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Sleep Apnea
How Can I Prevent Sleep Apnea?
Sleep apnea is a serious sleep disorder in which a person stops and starts breathing several times an hour during sleep. These pauses in breathing might only last a few seconds but can last as much as several minutes. Sleep apnea makes getting a good night’s rest impossible and if left untreated can result in some very serious health issues. It is a condition that affects roughly 1 in 5 adults, so chances are that you or a loved one suffers from sleep apnea. With it being such a common condition you might be wondering: How can I prevent sleep apnea?
Risk Factors
Sleep apnea is not just a condition for overweight men who snore. It’s true that those factors do increase your risks, but sleep apnea is far less picky than that. In fact, this stereotype is perhaps one of the most prevalent misconceptions about sleep apnea. The following factors increase your risk of developing sleep apnea:
- Genetics
- Family
- Lifestyle
- Health
- Weight
Genetics
Your genes play a big role in how likely you or a loved one are to develop sleep apnea. They decide everything about you from physical traits like your hair and eye color down to how you perceive certain tastes and smells. But how do they affect your risk factors for sleep apnea?
Most people who suffer from this type of sleep-disordered breathing have what doctors call Obstructive Sleep Apnea, or OSA. With OSA breathing stops and starts because the airway has become partially or completely blocked. This blockage might occur at any point in the airway such as the sinuses, mouth, or back of the throat. Certain genetic conditions or birth defects can cause the airway to be unusually narrow. A smaller airway means it takes less for your airway to become blocked. So other factors like nasal swelling or soft palate collapse will have a greater affect on your breathing.
Family
While many family related risk factors technically fall under the category of genetics, family factors extend beyond just your genes. Many risk factors for sleep apnea are heavily influenced by family culture. Family culture refers to the traditions, habits, and values you have as a family. Whether genetically predisposed or not, family culture affects your risk of many conditions that lead to sleep apnea. How active is your family? Do your traditions revolve around food? What is your family diet like? How does your family culture affect your sleep hygiene? Your answers to these questions may help you identify certain risk factors. If you or a loved one has sleep apnea, chances are family culture played a part.
Lifestyle
Many lifestyle choices can increase your risk of sleep apnea in ways you might not have considered. For example, the use of alcohol, tranquilizers, or sleep aids cause the body to relax more than usual. Where this becomes problematic is when the muscles of the throat and neck relax too much. Smoking and drug use also increase your risks. Smoking causes swelling in the airway and triples your risk of sleep apnea. Opiates, especially long-acting ones like methadone, also increase your risk.
Health
Having certain health issues can increase your risk of developing sleep apnea. Uncontrolled high blood pressure, diabetes, heart disease, and stroke can increase your risks. These health issues are also known complications from having untreated sleep apnea. Even something as seemingly benign as seasonal allergies can increase your risk.
Weight
Weight is a well known risk factor, but did you know you don’t have to be obese to develop obstructive sleep apnea? Studies show that a body mass index (BMI) of 25 is enough to cause difficulty breathing. The average BMI of a healthy adult should fall somewhere between 18.5 and 24.9. The greater your BMI, the greater your risk.
How To Prevent Sleep Apnea
The great news is that for most people sleep apnea is highly preventable. There are a lot of things you can do to address your risk factors. By addressing these you can prevent sleep apnea in you and your loved ones.
Surgery
While you have no control over your genetic risk factors, you can take steps to counteract them. Though rare, reducing some genetic risk factors may require surgery. Surgery may be indicated if you have:
- Enlarged tonsils or adenoids
- Deviated septum
- Enlarged turbinates
- Nasal valve collapse
- Underdeveloped or deformed lower jaw
It is important to note that surgical correction is rare. However, if you have one of these conditions, your doctor may recommend you for surgery.
Family Culture Shift
To prevent sleep apnea it is important to address any problematic aspects of your family culture. You can reduce your risks by working together as a family to eat healthier and be more active. You might also try establishing a consistent bedtime and bedtime routine. Studies show that irregular sleep patterns nearly double your risk of heart disease. Heart disease is a known complication and contributing factor in sleep apnea.
Lifestyle Changes
Making healthier lifestyle choices will also help you prevent sleep apnea. Smoking is an unhealthy habit to begin with. Your doctor may already be urging you to quit. There are many smoking cessation programs out there that can help. Reducing or eliminating alcohol, especially before bed, will also help to reduce your risks. You’ll also want to pay attention to your own personal sleep habits. As mentioned above your sleep schedule matters, but so do things like sleep environment and position. Making sure your room is a comfortable temperature and humidity will help. And avoid sleeping on your back. Episodes of OSA are much more common when sleeping on your back.
Follow Your Doctor’s Orders
Certain health conditions like diabetes, high blood pressure, and heart disease all contribute to or worse sleep apnea. Reducing your risk factors for these conditions will also help you prevent sleep apnea. If you already have one of these conditions it is important to follow your doctor’s advice to keep them well controlled.
Maintain a Healthy Weight
Maintaining a healthy weight will help you prevent sleep apnea. Pay special attention to your BMI as well and try to keep it below 25.
Seek Medical Advice
Sleep apnea is very common, and yet a surprising 80% of cases go undiagnosed. Of the 20% who do get diagnosed it usually only comes after a major health event or the insistence of their partner. Even just the short term effects of sleep apnea can have disastrous consequences. People suffering from mild to moderate sleep apnea are twice as likely to be involved in a traffic accident. Left untreated it leads to many serious and life shortening health problems. If you or a loved one have concerns about developing sleep apnea please seek medical advice. Your doctor or a sleep apnea specialist, like those at Sleep Better Columbus, can help you identify and reduce your risks.
Want to prevent sleep apnea? Call Sleep Better Columbus at (614) 362-7292 for more information!
Defend your oral device against infections
Sleep is a vital component of every person’s health and well-being, especially for sleep apnea patients using an oral device to get adequate sleep. We recently received questions from patients about the safeguards one can take to properly disinfect their device and how to avoid potential misuse that could damage the device. To help clarify how to use the device properly and prevent damage to the device we have put together this resource so users can wear their device every night with confidence.
FAQ
- Should I be concerned about handling the device with my hands?
