Sleep Apnea

Sleep apnea comes in two varieties: obstructive and central. Obstructive sleep apnea is the most common and commonly known form of this sleep disorder and some evidence supports the fact that obstructive sleep apnea may precipitate central sleep apnea.

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Central sleep apnea is a disorder characterized by the brain "forgetting" to tell the body to breathe at night during the sleep period. A person will simply stop breathing during the night and there will be no chest movements or struggling for breath.

After this pause in breathing, there may be a faster episode of catching one's breath for a time as the person's body is trying to catch up.

In severe cases of central sleep apnea, death can even occur. This is because the stoppages in breathing can lead to low levels of oxygen in the bloodstream (hypoxia) and high levels of carbon dioxide (hypercapnia), which in turn can trigger brain damage. Usually, however, central sleep apnea causes much milder symptoms and consequences.

Obstructive sleep apnea (OSA) is caused by relaxation of one's tissue nasal and throat tissue during the sleep period causing blockages in breathing that trigger the body to awaken temporarily to catch a breath. These mini-episodes stop breathing / awakenings or apneas can be as little as 5 times per hour or as many as 40 or more times per hour. The individual using doesn't realize that he or she has stopped breathing during the night, but will experience excessive daytime sleepiness.

Very often a person's bed partner will, however, realize that the person has stopped breathing periodically throughout the night. The preferred method to diagnose obstructive sleep apnea is with an overnight sleep study.

The sleep study can be conducted in one's home or in a hospital or clinic settings. Electrodes are hooked up to a person's head, chest, arms and legs to measure brain wave activity and limb movement. Also, a device is usually attached to one's finger to measure blood oxygen level during the night. The study is painless and can be used to rule in or rule out sleep apnea or diagnose another sleep disorder such as restless legs syndrome.

The profile of a person with obstructive sleep apnea used to be an overweight male over 60-years-old who drank and smoked too much. This profile has changed in recent years, however, as more younger, fit healthy males, females and children are being diagnoses with the disorder.

Obstructive sleep apnea is caused by the relaxing of throat or nasal tissue, during the night that obstructs breathing temporarily. Tongue, tonsils, narrow nasal passages and uvula have all been implicated to cause sleep apnea in different people.

The different treatments for sleep apnea may be by machine, dental device, medicine or with surgery. A CPAP machine is the most common treatment for those with obstructive sleep apnea. CPAP or continuous positive airway pressure is a machine that usually includes a hose and mask to blow air into one's nose and throat during the night to overcome the obstacle of the stoppage of breath.

For those who have a problem with their tongue relaxing back in their throats at night, sometimes a dental mandibular device is used to move the jaw forward and create room for both the tongue and airway. Sometimes medication is prescribed for sleep apnea, but it is more for symptoms surrounding the apnea and not a cure for the apnea itself

One of the most common surgical treatments for sleep apnea is uvulopalatopharyngoplasty (UUUP) or laser-assisted uvulopalatoplasty (LAUP), which both reduce the tissue of the soft palate and remove the uvula. As this surgery only works in 50-percent of the cases, CPAP or a mandibular device still may need to be used after surgery.

If this and other methods of correcting OSA don't work then Maxillomandibular advancement may be used as a surgery of last resort. This is the most invasive surgery and recovery time can take 1 year. In this surgery, the person's jaw is removed from the skull, moved forward and reattached with pins.

Another less invasive surgery is called Genioglossus Advancement where a small piece of the jaw at the front of a person's mouth is cut away from the jawbone, pulled forward, turned 90-decrees and sealed back in place. This type of surgery functions to move the person's tongue forward, opening the airway even when the tongue relaxes during the sleep period.

If sleep apnea is suspected because of excessive daytime sleepiness and tiredness it is important to contact a doctor right away. One doctor has noted that the physical effects of sleep apnea going unchecked is like smoking a couple of packs of cigarettes a day. Sleep apnea call also effect job performance, operation of motor vehicles, family and social relationships and bring on other health problems such as heart disease and immunological disorders.