Dr.K.O.Paulose FRCS (UK).
Consultant ENT Surgeon, Jubilee Hospital, Trivandrum.
Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep (Apnea and Hypopnea). Loud snoring is always present with OSA (Obstructive Sleep Apnea).
In OSA breathing pauses can last from a few seconds to minutes. They often occur 10 to 30 times or even more, say several hundreds of times in one night sleep.
It is believed that untreated sleep apnea can lead to high blood pressure, stroke, heart disease, memory problems, headaches; increase risk for or worsen heart failure; diabetes, make irregular heartbeats more likely; increase chance of having work-related or driving accidents and academic underachievement in children and adolescents.
Symptoms of OSA
The symptoms include loud snoring, daytime drowsiness/sleepiness, cessation of breathing during sleep, choking, night sweats, morning headaches, loss of concentration memory loss, loss of sexual drive-libido and many others.
Cause of Sleep apnea (OSA)
Narrowing or collapse of throat tissues during sleep causes OSA and Snoring. When this happens, oxygen levels fall, carbon dioxide levels rise, and there is a spike in blood pressure, heart rate, and hormones as the body reawakens to breathe.
Most people think it is people who are overweight or over the age of 40 that get sleep apnea. That is not true. There are slim, trim teenagers who have sleep apnea, although this is rare.
Sleep apnea has been linked to many chronic medical conditions, and even sudden death.
It is estimated that 50-70% of people with sleep apnea have hypertension, or high blood pressure. This increases the risk for heart attack, stroke, and other health problems.
In people with hard-to-control hypertension, it may be that sleep apnea is contributing.
Sleep Apnea and sudden death is something that appears to be on the rise from this deadly disorder. In a study of patients who died suddenly who had had recent sleep studies performed, it was shown that almost half of the patients with sleep apnea died between the hours of midnight to early morning-“silent death”, but no so silent.. It is possible that these individuals died suddenly during periods of apnea.
Coronary Heart Disease (CAD)
The risk for cardiovascular disease increases due to several mechanisms. Sleep apnea can lead to activation of the sympathetic nervous system. In addition, sleep apnea leads to problems with the lining of blood vessels, inflammation, and problems with metabolic regulation. All of these can cause problems with blood vessels and lead to major problems like a heart attack.
When apneic events occur, the decreased levels of oxygen can cause blood vessels in the lungs to constrict. This increases the blood pressure in these vessels and over time may lead to chronic right-sided heart failure. High blood pressure is a major contributor to left-sided heart failure. Some studies have shown that as many as 40% of people with heart failure may have sleep apnea.
According to research, the association between stroke and sleep apnea is perhaps as strong as the association between smoking and stroke. There may be several factors involved. During apnea, blood vessels within the brain dilate when the oxygen levels fall. Moreover, individuals with sleep apnea have higher levels of blood factors that make them more susceptible to clots that may lead to stroke. Approximately 40-60% of people with stroke are found to have obstructive sleep apnea.
After trying conservative treatment like loosing weight, avoiding alcohol, smoking, sleeping pills, doing Yoga and exercise, if symptoms still persist:
You have 2 options-Use CPAP or Get Surgery done.
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