You can insert or remove your device with your hands, but make sure to wash your hands thoroughly beforehand for at least 20 seconds. You can find the video about handwashing from CDC on https://www.youtube.com/watch?v=d914EnpU4Fo. - Can I disinfect the device with alcohol?
No, do not use alcohol on the device. Alcohol is a drying agent and can damage the material of your device, making it more susceptible to cracks. We also advise against putting your device in the microwave or heating it to “sterilize” it as this will only damage the device. - Can I keep the device in the water?
Whether you store your device in water or not depends on your device. Check your box for instructions. Most oral devices should be stored in a dry area that exposed to air and sunlight to prevent the growth of germs. - Should I be concerned about the hygiene of the device if I left it exposed to open air?
Washing your hands before inserting or removing your oral device, as well as properly cleaning and storing the device would prevent such contamination. According to the CDC, the virus is thought to spread mainly from person-to-person, either between people who are in close contact with one another (within about 6 feet) or through respiratory droplets produced when an infected person coughs or sneezes.
Can Sleep Apnea be Cured?
If you received a diagnosis of sleep apnea, you might wonder ‘can sleep apnea be cured?’ This form of sleep disordered breathing affects millions of adults around the world. This translates into roughly 1 in 5 adults. Sleep apnea contributes to serious, life shortening health issues and doubles your risk of heart disease. Your diagnosis might have you feeling pretty overwhelmed. But here’s the good news. Sleep apnea is easily treatable! And often can even be cured.
What is Sleep Apnea?
Sleep apnea is a condition in which breathing stops and starts several times an hour during sleep. These pauses in breathing can last anywhere from 5 seconds to several minutes. In mild cases breathing might stop as few as 5-15 times an hour. In more extreme cases these pauses can occur 30 or more times an hour. These pauses in breathing cause the blood oxygen levels to drop, triggering you to wake up.
These frequent sleep disruptions cause a lot of side effects. Symptoms may include:
- Sore or dry throat
- Loud snoring
- Choking or gasping during sleep
- Excessive daytime sleepiness
- Morning headaches
- Difficulty sleeping
- Trouble focusing or concentrating
- Mood changes, especially depression and irritability
- Low libido
Snoring is the most easily recognized symptom but many of the others are easily missed. Many sufferers self-diagnose their symptoms as other issues. Researchers estimate that as many as 80 percent of cases go undiagnosed. The other 20 percent only seek medical advice after their apnea causes a major health event or their partner complains.
What Causes Sleep Apnea?
There are two types of sleep apnea. With obstructive sleep apnea the airway is partially or completely blocked. This obstruction is usually due to soft palate collapse. During sleep the soft tissues of the neck and throat relax, but with OSA they relax too much and close off the airway. Obstructive sleep apnea is the most common.
The other type of sleep apnea is central sleep apnea. This type is rare. With central sleep apnea breathing pauses because the brain fails to send proper signals to the body to continue breathing. Usually, this is due to some neurological defect or injury such as a serious head injury or stroke.
Can Sleep Apnea be Cured?
Yes! Many patients who have sleep apnea are able to control their symptoms or eliminate them. It is important to note that sleep apnea is a multifaceted health issue. You may need to use more than one of the methods below to cure your sleep apnea.
Maintain a Healthy Weight
Being overweight or obese is a common cause of obstructive sleep apnea. If you are overweight, your doctor will likely recommend that you lose a few pounds. This is especially important if you carry a lot of your weight around your midsection. Carrying extra weight around your middle puts strain on your heart. This strain contributes to many risk factors for sleep apnea. Extra weight around the neck and throat also make soft palate collapse more likely. Losing weight will take the strain off you of your heart, reducing your other risk factors. It will also help prevent soft palate collapse.
It is important to know that losing weight isn’t a permanent fix. You will need to keep the weight off too. Losing weight can cure your sleep apnea, but if you gain it back your symptoms may return.
Exercise
This may seem like a given, considering that exercise plays a key role in weight loss. But, exercise does a lot more than just help you maintain a healthy weight. People suffering from sleep apnea often complain of fatigue and frequent sleep disturbances. Regular exercise helps to strengthen your heart and lungs, improving your blood oxygen levels. A strong circulatory system ensures your body can meet its oxygen needs. Better oxygenation of the blood means fewer symptoms. Workouts that focus on breath control are especially helpful, such as walking, running, and yoga.
Improve Sleep Habits
Some sufferers only have difficulty breathing in certain sleeping positions. Usually the position that causes the most trouble is sleeping on your back. Side-sleeping helps prevent airway blockages from occurring. There are wedges and other sleep products that help discourage back-sleeping. These products can help train you to sleep on your side, preventing soft palate collapse. This may not be effective for people with more severe cases of obstructive sleep apnea.
Sleeping at an incline can also help, especially for those who struggle to sleep on their side. Raising your head about 60 degrees during sleep will reduce symptoms. This is because it shifts your abdominal weight down away from your chest and neck. This makes breathing easier but also helps to prevent soft palate collapse. You can achieve this with a wedge, body pillows, sleeping in a recliner, or raising the head of your bed.
Lifestyle Changes
Healthy lifestyle changes will help to reduce your weight and other risk factors. But there are other lifestyle changes that can help cure your sleep apnea.
- Quit Smoking – Smoking causes swelling in the upper airways, making them narrower. A narrower airway is more prone to collapse or obstruction. Quitting will reduce this swelling.
- Avoid Alcohol – Drinking alcohol, especially before bed, relaxes the muscles of the throat. This increases the likelihood of snoring and airway collapse.
- Allergy Medications – Nasal decongestants like allergy medications can help reduce swelling in the airways, improving airflow.
- Use a Humidifier – Dry air can irritate your airway, causing swelling. A good humidifier will reduce this irritation and swelling.
Sleep Apnea Therapy
Sleep apnea therapy consists of using devices such as a CPAP or oral device. A CPAP uses positive air pressure to keep the airway from collapsing during sleep. This is the go-to treatment option prescribed by most doctors. It is an effective treatment and works for many patients.
