What is obstructive sleep apnea?
Obstructive sleep apnea (OSA) or sleep apnea is a disease that causes breathing disorders involuntarily for a short time during sleep. Normally, air flows smoothly from the mouth and nose into the lungs. The period when breathing stops is called apnea or asphyxia. In OSA, normal airflow is repeatedly stopped throughout the night. The air stops flowing because the airway space in the throat area is too narrow. Snoring is a characteristic of obstructive sleep apnea. Snoring is caused by airflow through a narrow airway space. Untreated sleep apnea can cause serious health problems, such as:
Correct diagnosis and treatment are essential to prevent complications.
Symptoms of sleep apnea
Symptoms of sleep apnea
Sleep apnea causes a decrease in oxygen supply to the brain and other parts of the body. Lack of deep sleep causes poor sleep quality, long sleep time, and lack of sleep leads to sleepiness during the day and lack of clarity in the morning. People with sleep apnea may also experience the following symptoms:
Other symptoms include:
Poor performance at work and school
Lost interest in sex
Swelling of the legs (called edema, which occurs when sleep apnea is severe)
Daytime sleepiness puts people suffering from sleep apnea at risk of motor vehicle collisions and industrial accidents. Treatment can help completely relieve daytime sleepiness caused by sleep apnea.
What causes sleep apnea?
There are several types of sleep apnea, but OSA is the most common. OSA is more likely to occur in the elderly and overweight people. There is evidence that weight loss can significantly improve symptoms. Sleeping face up can aggravate sleep apnea.
Types of sleep apnea
The three types of sleep apnea are:
Obstructive sleep apnea: This is the most common type in which the airway becomes narrow, blocked or loose.
Obstructive sleep apnea
Central sleep apnea: The airways are not blocked, but the brain does not send out signals to breathe in the breathing muscles.
Mixed sleep apnea: This is a combination of obstructive and central sleep apnea.
Who is at risk of obstructive sleep apnea?
If your condition or characteristics make the upper airway narrow, the risk of OSA increases. Risk factors for OSA include:
Children with large tonsils and adenoids
Men with a collar size of 17 inches or larger
Women with a collar size of 16 inches or more
Big tongue, which may block the airway
Retraction of the lower jaw, when your lower jaw is shorter than your upper jaw
Narrow upper jaw or airway, easier to collapse
Heart disease is more common in obese people. Obesity is a risk factor for heart disease, high blood pressure and sleep apnea.
How is sleep apnea diagnosed?
The diagnosis of sleep apnea begins with a complete medical history and physical examination. The history of daytime sleepiness and beating is an important clue. Your doctor will examine your head and neck to discover any physical factors related to sleep apnea. Your doctor may ask you to fill out questionnaires about daytime sleepiness, sleep habits, and sleep quality. The tests that can be performed include:
Polysomnography usually requires you to spend the night in a hospital or sleep research center. The test lasted all night. When you sleep, a polysomnogram will measure the activities of different organ systems related to sleep. It may include:
Electroencephalogram (EEG), used to measure brain waves
Electro-oculogram (EOM), used to measure eye movements
Electromyography (EMG), used to measure muscle activity
Electrocardiogram (EKG or ECG), which can measure heart rate and rhythm
Pulse oximetry test, which can measure changes in blood oxygen levels
Arterial blood gas analysis (ABG)
Electroencephalogram and electrooculogram (EOM)
During the EEG process, electrodes are connected to your scalp to monitor brain waves before, during and after sleep. EOM records the movement of the eyes. Place a small electrode 1 cm above the outer corner of the right eye, and place the other electrode 1 cm below the outer corner of the left eye. When the eyes leave the center, this action will be recorded.
Brain waves and eye movements tell the doctor the timing of the different stages of sleep. The sleep stage is non-rapid eye movement (rapid eye movement) and rapid eye movement (rapid eye movement). Dreams occur during REM sleep, muscle tone and movement are reduced, and paralysis.
During EMG, two electrodes are placed on the chin: one above the mandibular line and the other below the mandibular line. Place another electrode on each tibia. EMG electrodes absorb the electrical activity generated during muscle movement. Deep muscle relaxation should occur during sleep. When your muscles relax and exercise during sleep, EMG will recover.
A 12-lead ECG can help your doctor determine if there is heart disease. Long-term high blood pressure can also cause changes in the electrocardiogram. Monitoring the heart rate and rhythm allows the doctor to see if heart disease has occurred during an apnea episode.
In this test, a small device called a pulse oximeter is clamped to a thin area with good blood flow (such as a fingertip or earlobe). The pulse oximeter uses a miniature transmitter with red and infrared LEDs to measure the amount of oxygen in the blood. During an apnea episode, the amount of oxygen or oxygen saturation in the blood decreases. Generally, the oxygen saturation is about 95-100%. Your doctor will explain your results.
Arterial blood gas (ABG)
In this study, a syringe was used to obtain blood from the arteries. Arterial blood gas measures several factors in arterial blood, including:
Oxygen partial pressure
Partial pressure of carbon dioxide
This test will provide your doctor with more detailed information about oxygen, carbon dioxide, and blood acid-base balance. It will also help your doctor know if and when additional oxygen is needed.
The purpose of treating sleep apnea is to ensure that the airflow is not blocked during sleep. Treatment methods include:
Weight loss can relieve the symptoms of OSA well.
Nasal congestants are more likely to be effective in mild OSA. They can help alleviate snoring.
Continuous Positive Airway Pressure (CPAP)
Continuous positive airway pressure (CPAP) therapy is the first line of treatment for sleep apnea. CPAP is managed by wearing a sleep ventilator mask at night. The mask gently provides positive airflow to keep the airway open at night. The positive airflow supports the opening of the airway. CPAP is a highly effective method for the treatment of sleep apnea. It may also be necessary to use dental equipment to keep the lower jaw positioned forward.
Continuous positive airway pressure
Bilevel positive airway pressure (BiPAP or BPAP)
If CPAP treatment is ineffective, a bilevel positive airway compressor is sometimes used to treat OSA. The BiPAP machine has high and low settings that can respond to your breathing. This means the pressure change between inhalation and exhalation.
Because lying on the back (supine position) can worsen sleep apnea in some people, position therapy can help people with sleep apnea learn to sleep in other positions. Discuss the use of position therapy and CPAP with professionals in the sleep center.
Uvulopharyngoplasty (UPPP) involves removing excess tissue from the back of the throat. UPPP is the most common type of surgery for OSA, and it helps to reduce the impact. However, this operation has not been proven to completely eliminate sleep apnea and may cause complications.
A tracheotomy can be performed as a last resort. The tracheotomy pierces the opening in the trachea, thereby bypassing the blockage in the throat.
When sleep apnea does not respond to treatments such as CPAP, other surgical procedures may be required to correct structural problems in the face and other areas. Due to enlarged tonsils or adenoids, about 75% of children with OSA can be relieved by surgery. According to the American Sleep Apnea Association (ASAA), the American Academy of Pediatrics has approved surgical removal of tonsils and adenoids as the treatment of choice for children with sleep problems due to enlarged tonsils or adenoids.
What is the outlook for sleep apnea?
If you feel sleepy during the day or have persistent sleep problems, be sure to talk to your doctor. There are many different treatment options for OSA that can make symptoms easier to manage. Your doctor will create a treatment plan that combines lifestyle changes with other treatments.