Sleep Apnea

A condition characterized by temporary breathing interruptions during sleep. The pauses in breathing can occur dozens or even hundreds of times a night. The result of this interrupted breathing pattern is severely fragmented sleep, as the individual must wake up enough to regain muscle control in the throat and to reopen the airway. You may have sleep apnea if you snore loudly and you feel tired even after a full night’s sleep.

Symptoms include loud snoring and a gasping or snorting sound when the sleeping individual starts to breathe again. Although the individual may not be aware of having sleep apnea, the condition can disrupt the quality of sleep and result in daytime fatigue. The most common treatments for Sleep Apnea include Continuous Positive Air Pressure (CPAP), Oral Appliance Therapy (OAT) or Surgery that reduces the amount of soft tissue near the airway.

Increased Risk of Cardiovascular Disease
Untreated Obstructive Sleep Apnea (OSA) also increases the prevalence of Cardiovascular Diseases. The following is a list of diseases and their prevalence in OSA patients.

• 57% – Hypertension
• 25% – Ischemic Heart Disease
• 17% – Coronary Heart Disease
• 10% – Bradyarrhythmias
• 08% – Acute Myocardial Infarction
• 07% – Stroke

Clinical Consequences
Several conditions commonly seen in the primary care setting are known to be associated with obstructive sleep apnea (OSA) and should alert you to the possibility of this sleep disorder.

Excessive Daytime Sleepiness

• Increased Motor Vehicle Accidents
• Increased Work Related Accidents
• Poor Job Performance
• Depression
• Family Discord
• Decreased Quality of Life

Cardiovascular

• Systemic Hypertension
• Cardiac Arrhythmias
• Myocardial Ischemia
• Cerebrovascular Disease
• Pulmonary Hypertension

Symptoms
Approximately one third of the US population suffers from sleep disorders, but less than 10% have been diagnosed or treated to date. If left untreated sleep apnea can result in reduced cognitive performance, 10 times higher frequency of automobile accidents, increased cardiovascular disease, and increased mortality.

• Snoring and Excessive daytime sleepiness
• Restless tossing and turning during sleep
• Problems with memory and concentration
• Morning Headaches
• Heartburn or a sour taste in the mouth at night
• Swelling of the legs (for obese adults)
• Frequent need for urination at night (nocturia)

Causes
When you’re awake, throat muscles help keep your airway stiff and open so air can flow into your lungs. When you sleep, these muscles relax, which narrows your throat. Normally, this narrowing doesn’t prevent air from flowing into and out of your lungs. But if you have sleep apnea, your airway can become partially or fully blocked because:

• Your throat muscles relax more than normal
• Your tongue and tonsils are large compared with the opening into your windpipe
• The shape of your head and neck may restrict the size of your airway
• The aging process may limit your brain signals’ ability to keep your throat muscles stiff during sleep

Is there anything I can do?
Yes. These steps help many people sleep better, although if you suspect you may have a sleeping disorder you should consult a physician immediately.

• Refrain from using alcohol and sleep medicines
• Regular exercise to prevent or combat obesity
• Try sleeping on your side instead of your back