, leading to irritability, mood swings, and relationship problems.
The scope of triggering insulin resistance is also increased which is resulted in type 2 diabetes. It can also cause an excessive feeling of sleepiness during the day, thereby increasing the risk of accidents and injuries. The World Health Organization (WHO) has estimated that around 100 million people across the globe have sleep apnea, but this number might be higher since many cases go undiagnosed. The chances of being affected by sleep apnea are high among men as compared to women and the ratio is 2:1.
In the United States, around 22 million people suffer from sleep apnea. The prevalence of sleep apnea increases with age, with an estimated 60% of adults aged 65 and over experiencing the condition. In some countries, such as India, sleep apnea is becoming increasingly common due to lifestyle factors such as obesity and changes in sleep patterns. Sleep apnea is more prevalent in people with certain health conditions, such as obesity, type 2 diabetes, and high blood pressure. Treatment rates for sleep apnea vary widely across different countries and regions, with some areas having limited access to diagnosis and treatment options.
Main Types And Causes of Sleep Apnea
There are mainly two types of sleep apnea Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA).
Obstructive sleep apnea (OSA) is a type of sleep disturbance that takes place when the muscles in the throat become relaxed and block the airway while a person is asleep. This causes breathing to stop or become shallow, leading to a decrease in the amount of oxygen that reaches the body and brain. The cessation of breathing can last for several seconds or up to a minute, and it can occur multiple times during the night. The main symptoms of OSA are;
- Loud snoring
- Pauses in breathing during sleep
- Gasping or choking during sleep
- Restless sleep
- Daytime sleepiness
- Morning headaches
- Difficulty concentrating or remembering
- Irritability, mood swings, or depression
- Nighttime sweating
Causes of Sleep Apnea
Obesity or excess weight: Excess weight can lead to fat deposits around the upper airway, which can narrow the airway and increase the risk of OSA.
Narrowed airways: Certain physical characteristics, such as enlarged tonsils or adenoids, a deviated septum, or abnormalities in the shape of the jaw or throat, can cause the airway to become narrowed or obstructed.
Smoking or exposure to secondhand smoke: Smoking can cause inflammation and irritation of the airways, which can lead to narrowing and increased risk of OSA.
Alcohol, sedatives, or tranquilizers: These substances can cause the muscles in the throat to relax, leading to increased risk of airway obstruction.
Family history of sleep apnea: Genetic inheritance is also responsible for spreading of sleep apnea.
Medical conditions: The probability of having OSA can be raised due to some medical conditions, such as high blood pressure, heart disease, and diabetes.
Age: The muscles in the throat can become weaker with age, which can increase the risk of airway obstruction.
Figure: Age-wise increasing the risk factor of Obstructive Sleep Apnea
Health Complications Of Obstructive Sleep Apnea
Severe health complications are also associated with this Obstructive Sleep Apnea.
- Daytime fatigue: OSA can disrupt your sleep and lead to daytime fatigue, which can affect your ability to concentrate, perform daily activities, and operate machinery.
- High blood pressure: OSA is linked with a higher likelihood of developing high blood pressure, which in turn can elevate the risk of having heart disease and stroke.
- Cardiovascular disease: OSA is also associated with an increased risk of heart disease and stroke, possibly due to the changes in oxygen levels and blood flow that occur during apnea episodes.
- Type 2 diabetes: OSA is more common in people with type 2 diabetes, and may contribute to insulin resistance and poor glucose control.
- Depression: OSA is associated with an increased risk of depression, which may be related to the impact of sleep disruptions on mood and emotional regulation.
- Memory and cognitive problems: OSA can affect memory and cognitive function, leading to problems with concentration, memory, and other cognitive tasks.
- Sleep-related accidents: OSA may enhance the chances of accidents and injuries, especially those associated with driving or operating machinery while feeling drowsy or fatigued.
Central sleep apnea (CSA) is a type of sleep disorder that hinders the human brain from regulating breathing while a person is asleep. It is different from obstructive sleep apnea because it is not caused by any physical obstruction in the airway. CSA is also gets triggered when brain cannot send signals to the muscles that are responsible for breathing. This can lead to pauses in breathing or shallow breathing during sleep, which can result in a decrease in oxygen levels in the body and brain. Although less prevalent than obstructive sleep apnea, central sleep apnea can lead to severe repercussions if not treated.
This write-up aims to examine the reasons, indications, and potential remedies for central sleep apnea. Below are the main symptoms of CSA;
- Pauses in breathing during sleep
- Breathing difficulty while in sleep
- Restless sleep
- Difficulty staying asleep
- Daytime sleepiness
- Morning headaches
- Difficulty concentrating or remembering
- Mood swings or irritability
Causes of CSA
Heart failure: CSA is often seen in people with heart failure or other heart conditions. The changes in blood flow and oxygen levels that occur with heart failure can disrupt the brain’s ability to regulate breathing during sleep.
Stroke or brainstem injury: Damage to the brainstem, which controls breathing, can lead to CSA.
Certain medications: Some medications, such as opioids or sedatives, can affect the brain’s ability to regulate breathing during sleep and lead to CSA.
High altitude: Exposure to high altitude can disrupt the brain’s regulation of breathing, leading to CSA.
Obesity: Excess weight can lead to changes in breathing patterns during sleep and increase the risk of CSA.
Aging: As we age, the brain’s regulation of breathing can become less effective, leading to an increased risk of CSA.
Health complications of CSA
- Mental health problems: CSA can lead to a range of mental health problems, such as depression, anxiety, PTSD (Post-traumatic stress disorder), dissociative disorders, substance abuse, self-harm, and suicidal ideation.
- Sexual and reproductive health problems: CSA can cause physical injury to the genital area, leading to sexual and reproductive health problems such as STDs, unwanted pregnancies, and infertility.
- Eating disorders: Individuals who have experienced CSA have a higher probability of developing eating disorders like anorexia, bulimia, and binge eating disorder.
- Chronic pain: People who have endured CSA may undergo persistent pain in various regions of their bodies.
- Cardiovascular disease: Studies have shown that survivors of CSA are at an increased risk of developing cardiovascular disease due to the long-term effects of stress on the body.
- Sleep disorders: Survivors of CSA may experience sleep disturbances, such as nightmares, night terrors, insomnia, and sleepwalking.
- Substance abuse: Individuals who have experienced CSA may resort to drugs or alcohol to manage the distressing effects of the trauma.
Treatment of Sleep Apnea
The best treatment for sleep apnea depends on the severity and type of the condition.
- CPAP therapy: This therapy is suggested by most of healthcare professionals to treat sleep apnea. It involves wearing a mask over the nose or mouth during sleep, which delivers a continuous flow of air to keep the airway open.
- Oral appliances: Some people may benefit from using an oral appliance, which is a device that is worn in the mouth to help keep the airway open during sleep.
- Surgery: If structural abnormalities in the airway are the cause of sleep apnea, surgery may be suggested as a solution.
- Lifestyle changes: Adopting certain lifestyle modifications such as shedding weight, abstaining from alcohol and sedatives before sleeping, quitting smoking, and sleeping on one’s side may aid in decreasing the intensity of sleep apnea.
- Positional therapy: This involves using devices to keep you in a specific sleeping position, such as sleeping on your side, to help prevent the airway from becoming blocked.
- Adaptive servo-ventilation (ASV): This therapy is relatively new, and it utilizes a machine to administer air pressure that adapts to your breathing patterns while you sleep.
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