Sleep Apnea Causes, Treatment | Arunalaya Healthcare

Best Sleep Apnea Treatment in Delhi

What is Sleep Apnea ?

Sleep apnea is a potentially serious sleep disorder in which a person’s breathing repeatedly stops and starts during sleep. These breathing pauses, called “apneas,” can last for a few seconds to a minute or longer and can occur many times an hour. This leads to fragmented, non-restorative sleep and can have significant health consequences.

Types of Sleep Apnea

There are three main types of sleep apnea:
- Obstructive Sleep Apnea (OSA): This is the most common type. It occurs when the muscles in the back of the throat relax too much during sleep, causing the soft tissues to collapse and block the airway. Despite the blockage, the brain continues to try to send signals to breathe, often leading to loud snoring, gasping, or choking as the person struggles to get air.
- Central Sleep Apnea (CSA): This less common form occurs when the brain does not send proper signals to the muscles that control breathing. This means there is no effort to breathe for a short period, leading to a pause in breathing. Unlike OSA, there is not typically loud snoring associated with CSA, though people may still wake up gasping for air. CSA is often associated with underlying medical conditions like heart failure, stroke, or certain medications.
- Complex Sleep Apnea Syndrome (Mixed Sleep Apnea): This is a combination of both obstructive and central sleep apnea.

Causes of Sleep Apnea

For Obstructive Sleep Apnea (OSA):
- OSA is primarily caused by anatomical and physiological factors that lead to airway collapse during sleep. Risk factors include
- Excess Weight/Obesity: Fat deposits around the upper airway can obstruct breathing.
- Narrowed Airway: A naturally narrow throat, enlarged tonsils or adenoids (especially in children), or a large tongue can block the airway.
- Older Age: The risk increases with age, as muscle tone tends to decrease.
- Male Sex: Men are more likely to have OSA than women, although the risk in women increases after menopause.
- Family History: A genetic predisposition to OSA can exist due to inherited anatomical traits.
- Neck Circumference: A large neck circumference (e.g., greater than 17 inches for men, 16 inches for women) can indicate increased soft tissue around the airway.
- Certain Medical Conditions: Hypothyroidism, polycystic ovary syndrome (PCOS), diabetes, and high blood pressure are associated with an increased risk.
- Alcohol and Sedatives: These substances relax throat muscles, worsening airway obstruction.
- Smoking: Can cause inflammation and fluid retention in the upper airway, increasing obstruction.
- Nasal Congestion: Chronic nasal congestion can force mouth breathing, which can contribute to airway collapse.
- Sleeping Position: Sleeping on the back can cause the tongue to fall backward and block the airway.
For Central Sleep Apnea (CSA):

CSA is typically caused by medical conditions that affect the brain’s control of breathing, such as:

Heart Failure: People with congestive heart failure often experience CSA.
Stroke or Brain Tumor: Damage to the brainstem, which controls breathing.
Opioid Use: Certain pain medications can affect breathing regulation.
High Altitude: Can temporarily induce CSA.

Symptoms of Sleep Apnea

Common symptoms for both OSA and CSA include:-
- Loud Snoring: (Especially prominent in OSA, often with pauses followed by gasps or snorts).
- Episodes of Stopped Breathing During Sleep: Witnessed by another person.
Gasping or Choking for Air During Sleep.
- Excessive Daytime Sleepiness (EDS): Feeling very tired or drowsy during the day, even after a full night’s sleep. This can lead to difficulty concentrating, irritability, memory problems, and even falling asleep at work, while driving, or watching TV.
- Morning Headache.
- Dry Mouth or Sore Throat upon Waking.
- Insomnia: Difficulty falling or staying asleep.
- Frequent Nighttime Urination (Nocturia).
- Irritability, Mood Changes, or Depression.
- Decreased Libido or Erectile Dysfunction.
Symptoms more specific to CSA:
- Waking up with shortness of breath.
- Difficulty getting to sleep or staying asleep.

Diagnosis of Sleep Apnea:

Medical History and Physical Exam: The doctor will ask about symptoms, medical history, and may examine your mouth, throat, and neck. Information from a bed partner is often very helpful.
Sleep Study (Polysomnography): This is the definitive diagnostic test.
Nocturnal Polysomnography (in-lab sleep study): You spend a night at a sleep center where equipment monitors your heart, lung, and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
Home Sleep Test: For suspected OSA, a simplified at-home test can measure airflow, breathing patterns, heart rate, and blood oxygen levels. It is less comprehensive than an in-lab study but convenient.

Treatment for Sleep Apnea:

Treatment aims to keep the airway open during sleep or address the underlying cause of breathing pauses, improving sleep quality and reducing associated health risks.

Lifestyle Changes :
Weight Loss: Even modest weight loss can significantly improve OSA in overweight or obese individuals.
Avoid Alcohol and Sedatives: Especially before bedtime, as they relax throat muscles.
Change Sleeping Position: Sleeping on your side instead of your back can prevent the tongue from falling back. Positional therapy devices can help.
Quit Smoking: Smoking causes inflammation and fluid retention in the airway.
Treat Nasal Congestion: Use nasal sprays or allergy medications to keep nasal passages open.

Breathing Devices:

Continuous Positive Airway Pressure (CPAP): This is the most common and effective treatment for moderate to severe OSA. A CPAP machine delivers a continuous stream of pressurized air through a mask worn over the nose or nose and mouth during sleep. The air pressure keeps the airway open, preventing apneas and snoring.
Auto-CPAP (APAP): Automatically adjusts pressure throughout the night based on breathing needs.
Bi-level Positive Airway Pressure (BiPAP/BiLevel): Delivers two different pressure levels: a higher pressure during inhalation and a lower pressure during exhalation, which some find more comfortable.

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