Obstructive sleep apnea (OSA)
OSA occurs when the muscles in the back of the throat relax too much to allow normal breathing. When the muscles relax, the airway narrows or closes as you breathe in and breathing may be inadequate for 10 to 20 seconds. Or the airway can become completely blocked and not air is able to enter the longs. This lowers the oxygen saturation in your blood and cause a increase of carbon dioxide.
Your brain senses dangerous oxygen and carbon dioxide levels and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don’t remember it.
This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you’ll probably feel sleepy during your waking hours.
Risk Factors for Obstructive Sleep Apnea
- Being overweight – People who are obese have four times the risk of sleep apnea that people who are a normal weight people do. Fat deposits around your upper airway may obstruct your breathing. But not everyone who has sleep apnea is overweight.
- Male gender. Although, women can also get OSA. Men are twice as likely to have sleep apnea. However, women increase their risk if they’re overweight, and their risk also appears to rise after menopause.
- Neck size >17 inches in men, and >15 inches in women. People with thicker necks may have narrower airways. For men, the risk increases if neck circumference is 17 inches (43 centimeters) and larger. In women, the risk increases if neck circumference is 15 inches (38 centimeters) or more.
- Lung disease, atrial fibrillation and heart failure.
- Narrowed airway. You may have inherited a naturally narrow throat. Or, tonsils or adenoids may become enlarged and block the airway, particularly in children with sleep apnea.
- Family history. If you have family members with sleep apnea, you may be at increased risk.
- Increasing age. Sleep apnea occurs significantly more often in older adults.
- Anatomy and physiology of the airway.
- A decrease in tone of muscles holding airway open.
- Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking may increase the amount of inflammation and fluid retention in the upper airway. This risk likely drops after you quit smoking
- Scoliosis or muscle weakness.
- Sedating medicines and alcohol. These substances relax the muscles in your throat.
- TMJ and jaw pain.
- Bruxism (teeth grinding).
- Malformation of the orofacial area (misaligned teeth, jaw, palate).
- Nasal congestion or obstruction. If you have difficulty breathing through your nose — whether it’s from an anatomical problem or allergies — you’re more likely to develop obstructive sleep apnea.
- Large tonsils and/or adenoids, having a “crowded throat”, a large tongue or small jaw.
- Hypothyroidism and certain other endocrine (hormonal) disorders.
- Progesterone/Estrogen deficiency.
Symptoms of Snoring / Obstructive Sleep Apnea
Below are listed several common symptoms of apnea. However, it is important to understand that symptoms of sleep apnea vary in their intensity. Plus, some patients have sleep apnea have very few symptoms.
- Excessive daytime fatigue/sleepiness.
- Memory problems.
- Weight change.
- Choking or gasping for breath while sleeping.
- Difficulty falling or staying asleep.
- Falling asleep while at work, while driving, or other inappropriate times.
- Fragmented, non-refreshing sleep.
- Morning headaches.
- Decreased sex drive.
- Irritability gastro-esophageal reflux.