An estimated 18 million Americans suffer from sleep apnea, a potentially life-threatening disorder in which the sleeper experiences intermittent cessation of breathing. The more common form of this condition is obstructive sleep apnea, in which the air passages become blocked, causing respiratory distress. Obstruction may be caused when the throat muscles and tongue relax during sleep, allowing the tongue and uvula (the small, fleshy tissue hanging from the back of the throat) to sag and block the airway. Excessive tissue in the airways (prevalent among overweight people) and excess swelling and mucus production in the nose (often caused by childhood allergies) can also narrow and substantially obstruct breathing during sleep. Central sleep apnea is less common and is triggered when the brain fails to signal the respiratory muscles to breathe.
In an episode of sleep apnea, the sleeper involuntary stops breathing for ten to sixty seconds, resulting in decreased blood levels of oxygen and increased amounts of carbon dioxide. This change in blood gases alerts the brain to begin breathing. To do so, the brain must awaken the body from deep sleep. The sleeper then resumes breathing, usually with a loud snort or gasp, and then quickly falls back to light sleep. People with obstructive sleep apnea usually snore heavily before and after the breathing pauses.
These apneic events can occur up to 30 times each hour, although the sleeper rarely realizes this because the awakenings are so brief. However, these constant arousals prevent patients from getting enough deep sleep, and lead to excessive daytime sleepiness, morning headaches (from lack of oxygen), depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep during daily activities. Sleep apnea has also been linked to irregular heartbeat, heart attack, high blood pressure, and stroke, as well as sudden infant death syndrome (SIDS), so it is prudent that people who suspect that they or their children suffer from this disorder get medical care. However, the American Sleep Apnea Association contends that up to 83% of those people don’t realize they suffer from this serious sleep disorder, due to the sleepers’ inability to detect their own problem. Sleeping partners often observe the apneic episodes and can provide valuable information as to whether you suffer from the symptoms of sleep apnea. Doctors usually use the polysomnography test and/or the Multiple Sleep Latency Test to diagnose this problem.
Doctors often advise sleep apnea patients to avoid alcohol and sleeping pills, as they lessen the body’s ability to awaken from sleep, and to lose excessive weight. The National Institutes of Health reports that even a 10% weight loss can reduce the incidence of sleep apnea. Sleeping in a side position and wearing a dental appliance that repositions the jaw and tongue may prove helpful in relieving mild sleep apnea.
Doctors may also prescribe the use of a continuous positive airway pressure (CPAP) device, which involves having the sleeper wear a mask that forces air through the nose and keeps the throat from collapsing. In some cases, doctors recommend surgery to remove adenoids and tonsils (most effective in young children), nasal polyps, and other tissue blocking the airway. In another surgical procedure, excess tissue in the back of the throat is removed using surgical instruments (uvulopalotopharyngnoplasy) or lasers (uvulopalatoplasty). This procedure may eliminate sleeping problems but not sleep apnea itself; additionally, the long-term effects are unknown. The most drastic conventional measure is tracheostomy, in which a small hole is made in the windpipe, allowing the sleeper to breathe uninterrupted during the night. This procedure works, but it is rarely used. There is also new research that says as we age the core muscle of the tongue atrophies causing it to possibly block the air passage.