An alternative to the traditional CPAP is the oral appliance. Oral appliances fit much like a sports mouthguard. An oral appliance shifts the lower jaw forward to prevent soft palate collapse. Because it fits inside the mouth an oral appliance is much more comfortable and less restrictive than a CPAP. Many patients find that they have greater success complying with their prescribed therapy. Better compliance means better sleep. With a custom fit oral appliance, like the ones available through Sleep Better Columbus, you can be certain you’ll have a comfortable fit.
Seek Medical Advice
The methods mentioned above are easy to implement. However, sleep apnea is a serious condition. You should consult with your doctor before making any changes to your prescribed therapy. Many of the symptoms of sleep apnea are easy to miss. Without proper monitoring your condition may not be as well controlled as you think. It is important to follow up with your doctor to ensure your condition continues to improve.
Can sleep apnea be cured? Call Sleep Better Columbus at (614) 362-7292 for information.
Is Sleep Apnea A Disability?
Is sleep apnea a disability? If you suffer from this common form of sleep-disordered breathing, you might wonder if it is. It affects your ability to get restful sleep, increasing your risks for a variety of health and safety issues. But is it a disability?
What Is Sleep Apnea?
People with sleep apnea have a hard time breathing or stop breathing for several seconds during sleep. These episodes happen at least 5 times an hour. In the most extreme cases these episodes can last for several minutes and occur a few hundred times a night.
There are two types of sleep apnea. The most common is Obstructive Sleep Apnea (OSA). With OSA the airway becomes partially or completely blocked during sleep. This partial or complete blockage prevents air from moving through the lungs.
Central Sleep Apnea (CSA) is less common. CSA is the result of the brain failing to send proper signals to the muscles of the chest involved in breathing. The brain ‘forgets’ to breathe for several seconds to several minutes at a time.
Symptoms Of Sleep Apnea
Someone suffering from sleep apnea may experience the following symptoms:
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Loud snoring
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Observable periods where breathing stops and starts
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Choking or gasping during sleep
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Dry mouth
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Morning headaches
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Frequent/sudden waking
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Excessive daytime sleepiness
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Difficulty thinking or concentrating
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Changes in mood, especially depression or irritability
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High blood pressure
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Nighttime sweating
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Decreased libido
You may not experience all these symptoms. Some sufferers only experience a handful of symptoms. Because many of these symptoms occur during sleep, many are not aware they have the condition. Others may write off their symptoms as something else. Researchers estimate that only approximately 20% of cases are ever diagnosed. Of those cases, most do not seek a diagnosis on their own. A diagnosis of SA is most common after a major adverse health event or after a partner complains.
Complications Of Sleep Apnea
Even mild cases of sleep apnea can cause a variety of health and safety issues. Left untreated sleep apnea contributes to the development of the following conditions:
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High blood pressure, especially drug-resistant
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Obesity
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Heart Disease
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Diabetes
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Heart Attack
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Stroke
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Metabolic Syndrome
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Lung Problems
Many of these conditions also contribute to worsening symptoms of sleep apnea. But, these health issues are not all that make sleep apnea such a dangerous condition. Sleep apnea makes it impossible to get restful sleep. Sufferers report falling asleep many times throughout the day. OSA doubles your risk of workplace accidents. The risk is even higher if your job requires you to do a lot of driving, such as long haul trucking and public transport. Studies show mild to moderate sleep apnea doubles your risk of traffic accidents. For individuals with moderate to severe sleep apnea the risk is 15 times greater. Sleep apnea is the most important preventable cause of traffic and workplace accidents.
Is Sleep Apnea A Disability?
Unfortunately, the Social Security Administration (SSA) no longer lists sleep apnea as a disability. But, that doesn’t mean that you won’t qualify. Sleep apnea contributes to a wide range of physical and mental health issues that are recognized as disabilities.
For example, sleep apnea increases your risk of lung problems like chronic pulmonary hypertension. The Disability Evaluation Under Social Security has a section for respiratory problems. Chronic pulmonary hypertension is listing 3.09. Sleep apnea also contributes to many risk factors for chronic or congestive heart failure. These conditions are included under listing 4.02. There is a long list of criteria you must meet to qualify for disability under those diagnoses. Listing 12.02 covers ‘organic mental disorders’. As defined by the SSA:
Organic Mental Disorders, also referred to as chronic Organic Brain Syndromes, are afflictions of the brain that can lead to severe mental or behavioral problems. They may be permanent or temporary, and can be either hereditary or caused by injury, disease, or a structural or systemic defect in body chemistry or hormones. Organic Mental Disorders do not include disorders that result from substance abuse, nor do they include psychiatric disorders.
This definition covers many of the mental health issues that can result from chronic sleep apnea.
What If I Don’t Qualify?
Not everyone will qualify based on the criteria mentioned above. However, you may qualify based on your Residual Functional Capacity, or RFC. An RFC assessment determines what type of work you are still able to perform in spite of the limitations imposed by your condition. The SSA will look at how your symptoms and other conditions affect your job performance. For example, if you have heart problems as a result of your sleep apnea, you should not be lifting heavy objects. If you struggle with excessive daytime sleepiness, you should not be operating heavy machinery. The SSA may assess your mental RFC too if you have difficulty thinking, concentrating, remembering, or do not work well with others. You will qualify for benefits if your symptoms are severe enough that you are unable to work.
Treating Sleep Apnea
Not everyone with sleep apnea will qualify for disability whether through related diagnoses or their RFC assessment. But the good news is that sleep apnea is highly treatable. Long term solutions involve controlling risk factors that can worsen your symptoms. This might include losing weight or starting medication to control your diabetes or high blood pressure. But getting your underlying conditions under control will take time. You need a good night’s rest, and soon. The best ways to achieve quick relief from your symptoms is to begin sleep apnea therapy. Therapy typically includes the use of a CPAP or similar machine, an oral appliance, or both.
A CPAP is a machine that prevents airway obstruction by creating positive pressure in the airway. The masks required to create a seal around the nose and mouth can be heavy. Many patients have a hard time adjusting to sleeping with the mask on. Patients report they don’t wear it as often as they should.
An oral device fits in the mouth much like an athletic mouthguard. It prevents airway obstruction by shifting the jaw and tongue forward. This helps to eliminate soft palate collapse. A custom oral appliances will form to fit the size and shape of your mouth, providing comfortable, lightweight sleep apnea relief. At Sleep Better Columbus we know how important it is to get a good night’s sleep. With the help of Dr. Mark Levy, we’ll find you just the right form and fit for your custom oral appliance. Our patients report a far better compliance rate with their custom oral appliance. And better compliance means better sleep.
