What Is Sleep Apnea? Sleep apnea is a sleep disorder characterized by repeated interruptions in breathing during sleep. These interruptions, known as apneas, can last several seconds to minutes and occur multiple times per hour. They can lead to poor sleep quality and decreased oxygen levels in the body.
There are three main types of sleep apnea:
Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is the most common type. It occurs when the throat muscles relax excessively, causing airway blockage.Due to the collapse of the upper airway, airflow is blocked through the airway. Generally, it means that during the 7-hour sleep period of an adult every night, the number of episodes reaches more than 30 times. During each episode, the airflow from the mouth and nose stops for 10 seconds or more, accompanied by a decrease in blood oxygen saturation.
Central Sleep Apnea Syndrome (CSAS)– A less common form, where the brain fails to send proper signals to the muscles that control breathing. Due to the disorder of the brain center that controls breathing, there is no airflow in the upper airway for more than 10 seconds, and there is no chest or abdominal breathing movement. In particular, central sleep apnea may occur in the elderly due to cerebral cortex and autonomic nervous dysfunction or brain disease.
Mixed sleep apnea syndrome (MSAS) – A combination of both OSA and CSA, sometimes referred to as treatment-emergent central sleep apnea.
Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated pauses in breathing or shallow breathing during sleep. This condition may cause daytime sleepiness, memory loss, mood swings, and even lead to health problems such as heart disease and high blood pressure in severe cases. This article will introduce the causes, symptoms, treatments, and prevention measures of OSA.
Causes of OSA
The main cause of OSA is the relaxation of the upper airway muscles during sleep, leading to airway obstruction. The upper airway refers to the part from the nasal cavity or mouth to the throat, which includes structures such as the soft palate, uvula, tonsils, and tongue. When these structures are too relaxed or hypertrophic, they will collapse or move during inhalation, causing the airway to narrow or close. This will prevent air from entering the lungs, causing apnea or hypopnea. Apnea refers to breathing cessation for more than 10 seconds, and hypopnea refers to a decrease in breathing of more than 50% and lasting for more than 10 seconds.
The occurrence of OSA is related to many factors, the most important of which is obesity. Obesity can cause fat accumulation around the upper airway, increasing airway resistance and the risk of collapse. According to statistics, about 70% of OSA patients are overweight. Other factors related to OSA include:
(1) Nasopharyngeal diseases: such as rhinitis, sinusitis, nasal polyps, deviated nasal septum, adenotonsillar hypertrophy, nasal or pharyngeal tumors, etc., which can affect nasal ventilation and upper airway stability. Smoking and drinking: Smoking can irritate and damage the upper airway mucosa, increase inflammation and edema; drinking can inhibit the central nervous system and upper airway muscle tension, and reduce the response to hypoxia and hypercapnia.
(2) Family inheritance: Some people may be born with narrower upper airways or larger soft tissue structures, which may be related to genetics.
(3) Gender and age: Men are more likely to suffer from OSA than women, with an incidence rate of about twice that of women; the incidence of OSA also increases with age, especially between the ages of 40 and 65.
(4) Hormone levels: Some diseases or conditions that affect hormone levels, such as hypothyroidism, polycystic ovary syndrome, menopause, etc., may also increase the risk of OSA.
Symptoms of OSA
The typical symptom of OSA is snoring, especially loud and irregular snoring. Snoring is the sound caused by the vibration of soft tissue when air flows through the upper airway. When the airway is narrowed or blocked, snoring will be more obvious and louder. However, not all people who snore have OSA, and not all people with OSA snore. Some people may have airway obstruction due to other reasons, such as allergies, colds, nasal polyps, etc.; some people may not have obvious snoring sounds because their airway is too relaxed or their muscles are too stiff.
In addition to snoring, OSA can cause a range of symptoms both at night and during the day, including:
(1) Repeated awakening at night: Hypoxia and hypercapnia caused by apnea or hypoventilation will stimulate the brain’s awakening response, causing the patient to switch from deep sleep to shallow sleep or wake up. This awakening response is usually short-lived, and the patient may not be conscious, but it will affect the quality and continuity of sleep. Some patients may wake up due to panting, choking, panic, etc., sometimes accompanied by sweating, frequent urination, etc.
