Sleep apnea – causes, symptoms, diagnosis, treatment, pathology

Sleep apnea – causes, symptoms, diagnosis, treatment, pathology


Sleep apnea is
a sleep disorder which causes irregular breathing and snoring patterns that can ultimately cause
apnea, which is where a person momentarily stops breathing altogether. The inability
to get restful sleep can also lead to severe exhaustion. Individuals can have obstructive sleep apnea,
central sleep apnea, or features of both. Obstructive sleep apnea is the most common
form, and it develops when there’s a blockage of the airways. Air has to go from the nose
through the nasopharynx into the laryngopharynx, through the larynx and then into the trachea.
Somewhere along that path, there might be a blockage in the flow of air. Allergies might
cause swelling of the tissue in the nasopharynx, or there might be swollen adenoid glands or
tonsils because of an infection. There might be a severe overbite which pulls the jaw back
and blocks the airway. In individuals that are overweight, there could be too much weight
in the soft tissues of the neck, which can weigh down the airway especially when a person
is lying down. These problems are most obvious at night because hormonal changes at night
cause the muscles around the airway to becomes slightly less stiff while sleeping. This means
that they are less able to keep the airway open, making it more likely to get a bit squashed
or obstructed. Central sleep apnea refers to the fact that
the problem is “central” or related to the central nervous system. This is where
the brain intermittently stops making an effort to breathe for 10 to 30 seconds. The apnea
can persist for several seconds even after waking up, triggering feelings of panic and
further disrupting the sleep cycle. Central sleep apnea starts with an initial episode
of hyperpnea, which is when the brain directs the lungs to start hyperventilating during
sleep by increasing the respiratory rate. This rapid breathing causes hypocapnia, a
drop in the blood’s carbon dioxide levels. When the carbon dioxide falls below a certain
threshold, the body slips into a state of apnea, making no effort to breathe and taking
in no oxygen. This causes the carbon dioxide levels to rise back to normal levels and then,
as the apnea persists, they keep rising to which is called hypercapnia. The really high
carbon dioxide levels triggers hyperpnea again, and the cycle starts all over. Essentially,
the respiratory system is going rapidly back and forth between two states, first making
no effort to breathe and then hyperventilating, with no in-between. The most common symptom of sleep apnea is
severe sleep deprivation. Interrupted sleep can cause nocturia, the excessive need to
urinate during the night and stress-induced insomnia. The effects are also apparent during
the day, because the loss of restful sleep leads to difficulty concentrating, headaches,
and fatigue. Apneic episodes are usually preceded by loud snoring, which can interrupt the sleep
of other people as well. Sleep apnea on its own is rarely fatal, but it can worsen other
health problems. For example, drops in oxygen levels can trigger anginal chest pain, and
can irritate heart cells leading to an arrhythmia—an irregular heartbeat. Broadly speaking, individuals
with sleep apnea have a higher risk for heart failure, respiratory failure, diabetes, and
certain types of cancer. Diagnosing sleep apnea requires a sleep study
to help identify episodes of sleep apnea, the more episodes the more severe the sleep
apnea. A sleep study usually involves getting monitored overnight with a polysomnogram.
A polysomnogram tracks things like brain movement, oxygen and carbon dioxide blood levels, vital
signs, and outward symptoms like snoring and movement. Treating sleep apnea starts with avoiding
things like sleeping pills, alcohol, and other depressant medications because they can relax
the throat muscles around the airway and make the airways more likely to collapse during
sleep. In addition, sleeping on the side instead of on the back can also help because it creates
better airflow into the lungs. For severe sleep apnea, individuals can use a continuous
positive airway pressure device or CPAP device for short. This machine forces the airways
open with a steady stream of pressurized air delivered through a plastic facemask or nasal
prongs. Used properly, This is very effective, but it requires continuous use. Many people
eventually stop using it, finding it annoying or difficult to wear, and the problem persists.
Some people with obstructive sleep apnea can benefit from custom made oral mouthpieces
that help improve airflow during sleep. Sometimes, obstructive sleep apnea can be managed surgically,
for example removing large adenoid tissue or realigning the jawbone, however, procedures
can be complicated because the anaesthesia and surgical swelling can both worsen sleep
apnea in the short term. All right, as a quick recap – sleep apnea
can be due to physical obstruction of the airway or from a neurological malfunction
initiated by imbalances in the blood’s oxygen and carbon dioxide levels, which regulate
breathing cycles. Left untreated, the condition can interact negatively with other underlying
health conditions, leading to serious complications.

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