Want to know if sleep apnea is a disability? Call Sleep Better Columbus at (614) 362-7292 for more information.
Irregular Sleep Patterns May Double Heart Disease Risk
A new study conducted by the Brigham and Women’s Hospital in Boston suggests that irregular sleep patterns may double your risk of heart disease. “Our study indicates that healthy sleep isn’t just about quantity but also about variability, and that this can have an important effect on heart health,” says Huang, the lead author on the study.
What Is Heart Disease?
Heart disease describes conditions that affect how the heart functions. It can refer to heart defects or conditions that cause irregular heart beats. These diseases can also affect the tissues surrounding the heart, such as the blood vessels and arteries. Heart disease includes the following conditions:
- Congenital Defects
- Arrhythmia
- Coronary Artery Disease
- Dilated Cardiomyopathy
- Myocardial Infarction (Heart Attack)
- Heart Failure
- Hypertrophic Cardiomyopathy
- Mitral Regurgitation
- Mitral Valve Prolapse
- Pulmonary Stenosis
According to the Center for Disease Control, “Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States.” This translates into heart disease being the leading cause in 1 of every 4 deaths in the US.
Risk Factors
High blood pressure, high cholesterol, and smoking are major risk factors for heart disease. According to the CDC, roughly half of Americans (47%) have at least one of these risk factors. Other health issues and lifestyle choices also increase your risk. These factors for heart disease include:
- Age – Age increases your risk of a variety of health problems. As we age the tissues of the heart and arteries thicken, become weak, or simply break down over time.
- Sex – Men are at increased risk of developing heart disease. Doctors believe this is due to where men carry most of their weight. A woman’s risk of heart disease increases after menopause.
- Family History – Your genes may predispose you to developing certain types of heart disease. Your risk may be especially high if a parent developed heart disease at an earlier age than normal.
- Diet – Diets high in fats, sugar, salt, and cholesterol can contribute to heart disease.
- Diabetes – Diabetes shares many of the same risk factors as heart disease.
- Obesity – Excessive weight gain worsens many of the other risk factors for heart disease.
- Physical Inactivity – Less active, less fit individuals are more likely to develop high blood pressure. They are also more likely to develop diabetes and become obese.
- Stress – Stress damages your arteries and worsens other risk factors.
Irregular Sleep Patterns: A Major Risk Factor
These risk factors are well documented by decades of studies and research. However, one major risk factor that has gone largely unresearched until now is sleep. “When we talk about interventions to prevent heart attacks and stroke, we focus on diet and exercise,” says Huang. “Even when we talk about sleep, we tend to focus on duration – how many hours a person sleeps each night – but not on sleep irregularity and the impact of going to bed at different times or sleeping different amounts from night to night.”
What we have learned from these decades of sleep studies is that sleep duration is very much a ‘Goldilocks’ zone. If you are getting too much or too little, your health outcomes decline. But when your amount of sleep is ‘just right’ health outcomes improve. These studies show that too much sleep has many of the same negative effects as too little sleep. And both contribute dramatically to many of the same risk factors for heart disease. According to a Gallup poll, the typical American adult gets less than 7 hours of sleep a night. While individual sleep needs may vary slightly, most people perform best on 8 hours of sleep a night. But if the duration of sleep was the only factor, then those who get 8 hours each night should have a lower risk, right? The study found that it may not be that simple.
The Brigham and Women’s Hospital study found that variation in bedtime and sleep duration had a major impact on health outcomes. The data showed those whose bed time varied by 90 minutes or more, and whose sleep duration varied by 2 or more hours a night were at the greatest risk. This group was “more likely to develop metabolic disorders such as hypertension, obesity and diabetes.” As a result, this group also reported nearly double the number of heart problems and cardiovascular events.
How Do I Reduce My Risks?
Huang states that “Sleep regularity is a modifiable behavior. In the future, we’d like to explore whether changing one’s sleep patterns by going to bed consistently each night may reduce a person’s risk of future cardiovascular events.” There are many things you can do to ensure a more consistent bedtime, including the following:
- Have a set bedtime
- Don’t wait to feel sleepy before getting ready for bed
- Turn off your phone, computer, and TV an hour before bed
- Avoid caffeine
- Have a nightly routine
Altering your habits to ensure a consistent bedtime and sleep duration should help reduce your risks.
Could Sleep Apnea Be To Blame?
The study did not address the causes of irregular sleep patterns, but they hypothesized that frequent waking was a factor. As many as 70 million US adults suffer from a some form of sleep disorder. The most common of which is Sleep Apnea.
Around 1 in 5 adults suffer from mild symptoms of Obstructive Sleep Apnea, with 1 in 15 having moderate to severe symptoms. Untreated, sleep apnea contributes to many of the same risk factors for heart disease. Unfortunately, most people who have the condition are unaware that they do. Researchers estimate that only about 20% of cases are ever diagnosed. If you have many of the same risk factors for heart disease or suspect you may not be getting restful sleep, speak with your doctor about sleep apnea.
Thankfully, sleep apnea is easy to treat. The usual, go-to treatment is to use a CPAP machine. With Obstructive Sleep Apnea the airway becomes partially or completely obstructed, preventing the movement of air through the lungs. The most common cause of obstruction is soft palate collapse. The soft tissues of the throat relax too much, blocking the airway. A CPAP works by pumping pressurized air into the airway to prevent airway collapse. However, CPAP masks are large, heavy, and often uncomfortable. As a result, patients often report low compliance with their prescribed sleep apnea therapy.
An equally effective, and less restrictive option is an oral appliance. An oral appliance is a device designed to fit in the mouth. It shifts the lower jaw forward to prevent soft palate collapse. At Sleep Better Columbus we know the importance of getting a good night’s sleep. And an uncomfortable heavy mask is not the best solution for most patients. We specialize in custom fitted oral appliances. We ensure you get the best fit for a better night’s sleep.
Call Sleep Better Columbus at (614) 362-7292 for more information about irregular sleep patterns.
