Willoughby Hills patient guide to sleep apnea
You might call it sawing logs, mowing hay, or hitting a knot. No matter what name you use, snoring can disrupt sleep and strain relationships. It can also signal a very serious health condition known as sleep apnea, which is treatable at our Snoring & CPAP Solutions LLC office in Willoughby Hills.
Understanding Sleep Apnea
Apnea is a classification of sleep disordered breathing. It is characterized by pauses in breathing during sleep. There are two types of apnea. Central sleep apnea (CSA), the less common form, is caused by interruptions in the brain signals that “tell” the body to breath. Obstructive sleep apnea (OSA), which is much more common, is caused by a physical blockage or collapse of the airway. Complex sleep apnea refers to a combination of obstructive and central apnea.
Analysts estimate that more than 20 million Americans are afflicted with apnea, primarily OSA. However, the exact numbers are unknown, because this potentially serious disorder often goes undiagnosed. In fact, most people don’t even realize that they have a problem, because they never fully wake during an apneic episode. Why?
We tend to think of just two states of consciousness, we are either asleep or awake. However, the brain actually goes through multiple stages, from drowsiness to deep sleep. When we first fall asleep, we lose awareness of what is going on, but the brain and body remain essentially “on alert.” Gradually, we sink into deeper sleep, brain waves slow, and muscles enter an enhanced state of relaxation. This deeper sleep is when the mind and body rest; it is also when apnea strikes.
If the airway is especially narrow, crowded by excess soft tissue, or otherwise blocked, the complete relaxation of muscles can close it. Breathing stops, until the brain registers a lack of oxygen, triggering an increase of adrenaline. The heart rate and blood pressure increase, and brain activity increases. As a result, the individual begins to wake, first transitioning from deep to lighter sleep. When deep sleep ends, muscles automatically tighten, reopening the airway, usually with choking and snoring. Sensing the crisis has passed, the brain begins to calm, and slip back into deeper sleep. With deeper sleep comes muscle relaxation, and the cycle repeats.
Potential health risks
During an apneic event, the body is very briefly subjected to coronary strain, oxygen deprivation, and more. If this only happened once, it would be harmless. However, it isn’t just once. It can happen as often as hundreds of times every hour, with a potentially devastating cumulative impact on your health.
Untreated sleep apnea has been associated with:
- Cognitive disfunction – Chronic disruptions in sleep deprive the mind and body of an essential resting phase. Apnea can lead to problems such as excessive daytime sleepiness, fatigue, and brain fog. It has been shown to increase the risk of having a traffic accident, due to reduced alertness.
- Hypertension (high blood pressure) – In addition to minor spikes in blood pressure during apneic events, this condition can worsen existing hypertension. Sleep apnea treatment may lower blood pressure in some patients.
- Stroke and heart disease – Obstructive sleep apnea patients are more likely to have heart attacks. This condition has also been linked to irregular heartbeat (atrial fibrillation), stroke, and similar health problems.
- Diabetes – There is a strong connection between apnea and diabetes, though a cause-and-effect link has not been established. Four out of five adults with type 2 diabetes also have obstructive sleep apnea.
- Obesity – There seems to be a two-way link between these conditions. Overweight individuals have a higher risk of obstructive sleep apnea, due to fat accumulation in the neck area. People with untreated apnea have greater difficulty losing weight, thus creating a “catch 22” situation.
- Asthma – A link has not been scientifically confirmed but not disproven. However, many asthmatic patients have self-reported fewer attacks after beginning sleep apnea treatment.
Sleep apnea is associated with a number of potentially deadly diseases, yet many afflicted people don’t know they have it. This has led apnea to be dubbed a “silent killer,” but that is a bit of a misnomer. In reality, it is quite loud, as an apnea patient’s sleeping partner can attest to.
The symptoms of sleep apnea include:
- Snoring – This is the most common and recognizable symptom. Apnea patients typically have frequent, loud bouts of snoring, interspersed with brief silences.
- Nighttime choking – Immediately following an apneic event, the person may gasp, cough, or snort, often without fully waking.
- Fatigue – Apnea patients do not get adequate rest during sleep. They might have trouble waking up in the morning, doze off during the day, or simply feel run down constantly.
- Insomnia – Sometimes a person does completely wake up, usually without realizing why. Some apnea patients feel like they just can’t stay asleep, no matter how tired they are.
- Headaches – It is common for a person with apnea to wake with a headache in the morning, which usually fades gradually.
It can affect anyone, at any age. However, some people have a greater risk including: people over the age of 40, anyone with a large neck, obese or overweight people, and males.
No. Snoring is the sound produced when the airway is restricted, but not closed. In and of itself, snoring is harmless because the person is still breathing, although loudly. However, it is also a red flag, because snoring is the number one symptom of apnea. There is no breathing during an apneic event, but there is usually loud snoring immediately after, when the airway is beginning to reopen.
No. Snoring is a common symptom. However, every person is different. It is possible to have apnea without snoring.
A medical examination or self-assessment might indicate the potential for sleep apnea. However, the only way to accurately diagnose sleep disorders is with a sleep study, which may be performed in a laboratory or with an at-home test.
There are several potential factors. Some people naturally have a narrow airway, or it may be restricted by facial anatomy, such as a small jaw. In other cases, obesity, inflammation, or excess laxity of soft tissues in the area.
CPAP (continued positive airway pressure) is a machine that forces air into the airway, keeping it open during sleep. It is considered very effective when used correctly and consistently. However, patient compliance is low because many people object to the uncomfortable mask, constant noise, and cumbersome machine.
Yes! Many patients who cannot tolerate CPAP find relief with a comfortable, convenient, custom-made oral appliance. It works by stabilizing oral structures during sleep, preventing airway collapse.
Some patients report mild muscle soreness in the mornings, especially for the first few days. Most people adjust to wearing the appliance within about ten days, and find it to be very comfortable. They are considered safe and effective, with over 100 appliances having earned FDA clearance.
We test the effectiveness of the therapy with a follow-up sleep test. The results are compared to those of the pre-treatment test to measure improvement.
That depends entirely on the specific insurance carrier and policy. Generally speaking, dental insurance rarely covers apnea appliances, but medical insurance may. Please contact your provider to find out the limits of your coverage. We would be pleased to research your medical coverage as well!
Avoid sleeping on your back. Side sleeping is much better. Most importantly, treat your apnea, don’t just cope with it. If you are unhappy with your current solution, look into alternatives.
Just contact our Snoring & CPAP Solutions LLC office in Willoughby Hills (near Classic Lexus) and arrange a free apnea consultation with Dr. Stern.