If you find yourself waking up frequently throughout the night and never seem to have enough energy to do the things you want to do during the day, you may be suffering from sleep apnea.
“Apnea” is the cessation of breathing, and “sleep apnea” is the medical term that’s used to describe this process when it occurs while a person asleep. While approximately 20 million Americans are affected by sleep apnea, the majority of these people don’t realize it’s a medical diagnosis, so they never seek help for their condition.
What Are the Symptoms of Sleep Apnea?
Symptoms associated with sleep apnea include loud snoring, daytime headaches and daytime fatigue that can lead to irritability and an inability to concentrate. Additionally, untreated sleep apnea can put you at higher risk for a variety of serious health issues, including heart arrhythmias, heart attacks, high blood pressure, diabetes, depression and chronic headaches. Fitful sleep may also lead to excessive daytime sleepiness, which can increase the risk of accidents.
Central sleep apnea (CSA)
For as many as 20% of individuals suffering from sleep apnea, the underlying cause is neurological. The breathing centers in the brainstem fail to send the necessary impulses that signal respiratory muscles to breathe. Central sleep apnea may be related to small, cumulative insults to the brain caused by strokes, heart attacks and chronic conditions like Parkinson’s disease. Sometimes central sleep apnea is triggered by high altitudes.
Obstructive sleep apnea (OSA)
Most people who momentarily stop breathing while slumbering suffer from obstructive sleep apnea. When you’re asleep, your throat muscles relax, which can allow your tongue to roll up against the back of your throat, thereby restricting the flow of air into the lungs. Your brain responds to decreased blood oxygen levels by waking you up just enough to restart the flow of oxygen again. Typically a loud gasping or choking sound accompanies this partial awakening. Once oxygenation begins again, the brain falls back into deeper sleep. In people with mild obstructive sleep apnea, this process occurs as often as 15 times an hour. People with severe OSA, however, may stop breathing as many as 30 times an hour.
What Are the Common Risk Factors for Sleep Apnea?
Common risk factors associated with obstructive sleep apnea include:
Excess weight is one of the most common risk factors associated with obstructive sleep apnea, particularly if the excess weight is in the neck or trunk area. Fatty tissues around the throat can block the flow of air. Sleep-associated breathing disorders also lead to grogginess throughout the day that can make it difficult to sustain an exercise program that may be able to help you lose weight.
As people age, their muscles tend to lose tone. This is as true for the muscles in the throat area as it for muscles elsewhere in the body. Slack throat musculature can contribute to airway obstruction during sleep.
Men are twice as likely as women to be diagnosed with sleep apnea.
Statistically, people with thicker necks have a higher incidence of obstructive sleep apnea. Men whose neck circumference is 17 inches or higher and women whose neck circumference is 15 inches or higher are more likely to develop the symptoms associated with sleep apnea. Additionally, if your throat is more likely to be inflamed due to allergies, or you suffer from chronic nasal obstruction due to allergies, sinus problems or a
People with throats that are narrower, or deal with tonsils, adenoids or tongues that are larger than average may also be predisposed towards developing sleep-related breathing disorders. In fact, if a close family member has been diagnosed with obstructive sleep apnea, you have a higher likelihood of being diagnosed with it yourself.
Smoking and alcohol use
Smokers develop sleep apnea at three times the rates of nonsmokers. Smoking irritates the tissues of the nose and throat, which restricts the free flow of air. Nicotine withdrawal can also disrupt the natural sleeping-waking cycle. Alcohol consumption relaxes throat musculature and decreases the respiratory drive. People with significant blood alcohol levels breathe more slowly and more shallowly, which can lead to under-oxygenation.
What’s the Best Treatment for Obstructive Sleep Apnea?
Obstructive sleep apnea is a very serious health challenge. While patients with this disorder can implement some lifestyle changes such as weight loss and smoking cessation without medical supervision, if you suspect you’re suffering from OSA, it’s wise to tell your primary healthcare provider right away. A definitive diagnosis can only be made following a thorough physical examination of your nose and throat, and a sleep study.
The first line of treatment for OSA typically involves the use of medical devices such as mouth guard or a continuous positive airway pressure (CPAP) machine. A mouth guard may be able to keep your airway unimpeded by immobilizing your tongue while a CPAP machine uses a steady stream of air to keep your airway patent. Both these treatments, however, often feel very restrictive to patients in ways that may also interfere with restful sleep. Moreover, in instances when a significant anatomical irregularity is contributing to OSA, medical devices may be of only limited effectiveness.
Interventions such as orthognathic surgery promise a more permanent solution to OSA. Surgeons can actually make minor adjustments to maxillary and mandibular bones that can increase the size of the airway. The procedure is performed under general anesthesia and usually involves a one- or two-day stay in the hospital as surgical inflammation around the operation site subsides. Recognizing that obstructive sleep apnea is a major wellness issue, an increasing number of healthcare plans are electing to cover this procedure.
As a board-certified maxillofacial surgeon with extensive training in cosmetic dentistry, dental anesthesia and facial reconstructive (orthognathic) surgery, Dr. Majid Jamali performs numerous surgeries every year aimed at correcting obstructive sleep apnea. Dr. Jamali and his team are based in New York City. For more information and to set up an appointment to explore the surgical alternatives that may be available to you, contact Dr. Jamali’s office today.