What Are The Signs Of Sleep Apnea?
Sleep apnea is a condition in which breathing stops and starts during sleep. It is a condition that affects as many as 100 million people world wide. Sleep apnea causes a variety of potentially serious health issues and side effects. But the most startling thing about sleep apnea is most sufferers don’t actually know they have it. At least not until it has begun to take a serious toll on their health. You might wonder how that is possible. How could someone stop and start breathing several times a night and not even know? What are the signs of sleep apnea? How do we so often miss these signs?
What is Sleep Apnea?
Before we get into the signs of sleep apnea, let’s talk a little bit about what it is. An apnea is a period in which breathing stops unexpectedly, especially during sleep. These apneas can last anywhere from 5 seconds to several minutes at a time. With mild to moderate sleep apnea a person may stop breathing anywhere from 5 to 30 times an hour during sleep. In the most extreme cases these pauses may occur several hundred times a night.
There are two main types of sleep apnea.
The most common type is Obstructive Sleep Apnea. With this type, the brain continues sending messages to the muscles of the chest and diaphragm to keep breathing. However, the airway becomes partially or completely blocked. The heart, lungs, and muscles of the chest work harder to try to keep blood and oxygen moving through the body. When these efforts to clear the blockage fail, blood oxygen levels begin to drop. If normal breathing does not resume, the patient will begin to suffocate. This triggers a gasp reflex, causing you to wake suddenly and begin breathing again.
The other main type of sleep apnea is Central Sleep Apnea. With Central Sleep Apnea the brain fails to properly signal the body to continue breathing. Unlike Obstructive Sleep Apnea, with CSA all breath functions stop. The muscles of the chest and diaphragm do not continue trying to move air through the lungs. Normal breathing resumes only after blood oxygen levels drop low enough, triggering you to wake up.
Signs and Symptoms
We’ve talked a little about what sleep apnea is, but what does it look like? What do sufferers experience?
If you have ever lived with someone who snored, you are probably already familiar with the most common signs of sleep apnea. While not all snorers have sleep apnea – and not all people with sleep apnea snore – it is a classic symptom of the condition. With Obstructive Sleep Apnea the airway becomes partially or completely blocked.
As you struggle to clear the obstruction, the movement of air past the blockage causes these soft tissues to vibrate. The result is a loud, chain-saw like snore interrupted by observable periods where breathing stops. These apneas are usually accompanied by a fit of gasping or choking before normal breathing resumes. The sufferers themselves are usually completely unaware of these particular symptoms. Depending on how violent their fits of choking or gasping are, they may not even realize how often they wake up.
Because they occur during sleep, someone with sleep apnea is usually only aware of the lingering side effects. These might include waking up with a dry mouth or sore throat, chest pain in the morning when waking up, or morning headache. These symptoms are easily misinterpreted as other issues and often go misdiagnosed. Chest pain from sleep apnea might result from your sleeping posture, lifestyle, or other health issues. A morning headache might get ignored as just needing your morning cup of coffee. Dry mouth could be the result of dehydration, sleeping with your mouth open, or a side effect from medication.
Other symptoms include excessive daytime sleepiness, difficulty concentrating, mood changes, and decreased libido. Most of those symptoms, especially in the absence of loud snoring, are very often misdiagnosed as depression. The nighttime sweating is easily ignored as preferring a cooler sleep environment. Sleep apnea also causes high blood pressure. However, high blood pressure is common among people who do not suffer from sleep apnea. So high blood pressure on its own is not a major red flag.
Diagnosing Sleep Apnea
So how do so many people with sleep apnea go un- or misdiagnosed? As discussed, many of the symptoms are easily explained away by other complaints. Imagine a patient comes in to see their doctor. They complain of poor sleep, low moods, and difficulty focusing. Because they live alone, they are not aware of their loud snoring. To the doctor, this presents as a fairly typical case of depression. It’s not until they develop or complain of other common symptoms that the cause becomes clear, if ever.
In fact, most people who do finally seek medical advice don’t actually think there is anything wrong. They only speak to their doctor because their loved one is losing sleep too, due to their loud snoring. Individuals who live alone or who do not snore may go months or even years before they see a doctor.
Sleep apnea affects as many as 70 million US adults. The condition is most common among men and people over the age of 60. But, women and children are also affected. Being overweight, diabetic, or a smoker also increases your risk of developing sleep apnea. Other risk factors include asthma, narrow airway, family history, illness, and hypertension.
Treating Sleep Apnea
Thankfully, sleep apnea is easy to treat. Reducing your risks and contributing factors are a great long term goal. Ways to reduce your risks and improve your symptoms include:
- Weight Control
- Making sure underlying conditions are well controlled
- Change sleeping positions
- Use a humidifier
- Quit smoking
But in the meantime, you need to get some restful sleep. The frequent waking has left you exhausted and falling asleep at work. You need relief now. So what can you do? A CPAP machine is usually the go-to answer for most sleep apnea patients. CPAP stands for Continuous Positive Airway Pressure. It’s a mask that fits over the nose and mouth to pressurize your airway, preventing it from collapsing during sleep. These masks are large and usually fairly heavy. Many patients have difficulty falling or staying asleep while wearing it.
As a result, many patients do not wear their CPAP as often as they should to see relief. Thankfully, there are other options. An alternative, and equally effective option is to use an oral appliance. An oral appliance is a device worn in the mouth to maintain an open airway during sleep. It does this by shifting the lower jaw forward to prevent soft palate collapse. Oral appliances come in generic versions or can be custom designed to fit your mouth. With a custom fit appliance, patients report much higher compliance with their prescribed sleep apnea therapy. And better compliance means better sleep.
At Sleep Better Columbus we pride ourselves on providing high quality custom fitted oral appliances. With Dr. Mark Levy’s extensive experience and education, you can rest assured you’re getting the best possible care.
What are the signs of sleep apnea? Call Sleep Better Columbus at (614) 362-7292 for more information.
Can Sleep Apnea Cause Lung Problems?
Sleep apnea can lead to many other health issues. Some of these health problems can cause sleep apnea, and others result from it. Interestingly, many of these health conditions involve the heart and lungs. So it might have you wondering: Can sleep apnea cause lung problems?
