Sleep apnea is defined as episodes where there is a stop of breathing than last ten seconds or more while sleeping.
Episodes of apnea disrupt the normal sleep cycle impeding a proper rest. It leads to daytime drowsiness, which is a typical feature of the disorder.
While sleeping, the muscles located at the base of the throat can obstruct the airway resulting in loud snoring and difficulty breathing. If the airway is totally obstructed the breathing stops and the patient may experience partial or complete wakefulness.
Breathing obstruction prevents the patient from entering deeper stages of sleep, leading to symptoms of daytime drowsiness.
The prevalence of sleep apnea is estimated around six out of every hundred people.
The primary risk factors for developing sleep apnea in adults are:
In children, in addition to a family history and oral and nasal abnormalities similar to those seen in adults, the risk factors for developing sleep apnea are:
The most common presentation of obstructive sleep apnea is snoring shortly after falling asleep. The snoring is typically rhythmic and may become progressively louder, but is then abruptly interrupted by periods of silence during which no breathing occurs (apnea).
The apnea is then followed by a sudden and audible gasp or snort before resuming normal breathing patterns. This pattern may occur multiple times throughout the night. Additionally, during apneic episodes, the oxygen levels in the bloodstream may decrease.
Persistent low levels of oxygen, also known as hypoxia, can result in various daytime symptoms. However, it's important to note that the affected individual may not experience dyspnea, or difficulty breathing, despite these symptoms.
The most common symptoms related to sleep apnea are:
In addition to the previously mentioned symptoms, the following may also be associated with this disease:
Patients presenting with the described symptoms and one or more risk factors should undergo testing to rule out sleep apnea.
Additionally, individuals with chronic diseases such as hypertension, diabetes, heart disease, or a history of cerebrovascular diseases should also be considered for these studies.
To begin the evaluation process, patients and their partners (if available) should be questioned regarding symptoms such as snoring, gasping, snorting, and periods of breathing cessation during sleep.
If a physical abnormality of the mouth or throat is suspected, a thorough examination by an otorhinolaryngologist is recommended to identify any anatomical anomalies.
Other tests (usually performed by a pulmonologist) may include:
The primary objective of treatment for sleep apnea is to establish and maintain an open airway to prevent apneic episodes during sleep.
Weight management and avoiding alcohol and sedatives at night can be effective in reducing symptoms.
If these lifestyle measures are insufficient and the obstruction persists, other treatment options are available:
Oxygen therapy may be beneficial in certain cases to improve symptoms.
When there are structural causes of sleep apnea, surgical interventions may be necessary. These can include:
Maintaining a healthy weight and avoiding alcohol and sedatives can be effective in reducing the risk of sleep apnea.
In children, adenoiditis and tonsillar hypertrophy can cause obstructive sleep apnea, which can lead to various health problems. In such cases, the treatment options may include tonsillectomy and adenoidectomy.
Although treatment can be effective, it may not always work for everyone. Additionally, some patients may find it difficult to lose weight or may struggle to comply with the treatment due to its discomfort or inconvenience.
In severe cases where the condition is left untreated, sleep apnea can lead to the development of pulmonary hypertension, which may cause right-sided heart failure (cor pulmonale) or myocarditis.
If you experience symptoms of obstructive sleep apnea, it is important to contact your doctor for an evaluation.
You should schedule an appointment with your healthcare provider if you have this condition and your symptoms do not improve, or if you experience new symptoms.
In some cases, such as when you experience decreased consciousness, extreme drowsiness, hallucinations, personality changes, or persistent confusion, it may indicate a medical emergency and prompt medical attention is necessary.