(2) Daytime sleepiness: Due to poor sleep quality and lack of sleep at night, OSA patients will feel sleepy, tired, and listless during the day. They may have difficulty concentrating, have low work efficiency, and reduced learning ability. They may also fall asleep involuntarily in inappropriate situations (such as driving, watching TV, meetings, etc.), which increases the risk of accidents.
(3) Memory loss and mood swings: OSA affects the cognitive function of the brain, resulting in impaired memory, judgment, logical reasoning, etc. OSA patients may also experience psychological problems such as low mood, depression, anxiety, and irritability.
(4) Cardiovascular problems: OSA can cause cardiovascular disorders such as high blood pressure, irregular heartbeat, myocardial ischemia, etc. Long-term untreated OSA patients will increase the risk of serious complications such as coronary heart disease, heart failure, myocardial infarction, and stroke.
If you have the above symptoms and feel that you have a lack of energy during the day, you may need to seek help from a doctor. The doctor will diagnose whether you have OSA and assess its severity based on your medical history, physical examination, and related tests (such as polysomnography).
OSA Treatment
There are two treatment methods for OSA: non-surgical and surgical. Non-surgical treatments include lifestyle changes, oral devices, and ventilators; surgical treatments include removal or reduction of upper airway soft tissue or bone structure. Different treatments are suitable for different OSA patients, and you need to follow your doctor’s advice.
(1) Changing lifestyle is the basis of OSA treatment and is beneficial to all patients. The main points are as follows:
Lose weight: Obesity increases the risk of airway collapse and obstruction. Losing weight can effectively improve the symptoms and complications of OSA patients, which is especially important for patients with mild to moderate OSA.
Quit smoking and drinking: Smoking and drinking can irritate and damage the upper airway, making it more prone to collapse and obstruction, aggravating the distress of OSA patients.
Regular work and rest: Ensuring adequate and high-quality sleep is the key to improving the daytime function and quality of life of OSA patients. Factors that affect sleep quality should be avoided, such as excessive fatigue, staying up late, working at night, taking sedatives or sleeping pills, etc.
Change sleeping position: For patients with position-related OSA, that is, patients who have more apnea when lying on their back and less apnea when lying on their side or prone, changing sleeping position can alleviate symptoms. Some special equipment or items can be used to help change the position.
(2) An oral device is a device that can be worn in the mouth and can keep the mandible protruding or the tongue moving forward at night to increase the patency of the upper airway. Oral devices are suitable for patients with mild to moderate OSA or patients who cannot tolerate ventilator therapy. Oral devices need to be customized and adjusted by professionals. They are easy to use, less invasive, have few side effects, and are easy to carry, but they may affect the structure and function of the teeth and temporomandibular joint and are not effective for patients with severe OSA.
(3) Ventilator therapy is a treatment method that provides positive pressure airflow to the upper airway through an external device to prevent airway collapse and apnea. Ventilator therapy is the first choice for OSA treatment and is especially effective for patients with moderate to severe OSA or those with serious complications. Ventilator therapy requires patients to wear a mask or nasal mask at night, connected to a pump and a hose. The ventilator can automatically adjust the pressure and flow of the airflow according to the patient’s breathing conditions, significantly improve the patient’s sleep quality and daytime function, and reduce the risk of cardiovascular disease, but may cause side effects such as mask discomfort, nasal congestion, dry mouth, and tinnitus.
(4) Surgical treatment is a treatment method that increases the patency and stability of the upper airway by removing or reducing the soft tissue structure of the upper airway or changing the bone structure of the upper airway. Surgical treatment is suitable for patients with clear anatomical abnormalities or who cannot tolerate other treatments. There are many types of surgical treatments, including tonsillectomy, soft palate resection, tongue root resection, mandibular advancement, etc. The effect of surgical treatment varies from person to person, and it may take multiple surgeries to achieve the desired effect, which may cause complications such as bleeding, infection, trauma, and throat discomfort.
Conclusion
Obstructive sleep apnea syndrome is a serious health problem that requires prompt diagnosis and treatment. If you have related symptoms, you should seek medical help as soon as possible. Your doctor will choose the right treatment for you based on your specific situation. With effective treatment, you can improve your sleep quality and daytime function, reduce the risk of complications, and improve your quality of life.