It’s true that sleep apnea affects your breathing. These apneas, or periods when breathing stops and starts, might make you think it is a lung disease. According to the American Lung Association, the term lung disease refers to any disorder affecting the lungs. This includes disorders like asthma, COPD, cancer, influenza, pneumonia, tuberculosis, and many others. While sleep apnea can have serious consequences for lung health, the primary function of the condition is sleep related.
What Is Sleep Apnea?
Before we look at how it affects your lung health, let’s look at what sleep apnea is.
Apnea is a ‘temporary cessation of breathing, especially during sleep’. Based on the definition, referring to the condition as ‘sleep apnea’ may seem redundant. But because apneas can occur at other times, it is an important distinction to make.
With sleep apnea, breathing stops and starts at least 5 times an hour, but can pause as many as several hundred times a night. These pauses can last anywhere from 5 seconds to several minutes at a time. When this happens, blood oxygen levels drop and trigger you to wake up. Frequent sleep disruptions causes a variety of side effects. These side effects may include:
- Irritability
- Slowed reaction time
- Difficulty focusing
- Fatigue
- Forgetfulness
- Driving accidents
- Depression
There are a few types of sleep apnea but the most common type is Obstructive Sleep Apnea (OSA). With OSA these apnea events occur when the airway becomes partially or completely blocked during sleep. The blockage may be due to several different factors.
Common causes of Obstructive Sleep Apnea are:
- Relaxation of the neck and throat muscles, causing the soft palate to collapse
- Tongue balling up in the back of the throat
- Fatty deposits in the tongue or neck restrict the airway
- Narrow airway
With OSA the brain continues sending messages to the body to breathe. The muscles of the chest and diaphragm work even harder to breathe but are not able to completely clear the blockage. This results in the loud snoring, choking, or gasping during sleep that is common for people with the condition.
Is Sleep Apnea a Respiratory Disorder?
With lung diseases the primary function of the disorder begins in the lungs. But, in sleep apnea the issue starts in the brain or in the airway itself and occurs only during sleep. As a result, it is most accurate to refer to sleep apnea as a form of sleep-disordered breathing.
Can Sleep Apnea Cause Lung Problems?
While classified as a sleep disorder, sleep apnea does lead to or worsen lung problems.
Research published in BMC Pulmonary Medicine found that patients with OSA had increased lung elasticity recoil pressure. The elastic quality of lung tissues is what allows them to expand and contract when you breathe. With increased lung elasticity recoil pressure the lungs snap back too forcefully. This creates a vacuum effect that contributes to airway collapse in OSA. The resulting reduction in lung volume increases the risk or worsens the symptoms of some very serious lung problems.
Lung problems that are common in patients with sleep apnea include:
- Chronic Obstructive Pulmonary Disease (COPD)
- Pulmonary Hypertension
- Asthma
COPD
Chronic Obstructive Pulmonary Disease, or COPD, is an umbrella term for a group of conditions that make breathing difficult. This difficulty arises from clogged or narrow airways. It is usually the result of inflammation in the internal structures or damage to the air sacs in the lungs. This damage is typically caused by smoking and air pollutants.
A review in the journal Lung found that up to 66% of COPD sufferers also suffer from sleep apnea. As where only around 20% of patients with sleep apnea also have COPD. Doctors refer to this as “overlap syndrome”. Patients with COPD have an increased risk of heart attack. When paired with sleep apnea it will lead to high blood pressure, arrhythmia, heart failure, and stroke if left untreated. Unfortunately there is no cure for COPD and the condition tends to worsen over time. However, symptoms do improve with treatment and the use of sleep apnea therapy.
Pulmonary Hypertension
Patients with sleep apnea have an increased risk of developing pulmonary hypertension (PH). Pulmonary hypertension is a type of high blood pressure. It causes increased blood pressure in the arteries of the lungs and in the right side of the heart. Patients with pulmonary hypertension experience shortness of breath, dizziness, and chest pressure. How exactly sleep apnea causes pulmonary hypertension remains controversial. However, we know that periods of low blood oxygen (hypoxia) cause the heart to work harder to continue supplying oxygen to the body. With sleep apnea these periods of hypoxia happen more frequently, sometimes several hundred times a night. Studies show that as many as 82% of patients with PH have some form of sleep apnea. Like COPD, pulmonary hypertension worsens over time. Similarly, patients can reduce the severity of their symptoms and improve quality of life with treatment.
Asthma
Asthma is a condition in which a person’s airways are highly sensitive. When exposed to a trigger the airway becomes inflamed and swollen, restricting the flow of air through the lungs. This irritation also causes the lungs to secrete more mucus, making it even harder to breathe. Asthma and sleep apnea are both common conditions and seem to play off each other. In the BCM Pulmonary Medicine review researchers found a synergistic link between the two conditions. Subjects with OSA had a narrower airway on average, as did subjects who only had asthma. Airway diameter was even smaller in subjects who had both. They found that 49% of subjects with difficult-to-treat asthma also suffered from mild to moderate OSA. The data also showed a direct link between how intense their OSA was and the severity of their asthma symptoms. When asthma is well controlled, OSA symptoms also decrease.
Reduce the Risk of Your Apnea and Lung Problems
The good news is that sleep apnea is easy to treat. Patients see improvement in their quality of life soon after beginning sleep apnea therapy. At Sleep Better Columbus we know how important it is to get a good night’s sleep. CPAP machines are a great option but we know they can be uncomfortable and make sleeping difficult. We provide high quality, custom fitted oral appliances to keep your airway clear. An oral appliance shifts the lower jaw forward. This prevents soft palate collapse and keeps the tongue from balling up at the back of the throat. Because our oral appliances are lightweight and custom fitted, patients have an easier time adjusting. This results in better compliance and faster relief. Reducing your symptoms will improve your quality of life and reduce your risks of lung problems.
Do you wonder if sleep apnea can cause lung problems? Call Sleep Better Columbus at (614) 362-7292 for more information.
What Triggers Sleep Apnea
Sleep apnea is a serious condition in which breathing stops and starts during sleep. These pauses in breathing last for at least 10 seconds at a time and occur no less than 5 times an hour. These pauses cause blood oxygen levels to drop, triggering periods of wakefulness. Unfortunately, symptoms of sleep apnea are easily missed or often ignored. Many patients are not aware of their condition until it has already taken a serious toll on their health. But what triggers sleep apnea?
