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12 / 12 / 2017
Sleeping Apnea
 
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Sleep apnea

 
BRAIN & NERVOUS SYSTEM

Sleep

 
 

Sleep apnea is a breathing disorder that occurs during sleep. Sleep apnea is not a single disease entity, but rather include several disorders. Apnea is Greek for "without breath."

Sleep apnea occurs in two types:

  • Obstructive sleep apnea. This type of sleep apnea is the more common of the two. If you have this condition, the muscles in the walls of your throat (pharynx) relax while you sleep so that the walls collapse on themselves and obstruct the flow of air. After 10 to 30 seconds or more of no air exchange, you rouse to a lighter level of sleep or brief wakefulness. The muscles then regain their normal tone (tenseness), the obstruction is relieved and you breathe again. If you have obstructive sleep apnea, you may not be aware that your sleep was interrupted. In fact, many people with this type of sleep apnea think they sleep well all night.
  • Central sleep apnea. In this type of sleep apnea, your brain fails to send proper signals to the muscles that control breathing. When breathing is interrupted, the level of carbon dioxide in your blood rises, which may cause you to awaken. People with central sleep apnea are more likely to remember awakening than are people with obstructive sleep apnea.

More than half of all cases of sleep apnea are diagnosed in people 40 years of age or older. The condition also is more common in men than women and is a major contributor to daytime drowsiness. Thirty percent to 60 percent of people with severe daytime sleepiness have sleep apnea.

Signs and symptoms

The signs and symptoms of obstructive and central sleep apnea overlap, sometimes making the type of sleep apnea more difficult to determine. The most common signs and symptoms of obstructive and central sleep apnea include:

  • Excessive daytime sleepiness (hypersomnia)

  • Loud snoring

  • Observed episodes of breathing cessation during sleep

  • Abrupt awakenings with shortness of breath

  • Awakening with a dry mouth or sore throat

  • Morning Headache

Disruptive snoring may be a more prominent characteristic of obstructive sleep apnea, while awakening with shortness of breath may be more common with central sleep apnea.

Causes

Obstructive sleep apnea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, uvula, tonsils and tongue.

When the muscles relax, your airway is narrowed or closed as you breathe in, and breathing is momentarily cut off. This lowers the level of oxygen in your blood. Your brain senses this decrease and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.

You can awaken with a transient shortness of breath that corrects itself quickly with one or two deep breaths. You may make a snorting, choking or gasping sound. This pattern can repeat itself 20 to 30 times or more each hour, all night long. Your ability to reach the desired deep, restful phases of sleep is impaired, and you'll probably feel sleepy during your waking hours.

People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they sleep well all night.

Central sleep apnea, which is far less common, occurs when your brain fails to transmit signals to the breathing muscles. You usually awake abruptly due to the progressive rise in the level of carbon dioxide in your blood and the accompanying drop in your level of oxygen. You may awaken with shortness of breath. People with central sleep apnea may be more likely to remember awakening than people with obstructive sleep apnea are.

Risk factors

Sleep apnea may occur if you're young or old, male or female. Even children can have sleep apnea, a problem more common than it's known. But certain factors put you more at risk:

Obstructive sleep apnea

  • Excess weight. A fat or thick neck tends to narrow the airway in your throat. A possible indicator of obstructive sleep apnea is if the diameter of a man's neck is larger than 17 inches, or if a woman's neck is larger than 16 inches around. Fat deposits around your upper airway may be a factor in obstructing your breathing during sleep. However, thin people also can develop sleep apnea.

  • Enlarged tonsils or adenoids. Your airway can become blocked if your tonsils or the tissues in the back of your throat (adenoids) are too large.

  • A naturally narrow throat. This may be an inherited characteristic.

  • Being male. Men are twice as likely to suffer from sleep apnea as women are. However, women increase their risk if they're overweight.

  • Being older. Sleep apnea occurs two to three times as often in older adults.

  • A family history of sleep apnea. If you have family members with sleep apnea, you may be at increased risk.

  • Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat.

Central sleep apnea

  • Stroke or brain tumor. These conditions can impair the brain's ability to regulate breathing.

  • Neuromuscular disorders. Conditions such as amyotrophic lateral sclerosis (Lou Gehrig's disease), spinal cord injuries and muscular dystrophy can affect central nervous system breathing functions.

  • High altitude. Sleeping at an altitude higher than you're used to may increase your risk of sleep apnea.

In both obstructive and central sleep apnea, congestive heart failure is a significant risk factor. High blood pressure is common in both types of sleep apnea. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system, raising the risk of heart failure and stroke. If there is underlying heart disease, these repeated multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from a cardiac event.

Sleep apnea > next > 1 > 2 > 3 > 4

 
 
 
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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.

In no event will the DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.
 
 
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