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Sleep Apnea Types, Diagnosis and Treatment
Sleep apnea is a common sleep disorder which is characterized by shallow breaths or infrequent pauses in breathing while a person is asleep. The abnormal shallow breaths are referred to as hypopnea. Pauses in breathing are caused by blockage of the airway and can last from several seconds to a few minutes. Each pause in breathing is scientifically referred to as apnea. In most cases, the patient resumes normal breathing for a few moments after each apnea. The condition is classified as dyssomnia because it interferes with the quality of sleep and causes excessive daytime sleepiness.
Palta & Dempsey (2013) explains that although sleep apnea can affect anyone, smoking and consumption of alcohol, sedatives, and tranquilizers increases the risk of this condition. Other risk factors include allergies, sinus problems, enlarged tonsils, and obesity. The National Institutes of Health estimates that more than 12 million Americans have sleep apnea, with a majority not knowing that they are suffering this condition.
Different Types of Sleep Apnea
There are three types of sleep apnea that can affect anyone at any age or at any given point in life: obstructive sleep apnea (OSA), central sleep apnea (CSA), and complex (or mixed) sleep apnea. Obstructive sleep apnea (OSA) is the most prevalent type of sleep apnea affecting many people in the world. Active smoking, aging, and being overweight increases the risk of OSA. Study shows that people who are born with low muscle tone and enlarged tonsil tissues are likely to suffer this condition. Likewise, individuals with structural features that give way to a narrowed airway, as well as the elderly people and individuals who have soft tissue in their throat, are also at high risk of being affected by OSA.
Obstructive sleep apnea is caused by blockage or collapse of the air passage-way during sleep. Young & Peppard (2012) explain that the blockage of the airway is often caused by relaxation of muscles in the back of the throat, resulting in shallow breathing or breathing pauses, which are usually accompanied by loud snoring.
Central sleep apnea (CSA) is a less common type of sleep apnea, which mostly affects adults who are older than 65 years. This disorder is caused by a lack of respiratory effort due to dysfunction of the part of the brain that controls breathing. It occurs when the part of the brain that controls breathing fails to transmit a signal to the breathing muscles. This means that the patient makes no effort to breathe for a short period of time. People suffering from CSA usually awaken with shortness inbreathe and find it difficult to sleep or to stay asleep.
Central sleep apnea is thus a serious condition that is more common in elderly people and those with certain medical conditions. Brain tumors, stroke, and heart disorders (such as atrial fibrillation) are some of the conditions which are known to alter the normal function of the brain to regulate breathing. CSA is more difficult to detect because typically snoring never occurs.
Diagnosis
Sleep apnea is a chronic condition that goes undetected by doctors because there is no known blood test that can help diagnose the condition. Since it occurs during sleep, most patients who suffer from the disorder are unaware of their condition. Only close family members or sleeping partners might be able to detect this disorder. Diagnosis of sleep apnea is, therefore, done through several conjoint analysis tests.
Diagnosis involves the study of clinical symptoms such as daytime sleepiness and evaluation of sleep study, which is done by running home-based tests. Asleep study (also known as polysomnography) is performed to determine the objective diagnosis indicator by establishing the frequency of occurrence of apneic events per hour of sleep. Home-based tests (also known as oximetry), are usually performed overnight in the patients home during routine sleeping hours. Such home-based tests are easier to administer and are often more precise compared to polysomnography. Home tests are also preferred because they provide a guiding prescription for self-management of the condition.
Treatment
Being a chronic disorder, sleep apnea requires long-term management since it can increase work-related risks and accidents or increase the chances of high blood pressure, heart attack, and stroke. Treatment of sleep apnea often starts with behavioral therapy and lifestyle changes. Many patients are often advised to quit smoking and avoid taking alcohol, prescription drugs, or other sedatives such as sleeping pills that interfere with brain function and which cause relaxation of respiratory muscles in the throat. Doctors also often advise patients to sleep on the side since the condition worsens when patients sleep on their back.
The condition is also managed successfully by the use of mouthpieces and breathing devices. A continuous positive airway pressure (CPAP) is a common breathing device that can be used by patients with severe OSA to manage their condition effectively. Another device used by patients with moderate OSA is the automatic positive airway pressure (APAP). Both devices are designed to ensure a steady supply of air for the patient by keeping the airway open by means of pressurized air. Treatment through several surgery procedures (sleep surgery) is also possible, although it is often deployed as the ultimate treatment option for patients with severe OSA who fail to respond well to breathing devices. Surgical treatment of tissues in the throat is a delicate procedure and is often individualized. It involves a lot of care to ensure that only the specific areas of obstruction are rectified.
References
Palta, M., & Dempsey, J. (2013).The Occurrence of Sleep Disordered Breathing in Young People. New England Journal of Medicine, 70(1), 102. Web.
Young, T., & Peppard, E. (2012). Epidemiology of Obstructive Sleep Apnea. American Journal of Respiratory and Critical Care Medicine, 101 (2), 48. Web.
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