Types of Sleep Apnea
Before we can dive into what triggers sleep apnea (SA), let’s take a look at the different types. There are two main types:
- Central
- Obstructive
With central sleep apnea (CSA) the wiring in the brain has become faulty. The brain fails to properly send signals to the muscles that control your breathing. Unlike obstructive sleep apnea, in CSA all breathing functions stop. It is not until oxygen levels drop enough that the brain is able to trigger you to wake up abruptly. This form of sleep apnea is less common.
Obstructive sleep apnea (OSA) is by far the most common. It is the result of the soft tissues of the mouth and throat relaxing too much during sleep. These structures collapse inward, either partially or completely blocking the airway. During an episode of OSA the brain continues sending signals to breathe. With a partial obstruction the added effort causes the soft tissues to vibrate. This results in the loud, chainsaw-like snoring associated with OSA. A complete obstruction results in observable periods where breathing stops. Either type of episode usually ends with a fit of gasping or choking before normal breathing resumes.
While it is possible to have both forms of SA, it is not as common. Doctors refer to this as complex sleep apnea. Patients will have alternating periods of apnea due either to failed signals or obstruction.
What Causes Sleep Apnea?
There are many causes and contributing factors in sleep apnea. Central sleep apnea is the result of the brain failing to signal the muscles of the chest to breathe. Conditions that reduce blood oxygen levels or impair the function of the central nervous system can increase your risk. Factors that increase the risk of CSA include:
- Age – As you age your risk of developing CSA increases. The groups most at risk are individuals over the age of 45 are at the greatest risk.
- Biological Sex – CSA is more common among men than it is among women.
- Heart Health – Heart health can have a tremendous impact on your risk factors. Conditions such as congestive heart failure or an irregular heartbeat are significant risk factors for CSA.
- Medications – Certain medications, particularly sedatives, opioids, and methadone can increase your risk.
- Stroke – Around 75% of patients who need physical therapy after a stroke are also diagnosed with sleep-disordered breathing. CSA is the most common diagnosis.
- Other Brain Abnormalities – Brain tumors and lesions on the brain stem can impair its ability to properly relay messages to the body.
- CPAP Use – Studies show that patients who use a CPAP machine to create positive pressure in their airway are more likely to develop CSA. Continued use of a CPAP often resolves this issue.
Obstructive sleep apnea is most greatly influenced by physical factors. Factors that increase your risk of developing OSA include:
- Weight – Obesity and excessive weight greatly increases the risk of sleep apnea. Fat deposits in the tongue and neck can obstruct breathing.
- Narrow Airway – Some people naturally have a narrow airway. Others may have enlarged tonsils or adenoids. While this can be an issue in adults, it is often identified and addressed in childhood. Having a thick neck can also cause a narrowing of the airway.
- Biological Sex – As with CSA, obstructive sleep apnea is more common in men than in women. Men are as much as 3 times more likely to develop the condition. Men tend to put on more weight in their midsection than women. Increased abdominal circumference is directly linked to OSA. Women have an increased risk of OSA if they are overweight or are post-menopause.
- Age – OSA is more common in adults over the age of 40.
- Family History – Many risk factors for OSA are hereditary.
- Substance and Drug Use – Alcohol, sedatives, and tranquilizers relax the muscles of the throat and slow your breathing.
- Smoking – Smoking causes inflammation and fluid retention in the upper respiratory tract. This narrows the airway and increases a smokers risk three times more than people who have never smoked.
- Nasal Congestion – Swelling in the nasal passages can cause the airway to become blocked or narrowed, especially when lying down. This may be due to allergies or illness. Anatomical abnormalities such as a deviated septum can also compound this issue.
Reducing Your Risks
Some risk factors like age, biological sex, and heredity are beyond your control. Some may require surgical correction. But, through an appropriate treatment plan you can reduce many other risk factors.
Ways you can reduce your risks include:
- Weight Management – Doctors recommend that most patients with sleep apnea lose weight. Maintaining a healthy weight can reduce many key risk factors.
- Exercise – A moderate exercise routine can strengthen your heart and improve circulation. Regular exercise can also improve lung capacity. This helps to reduce how often you wake due to poor oxygenation.
- Reduce Medication and Drug Use – Reducing the use of opioids, sedatives, and tranquilizers will lower your risks.
- Avoid Smoking and Drinking – Quitting smoking is a great way to reduce your sleep apnea risk factors. As your lungs recover, airway irritation will reduce and allow for clearer breathing. Avoiding alcohol use before bed, or cutting it out altogether will also help.
- Humidifier – Some airway obstruction is the result of inflammation. Using a humidifier helps to sooth and open the airway for clearer breathing.
- Sleep Position – Depending on the cause of your obstruction, changing your sleep position may provide relief. Studies show that adults with OSA may benefit from side sleeping. Oddly, the same is not true of children with OSA. The same study showed that back sleeping reduces symptoms in children.
- Oral Appliances – An oral appliance is a mouthpiece very similar in design to a sport mouthguard. This custom fitted mouthpiece helps to angle the jaw and tongue forward to prevent soft palate collapse. Patients report faster relief from symptoms and a better rate of compliance than with a CPAP.
It is important to take a combined approach to sleep apnea relief. Addressing underlying health issues and reducing risk factors will improve your quality of life. In the meantime, you need to get restful sleep. At Sleep Better Columbus we know the fastest, safest way to help you find relief is to use a custom oral appliance. Dr. Mark Levy has used oral appliance therapy to treat sleep apnea since 2005. He has dedicated himself to continuing his education to provide patients with the best possible care. At Sleep Better Columbus you can be sure you’ll get excellent care, quality appliances, and better sleep.
Do you wonder what triggers sleep apnea? Call Sleep Better Columbus at (614) 362-7292 for more information.
Is Sleep Apnea Dangerous?
