In sleep apnea, the airways in the nose, mouth or throat become narrowed or blocked during sleep, causing breathing to stop for 10 seconds or longer. Patients may have 5 to 50 apnea episodes an hour. Symptoms of sleep apnea include loud snoring, excessive daytime sleepiness, and high blood pressure. Statistics reveal that one in four men and one in ten women have sleep apnea.
Obstructive sleep apnea (OSA) can occur when the throat muscles and tongue relax during sleep and partially block the airway. It can also occur if there are bone deformities or larger than normal tissues in the nose, mouth or throat, such as enlarged tonsils. Other factors include obesity, certain medications or alcohol use at night, and sleeping on the back.
When breathing stops during sleep apnea, it can result in less oxygen in the blood. Over time, this can increase the risk of high blood pressure, abnormal heart rate, heart failure, coronary artery disease (CAD), and stroke. In a study published in the New England Journal of Medicine, researchers at Yale University School of Medicine conducted polysomnography studies of 1,022 adults with nighttime breathing problems. They found that OBS patients had a twofold risk of stroke or dying, compared with those without sleep apnea. Those with severe OBS had a threefold risk of stroke or dying. "The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension," the study authors conclude.
Lifestyle changes can help minimize OSA symptoms, including:
1. Losing and maintaining a healthy weight.
2. Avoiding alcohol and certain medicines (such as sleeping pills and sedatives) at night.
3. Stopping smoking.
4. Raising the head of your bed 4 to 6 inches.
5. Maintaining good sleep habits such as going to bed at the same time every night and sleeping on your side.
6. Using nasal strips to decrease snoring.
A continuous positive airway pressure (CPAP) breathing device can help relieve moderate to severe sleep apnea symptoms. CPAP is a small mask that automatically adjusts air pressure, which prevents airways from closing during sleep. Other treatments include oral breathing devices that position the tongue and jaw during sleep, keeping airways open.
Surgery may be indicated to remove overly large tissues, such as enlarged tonsils or adenoids. Other surgeries may be done to repair bone deformities in the mouth and throat. If all treatments have failed, a tracheostomy (a hole is created in the windpipe where a breathing tube is inserted) may be indicated. Unfortunately, experts have found that this is not a permanent cure.
REFERENCES:
1. Yaggi HK et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005 Nov 10;353(19):2034-41.
2. Sleep Apnea Topic Overview, WebMD:
http://aolsvc.health.webmd.aol.com/hw/sleep_disorders/hw49129.asp?printing=true
3. DeNoon D. New Stroke Risk Factor: Sleep Apnea, WebMD:
http://aolsvc.health.webmd.aol.com/content/article/115/111500.htm?printing=true
4. Sleep Apnea Treatment Overview, WebMD:
http://aolsvc.health.webmd.aol.com/hw/sleep_disorders/hw49327.asp?printing=true
Posted by Elaine Gavalas on June 18, 2006 02:19 PM
