Obstructive sleep apnea (OSA) is a very serious sleep disorder. It causes breathing to repeatedly stop and start during sleep. This cycle of not breathing, the brain being aroused from sleep and waking you up to open your airway happens all night long. This is a terrible stress on the human body and results in extremely fragmented sleep. OSA patients do not get the restorative and rejuvenating effects of sleep.
There are several types of sleep apnea, but the most common is obstructive sleep apnea. OSA is caused when the upper throat muscles relax too much during sleep, cutting off or restricting the airway. These episodes, which also cause the oxygen level in the blood to drop, last from 10 seconds to a minute or more. The brain registers lack of oxygen and the individual wakes up just enough to open the throat and begin breathing again, starting the cycle over. Most of the time, individuals don’t remember these episodes in the morning, but they severely disrupt the restorative effects of sleep. People with moderate or severe sleep apnea may be waking up hundreds of times every night without knowing it.
Treatments for obstructive sleep apnea are available. One treatment is the CPAP. This is where a bulky face mask it strapped onto the face of the patient. A constant stream of air is forced through a tube into the face mask. This constant air pressure keeps the airway open. Another option is a dental mouthpiece to position your jaw forward during sleep. In more severe cases, surgery may be an option too. Although, the positive effects of surgery usually don’t last.
What is Obstructive Sleep Apnea?
Obstructive sleep apnea (OSA) is the most common form of sleep apnea and is believed to affect approximately 4% of men and 2% of women. However, it is believed that only about 10% of people with OSA seek treatment leaving the majority of OSA sufferers undiagnosed.
Mechanism of Action of Obstructive Sleep Apnea
Obstructive sleep apnea is caused by partial or complete blockage of the airways during sleep. During sleep, a person’s throat muscles relax allowing the tongue and/or fatty tissues of the throat to fall back into the airways and block airflow. During an apnea event, air is restricted from moving beyond the obstruction to the lungs. This lowers the oxygen levels in the blood. The brain partially awakens from sleep to signal the body that it needs to breathe. This is often followed by a loud gasping, choking, or snorting sounds as the person takes a deep enough breath to fight past the obstruction.
Once a breath is taken the brain returns to sleep, and the process begins once again. This process can occur just a few times a night or hundreds of times a night depending on the severity of the condition.
Apnea Hypopnea Index (AHI)
The AHI is the number of apneas or hypopneas recorded during the study per hour of sleep. It is generally expressed as the number of events per hour. Based on the AHI, the severity of OSA is classified as follows:
- Mild OSA– The sufferer experiences 5-14 episodes of interruptions in breathing in an hour.
- Moderate OSA- The sufferer experiences 15-30 episodes of interruptions in breathing in an hour.
- Severe OSA- The sufferer experiences 30 or more interruptions in breathing in an hour.
Other symptoms of obstructive sleep apnea include
- Snoring that is loud, disruptive, and regular is one of the most obvious signs of potential OSA. However, people can snore without having OSA.
- Frequent breaks in breathing caused by an obstruction. These cessations are often followed by choking or gasping noises as the body’s respiratory system fights through the blockage.
- Restless sleep. Sufferers of obstructive sleep apnea often have fitful sleep as their mind and body are constantly awakened throughout the night, pulling them out of the much needed stages of non-REM and REM sleep.
- Excessive daytime sleepiness caused by frequent interruptions of sleep.
- Morning Headaches stem from the loss of oxygen in your bloodstream that flows to your brain as a result of the irregular breathing at night.
Depression or irritability. Lack of regular quality sleep can cause mayhem on a person’s mental well-being. Sufferers of obstructive sleep apnea often find themselves feeling short-tempered, and in time it can lead to more severe symptoms of depression.
Causes and Risk Factors of Obstructive Sleep Apnea
- Weight- In many cases a person’s body weight is directly linked to having obstructive sleep apnea. People who are overweight or obese are more likely to have sleep apnea than those that maintain a healthy weight. Sleep apnea can often be caused by excess fatty tissues that become built up in the neck and throat. This can lead to restrictions in airflow as the upper respiratory system’s pathway is narrowed or pinched off during sleep.
- Neck Size is considered to be a risk factor for snoring and sleep apnea when the circumference is greater than 17 inches (43.2 centimeters) for men and greater than 16 inches (40.6 centimeters) in women
- Age– As people age their muscles begin to lose muscle tone. This is also true of the muscles in the throat. As throat muscles lose definition, they become weaker and more likely to collapse into the airways during sleep.
- Enlarged tonsils or adenoids are the leading cause of obstructive sleep apnea in children but can also affect adults who never had a tonsillectomy when they were younger.
- Natural causes- Some people can be genetically predisposed to having a narrower throat or may have an enlarged tongue that falls back into their airway. If your family has a history of OSA you are more likely to have it yourself.
- Frequent alcohol use- Alcohol relaxes the muscles in the body, and this includes the throat muscles as well which may relax to the point of blocking the airway during sleep.
- Smoking– Smoke is an irritant to the lungs, throat, and esophagus. It can cause inflammation and fluid retention in the upper airways that can impede airflow.