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Sleep Apnea is a condition involving pauses or decreases in breathing during sleep. It is usually due to airway collapse. This collapse occurs in the nose and/or the throat - anywhere from where air enters the nostrils to the back of the tongue. Imagine a straw collapsing when trying to suck on a thick milkshake. Frequently, this airway collapsibility problem is inherited and starts in childhood. In the daytime, it is not a problem because there is good muscle-tone in the airway and the brain monitors breathing. But at night, the throat muscles become relaxed and the brain is not as attentive to the airway. So on inhalation, the airway walls can either completely collapse or significantly narrow. This is a problem because 1) the body must struggle to breathe and 2) the brain has to 'wake up' to reopen the airway.
These frequent awakenings lead to fragmentation of nighttime sleep. You may not remember them because they are so short. In fact, patients with sleep apnea can wake-up more than 30 times an hour and think that they slept uninterrupted through the night. Since sleep must be continuous and consolidated in order to be restorative, a number of cognitive problems can occur with sleep fragmentation: daytime sleepiness, memory problems, concentration difficulties, emotional instability, irritability, slowed reaction time, and most importantly, an increased risk of motor vehicle accidents.
There are also cardiovascular consequences of this constant 'struggling to breathe.' This puts a strain on the heart and blood vessels, leading to increased risk of high blood pressure, heart disease and stroke.
Finally, there are social implications to Sleep Apnea. The snoring associated with sleep apnea can disrupt the sleep of others. In fact, one study showed that when a person treats his/her sleep apnea, the sleep partner gets the equivalent of one hour more sleep per night.
Sleep apnea is a progressive disease and often gets worse with age. Weight gain, alcohol, and other sedating/relaxing substances exacerbate it.
Who Gets Sleep Apnea?
A common misconception is that only overweight men that snore loudly have sleep apnea, but the facts are:
In other words, anyone can have it. Even skinny women. Even children.
I Think I Might Have Sleep Apnea, How Do I Find Out If I Have It?
Make an appointment with your primary care physician, or if your insurance allows it, go straight to a sleep specialist. If your physician thinks you might have sleep apnea, then he/she can refer you for a sleep study or comprehensive sleep evaluation.
How Is Sleep Apnea Treated?
There are four main categories of treatment for sleep apnea: Continuous Positive Airway Pressure (CPAP), Surgery, Oral Appliances, and Behavioral Modification.
The most effective way to treat sleep apnea is with CPAP. CPAP is a mask worn over the nose attached by a hose to an air compressor. The air compressor gently and quietly blows room-air into the nose, which 'stents' the airway open, preventing airway collapse. This is the most effective way to treat sleep apnea, and all patients diagnosed with sleep apnea should at least try it before considering other options.
Surgery can be an effective way to treat sleep apnea. A number of different procedures can be performed. These range from nasal septum repair to jaw reconstruction. Talk to your doctor about whether surgery is the right option for you.
An oral appliance is a device made by a dentist or an orthodontist designed to pull your lower jaw forward. By pulling your lower jaw forward, the tongue is pulled away from the back of the throat. If your airway obstruction is occurring behind the tongue, then this can be an effective way to treat your sleep apnea. The treatment of sleep apnea with oral appliance should be a coordinated effort between the sleep physician, the dentist/orthodontist, and the patient.
Behavioral modifications can help in the treatment of sleep apnea, but are usually the least effective. These include such techniques as weight loss, sleeping on your side, and avoiding alcohol before bedtime.
None of these treatment options is ideal, but they all can be useful in treating sleep apnea and resulting in more restful sleep. With risks like heart attack and stroke, you should do everything you can to get your sleep apnea under control. If you think you have sleep apnea, contact your doctor or go to a sleep center. It could be the best decision you ever made.
Feeling crabby lately? It could be you aren't getting enough sleep. Work, household responsibilities and child care can make sleep difficult to come by. Factor in other unexpected challenges such as financial worries, layoffs, relationship issues or an illness, and quality sleep may be even more elusive.
You may not be able to control or eliminate all of the factors that interfere with your sleep, but you can create an environment and adopt habits that encourage a more restful night. Try these suggestions if you have trouble falling asleep or staying asleep:
*Go to bed and get up at about the same time every day, even on the weekends. Sticking to a schedule helps reinforce your body's sleep-wake cycle and can help you fall asleep better at night.
*Don't eat or drink large amounts before bedtime. Eat a light dinner about two hours before sleeping. If you're prone to heartburn, avoid spicy or fatty foods, which can make your heartburn flare and prevent a restful sleep. Also, limit how much you drink before bed. Too much liquid can cause you to wake up repeatedly during the night for trips to the bathroom.
*Avoid nicotine, caffeine and alcohol in the evening. These are stimulants that can keep you awake. Smokers often experience withdrawal symptoms at night, and smoking in bed is dangerous. Avoid caffeine for eight hours before your planned bedtime. Your body doesn't store caffeine, but it takes many hours to eliminate the stimulant and its effects. And although often believed to be a sedative, alcohol actually disrupts sleep.
*Exercise regularly. Regular physical activity, especially aerobic exercise, can help you fall asleep faster and make your sleep more restful. Don't exercise within three hours of your bedtime, however. Exercising right before bed may make getting to sleep more difficult.
*Make your bedroom cool, dark, quiet and comfortable. Create a room that's ideal for sleeping. Adjust the lighting, temperature, humidity and noise level to your preferences. Use blackout curtains, eye covers, earplugs, extra blankets, a fan, a humidifier or other devices to create an environment that suits your needs.
*Sleep primarily at night. Daytime naps may steal hours from nighttime slumber. Limit daytime sleep to about a half-hour and make it during midafternoon. If you work nights, keep your window coverings closed so that sunlight, which adjusts the body's internal clock, doesn't interrupt your sleep. If you have a day job and sleep at night, but still have trouble waking up, leave the window coverings open and let the sunlight help wake you up.
*Choose a comfortable mattress and pillow. Features of a good bed are subjective and differ for each person. But make sure you have a bed that's comfortable. If you share your bed, make sure there's enough room for two. Children and pets are often disruptive, so you may need to set limits on how often they sleep in bed with you.
*Start a relaxing bedtime routine. Do the same things each night to tell your body it's time to wind down. This may include taking a warm bath or shower, reading a book, or listening to soothing music. Relaxing activities done with lowered lights can help ease the transition between wakefulness and sleepiness.
*Go to bed when you're tired and turn out the lights. If you don't fall asleep within 15 to 20 minutes, get up and do something else. Go back to bed when you're tired. Don't agonize over falling asleep. The stress will only prevent sleep.
*Use sleeping pills only as a last resort. Check with your doctor before taking any sleep medications. He or she can make sure the pills won't interact with your other medications or with an existing medical condition. Your doctor can also help you determine the best dosage. If you do take a sleep medication, reduce the dosage gradually when you want to quit, and never mix alcohol and sleeping pills. If you feel sleepy or dizzy during the day, talk to your doctor about changing the dosage or discontinuing the pills.
If you're having problems sleeping more than three times a week for a month's time, see your doctor. You could have a sleep disorder, such as obstructive sleep apnea or restless legs syndrome. Identifying and treating the cause of your sleep disturbance can help get you back on the road to a good night's sleep.