By Eduardo Gonzales, MD
How common is sleep apnea? Can you die when you are having an episode of sleep apnea? How is the condition treated?—firstname.lastname@example.org
Sleep apnea is when a person stops breathing for 10 seconds to a minute or longer while sleeping. In fact, everyone stops breathing for a brief period of time while sleeping, but only occasionally. If this occurs more than five times an hour, that’s when it is diagnosed as sleep apnea. Sleep apnea causes blood-oxygen levels to dip, putting a strain on the heart. It also forces the brain to be on high-alert all night when it is supposed to be resting and recovering.
There are three types of sleep apnea, but obstructive sleep apnea, the most common type, accounts for more than 99 percent of cases. It occurs when the upper throat muscles relax while sleeping causing the air passages to narrow and close. Central sleep apnea, the second type, comes about when the brain doesn’t send the right signals to the muscles that control breathing. Complex sleep apnea, the third and rarest type, is when a person has both obstructive and central sleep apnea.
How common is sleep apnea?
One of every 15 people probably suffers from sleep apnea but in varying severity. More common in males, the condition primarily affects middle-aged and older people. It afflicts nine percent of middle-aged women and 24 percent of middle-aged men.
Sleep apnea is also more common in overweight and obese people, and in those with hypertension and diabetes. Also predisposed to the condition are those who are hypothyroid, or who have gastroesophageal reflux, nasal allergy, nasal polyps or adenoids, and those with narrow airways because of an anatomic abnormality such as a large tongue, small jaw, a deviated nasal septum, and enlarged tonsils. Likewise, the risk for sleep apnea increases with smoking, and intake of alcohol or drugs such as sedatives, narcotics, or opioids.
How do you know you have sleep apnea?
If you snore or are very restless when you sleep, or feel sleepy or very tired during the day, you probably need to consult a physician who specializes in sleep disorders to rule out sleep apnea.
Sleep apnea is easily diagnosed through an overnight sleep study (polysomnography) in a sleep clinic.
Is sleep apnea ever fatal?
No one dies during an episode of sleep apnea. When breathing momentarily stops during sleep apnea, carbon dioxide builds up in the bloodstream. This will be detected by chemoreceptors, which will signal the brain to make the person breathe.
But sleep apnea is not a benign condition. What it does is make you sleepy during the day. It also causes headache, fatigue, slow reflexes, memory and cognitive impairment, irritability, and depression. It likewise makes you prone to work or driving related accidents.
In the long term, sleep apnea increases your risk for coronary heart disease, high blood pressure, irregular heart rhythms or arrhythmias, strokes, and sexual dysfunction.
Sleep apnea should be treated
Sleep apnea should not be ignored. It should be treated because of its short and long-term complications.
If a medical or anatomic condition (e.g. allergic rhinitis, enlarged tonsils, etc.), is causing sleep apnea, treatment involves managing the underlying condition. Otherwise, sleep apnea can often be relieved by lifestyle changes such as keeping off alcohol and sedatives, avoiding caffeine and heavy meals within two hours of going to bed, stopping smoking, observing sleep hygiene, sleeping sideways, and reducing to and maintaining a desirable body weight. Cases that do not respond to lifestyle changes can be treated by a device called a continuous positive-air pressure, or CPAP, machine. The device sends air through a tube and a mask into a patient’s nose and mouth while asleep, keeping the airway open.
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