What are the new sleep apnea treatment and its types & symptoms?

Apnea is a derivation from the Greek word apnoia meaning absence of respiration or from apnos meaning without breathing. When understood literally, sleep apnea is potentially serious condition in which the breathing in a person stops and restarts multiple times in their sleep. Often, people who snore or wake up tired even after a full night’s sleep are known to suffer from this condition.

To qualify as sleep apnea, the breathing in a sleeping person must regularly stop for 10 seconds or more and the condition may be mild, moderate or severe based on the number of times within an hour that a sleeping person stops and restarts breathing.

The Apnea–Hypopnea Index (AHI) is an index used to indicate the severity of sleep apnea. It is represented by the number of apnea events per hour of sleep. The pauses in breathing must last for 10 seconds or more and be associated to decrease in blood oxygen level to qualify as sleep apnea.

Based this index, sleep apnea is graded on severity i.e. an AHI of less than 5 is considered normal. An AHI of 5-15 is mild; 15-30 is moderate and more than 30 events per hour characterize severe sleep apnea.

In India, almost 13% of the population is under threat of this disorder. The prevalence of sleep apnea is also higher in western parts of the country with as many as 19.7% men and 7.4% women suffer from it. Given this context, it is important for us to understand this condition.

TYPES OF SLEEP APNEA

There are three types of sleep apnea:

Obstructive sleep apnea

This is the most common kind of sleep apnea. It occurs when the muscles of the throat relax.

Central sleep apnea

This is the kind of sleep apnea in which the brain is not able to send signals to the muscles which control the breathing.

Complex sleep apnea syndrome

This is the combination of both the above mentioned sleep apnea variants.

CAUSES OF SLEEP APNEA

To understand this condition, it is important to understand the causes of a sleep apnea i.e. the reasons why there is a loss of control over breathing especially while asleep:

1. The most common cause is being overweight, especially in adults. The excess weight is associated with the soft tissues of the throat and mouth which, in sleep, relax and obstruct the airway leading to physical obstructions.

2. In children, an enlarged adenoid gland or tonsil can lead to this condition and so can dental issues like having a large overbite.

3. Excessive muscle relaxation during the night when a person sleeps. Normally, the relaxation does not lead to any issues but in sleep apnea it does.

4. Lapse in neurological control of breathing caused due to a stroke, heart failure or change in altitude.

RISKS ASSOCIATED WITH SLEEP APNEA

A lapse in regular breathing at night can actually lead to a couple of risks which people must be aware of:

1. Sleeping flat on the back can aggravate the condition
2. Early onset of obesity or recent weight gain, especially around the neck, can manifest into sleep apnea
3. Menopause and complications associated with it are risks associated with sleep apnea
4. Smoking
5. A family history of sleep apnea

SYMPTOMS OF SLEEP APNEA

So how do you know that you may have sleep apnea which may in fact need care on your part as well as a visit to the doctor?

It is important to be sensitive and mindful of the following symptoms, especially since the various kinds of sleep apnea have overlapping symptoms:

1. Restlessness in sleep or worse, insomnia
2. Loud snoring and recurrent awakening during the night
3. Waking up feeling tired and sleepiness during the day
4. Mood swings and irritability with a lack of energy, disinterest in sex and attention issues / forgetfulness
5. Morning headaches
6. Abrupt awakening in the night with a choking or gasping sensation

DIAGNOSIS FOR SLEEP APNEA

Sleep apnea diagnosis is essentially done through observation and recording the patient’s sleep patterns via tests like:

1. Nocturnal polysomnography

In this test, while the patient is asleep, he / she is hooked up to equipment that monitor the activity of heart, lungs and brain and the movement of the arms and legs.

2. Home sleep tests

Doctors may recommend a simple home sleep test where if the oxygen level in the blood changes as you sleep and subsequently wake up along with other changes in bodily function it is an indicator of sleep apnea.

3. Sleep labs

A doctor may recommend a sleep lab study in a sleep lab to monitor the sleep disorder more closely and pinpoint the exact disorder. The patient undergoes a polysomnography here as well and is put through a sleep test which is similar to the home sleep test

All these tests are offered by Apollo Spectra, for diagnosis of Sleep Apnea.

TREATMENT FOR SLEEP APNEA

Treating sleep apnea is very important, especially in kids. There are ways to get it treated which includes management of symptoms or medical intervention. Managing the symptoms include:

1. Lifestyle changes like losing weight and quitting the habit of smoking

2. Changing positions in sleep help with the breathing

3. Medication to treat nasal allergies in order to breathe better

4. Devices and therapies which help alleviate the symptoms like a CPAP device which increases the air pressure flowing into the nostrils thus keeping the pipes accessible or EPAP which are one-time use devices to ease breathing or oral appliances designed to keep the throat open.

5. Seeking help from sleep medicine specialists. Sleep medicine specialists are trained in the diagnosis and treatment of sleep-related disorders including sleep apnea and practice sleep medicine, which is a subspecialty dealing in treatment and therapy of sleep. Their specialty makes them equipped to deal with sleep apnea and its related symptoms more thoroughly and vigorously.

If these don’t bring relief, it is possible that one might need medical intervention in the form of surgery. Medical treatments only help with the symptomatic relief but won’t correct the condition.

Medical treatments offered at Apollo Spectra include:

1. Firstly, diagnosis is paramount with the help of sleep study, also called as nocturnal polysomnography, where a person’s brain waves, heart beats, eye and leg movement are all recorded as he or she sleeps. Home sleep tests are also administered to understand the severity of the condition.

2. Dental devices which are made by dental specialists in the field of sleep apnea are used to alleviate the symptoms and sometimes correct the breathing pattern.

3. There are minimally invasive procedures which reduce and stiffen the soft tissue of the soft palate. These procedures are most effective in treating snoring.

4. Surgery may be unavoidable if a deviated septum, enlarged tonsils or a small lower jaw with an overbite are causing the sleep apnea especially nasal surgery.

5. Other surgeries include Mandibular maxillomandibular advancement surgery which corrects facial problems or throat obstructions, implants into the soft palate, tracheostomy or tissue removal at the back of the throat

At Apollo Spectra, doctors who are trained in sleep medicine come together to establish the best route of treatment for your case of sleep apnea. Neurologists, psychiatrists, cardiologists as well as pulmonologists may also be involved, depending on the severity of the condition. Our patients have access to all the latest tools and technology for their diagnosis as well as treatment. Our doctors are also involved in research to find better treatment options for sleep apnea and other such disorders related to sleep.

We aim to provide our patients with the best facilities and ultimate care, during their time at Apollo Spectra. We also offer them post-treatment or surgery care.

FAQs

I have been diagnosed with sleep apnea, what should I do?

Simply try and get the best and most comfortable equipment and then get the best and most comfortable support group. Both will take some trial and error.

What are the benefits of using CPAP therapy?

It is advisable to use CPAP therapy to treat sleep apnea on account of the fact that it drastically improves the quality of sleep, increases energy and helps with mood and disposition.

How long will I have to use CPAP?

CPAP devices are not a cure for sleep apnea. It is important to know that this is therapy and therapy needs to be continuous.

I just can’t seem to adjust to my CPAP therapy. What should I do?

Most people take a week or to completely adjust to the CPAP therapy routine and device. Try an auto-adjusting device if you are eligible.

Remember that the sleep apnea is common and in many cases unnoticeable. It can also be severe and fatal. How does one know how and when to react? Well, all that one can do is be aware and take precautionary or curative steps as and when required.