Sleep apnea is a common sleep disorder affecting an estimated 42 million Americans, affecting roughly 1 in 5 adults. Approximately 9% of middle aged women and nearly 25% of middle aged men suffer from some form of sleep apnea. Disturbingly enough, however, most people who have sleep apnea are not aware that they do. Estimates suggest that as many as 75% of severe cases of sleep-disordered breathing go undiagnosed. Sleep apnea is also a major risk factor for serious life-shortening cardiovascular and metabolic health issues. But what is it and what makes sleep apnea so dangerous?
What Is Sleep Apnea?
Sleep apnea is a condition where a your breathing pauses for at least 10 seconds during sleep. In some cases these episodes may last several minutes before normal breathing resumes. The average healthy adult may have up to 5 episodes of paused breathing an hour during sleep. This is fairly normal and typically nothing to be concerned with. However, with sleep apnea these episodes occur at least 5 or more times an hour. In extreme cases a sufferer may have as many as 240+ episodes during an 8 hour night.
There are three types of sleep apnea. Obstructive sleep apnea occurs when the airway becomes blocked. This blockage either reduces or completely stops the flow of air through the lungs. During these episodes the body continues to try to breathe. The muscles of the chest and diaphragm work harder to try to force the airway open but are not able to. The most common cause of obstruction is the muscles of the neck and throat relaxing too much. As a result, the airway collapses. This obstruction reduces the flow of oxygen to your brain. When levels drop too low it triggers the gasp reflex, reopening your airway. Obstructive sleep apnea is the most common form of sleep apnea.
Central sleep apnea occurs when the brain fails to send proper signals to the body. Normally, breathing is an involuntary action. You keep on doing it whether you consciously choose to or not. But sometimes these signals fail to send due to differences in brain function. In this case, the airway is not blocked but there is no movement of air through the lungs. Breathing resumes when the oxygen levels drop low enough to trigger the gasp reflex. Central sleep apnea is less common but is, perhaps, the most dangerous form of apnea. It is possible to have both forms.
Signs of Sleep Apnea
One of the most interesting things about sleep apnea is that most people who have it are not even aware that they do. Diagnosis usually only comes after prolonged complaints from the patient’s sleep partner. Due to the nature of the condition misdiagnosis is common. Many doctors believe that sleep apnea is commonly misdiagnosed as depression, explaining why many cases of depression fail to respond to typical treatment. It is also common for patients to ignore their symptoms, writing it off as something else.
Common signs of sleep apnea include the following symptoms:
- Excessive daytime sleepiness
- Loud snoring
- Observable episodes of paused breathing during sleep
- Waking suddenly, usually accompanied by gasping or choking
- Morning dry mouth or sore throat
- Morning headache
- Difficulty concentrating during the day
- Changes in mood, such as depression or irritability
- High blood pressure
- Nighttime sweating
- Decreased libido
Not all sufferers experience every one of these symptoms. In fact, some individuals with sleep apnea do not snore at all.
Complications of Sleep Apnea
Because the symptoms of sleep apnea are easily missed and often go unnoticed by sufferers, it might lead you to wonder: Is sleep apnea dangerous? In a word, yes. While not typically immediately fatal, sleep apnea is caused by or contributes to many serious health issues. Interestingly, many of the risk factors that contribute to sleep apnea may also result from apnea itself. People most at risk of developing sleep apnea have one or more of the following traits:
- Male
- Obesity (BMI >30)
- Hypertension
- Alcohol or sedative use
- Abnormalities in airway or facial structure
- Smoker
- Family history of sleep apnea
- Large neck circumference
- Type 2 diabetes
- Metabolic disorder
Studies also show that patients with sleep apnea have a dramatically higher risk of developing the following:
- Hypertension, especially drug-resistant
- Obesity
- Congestive Heart Failure
- Need a pacemaker
- Atrial Fibrillation
- Diabetes
- Coronary Artery Disease
- Stroke
Studies have shown that sleep apnea is an independent risk factor for hypertension. Patients with no other risk factors are more likely to develop hypertension if they have sleep apnea. Sleep apnea also contributes greatly to stroke. Some 65-70% of stroke patients are also diagnosed with sleep-disordered breathing.
Sleep apnea was also found to double your risk of traffic accidents. The risk is significantly higher in people with moderate to severe sleep apnea. These individuals are 15 times more likely to cause an accident. This is due to excessive sleepiness and difficulty concentrating reducing reaction times. Estimates show that sleep apnea contributes to 980 traffic accident deaths per year.
Treating Sleep Apnea
Thankfully, sleep apnea is easy to diagnose and to treat. If you suspect you may have sleep apnea the first thing to do is speak with your doctor. Before your appointment be sure to keep a sleep diary. Record how often you wake in the night and any other symptoms you have noticed. Have your sleep partner record how many times they notice you waking or stop breathing in the night. This information will help your doctor to diagnose your condition. Your doctor will either give you a home test kit, or schedule a sleep study. The data collected during your test will show how often your breathing pauses, for how long, and how much your oxygen levels dip. With this information your doctor will be able to diagnose what form of sleep apnea you have and how to treat it.
Long term treatment for sleep apnea involves reducing your risk factors. This may include losing weight, lowering your blood pressure, and ensuring your diabetes is well controlled. Reducing or eliminating alcohol or sedative use will also reduce your risk. Unfortunately, it may not be possible to completely eliminate your risk factors.
More immediate solutions for treating sleep apnea involve the use of assistive devices.
- CPAP – Continuous Positive Airway Pressure machines connect to a face mask that cover the nose and mouth. It pumps pressurized air through the mask to keep the airway from collapsing. Patients sometimes struggle to use this mask every night as it can take some getting used to. They are not always particularly comfortable and can cause dry mouth. Some patients also report feeling claustrophobic.
- Oral Appliance – A less invasive but equally effective option is an oral appliance. These custom fitted mouthpieces move the jaw forward and prevent the soft palate from collapsing. Patients often report greater compliance with oral appliance than the CPAP because it is easier to use. Greater compliance with using your appliance helps to reduce your health risk factors and ensures you get better sleep.
In some cases it may be necessary to combine treatment options. At Sleep Better Columbus we dedicate ourselves to finding the best solutions for our sleep apnea patients. We tailor our sleep apnea therapy to each patient to address their individual needs and concerns. If you or someone you love suffers from sleep apnea, or feel may be suffering from it, please contact Dr. Levy for a screening consultation.