Sleep Apnea

Snoring is the primary underlying sign of Sleep Apnea. Sleep apnea is a medical condition in which simple snoring is not just snoring but leads to an obstruction of the airways because of backward movement of the jaw and obstruction of the back of the throat. So snoring and sleep apnea is the spectrum of the same condition. More than half of the people who snore may have underlying obstructive sleep apnea syndrome.

About sleep apnea

Snoring is the primary tell tale sign of obstructive sleep apnea syndrome.  All snorers may not have sleep apnea but all obstructive sleep apnea patient’s have snoring.  The most common feature is pauses in one’s breathing, leading to snorting and disruption of sleep including restless sleeping with tossing and turning. The obstruction related to sleep apnea occurs by the backward movement of the jaw, leading to obstruction of the throat. This is prevented by Sona Positioning TM trademark and using the patented Sona Pillow ® and Super Pillow TM.

The most common type of sleep apnea is obstructive sleep apnea. In this condition, the airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses.  This condition is more evident while sleeping on ones back as the jaw moves back and is most likely to obstruct airways in that position. As we age and or gain weight airways are more likely to obstruct.

As one falls asleep and the jaw relaxes, in the affected individuals it causes an obstruction at the back of the throat and snoring and snorting starts. This may lead to complete obstruction of the airway which is the primary salient feature of sleep apnea and leads to decrease in oxygen level, increasing heart rate and an interruption in sleep.  This is measured as RDI (Respiratory Distress Index), which is graded according to the number of times that a person stops breathing during their sleep and a disruption in the sleep pattern which is monitored during the sleep study is noted. According to the AASM American Academy of Sleep Disorders Medicine grading of sleep apnea is calculated by RDI:

RDI of 5-15 events per hour is mild sleep apnea
RDI of 15-30 events per hour is moderate sleep apnea
RDI of 30 and more is severe sleep apnea

The most common sign of sleep apnea is snoring. Sleep apnea is noted in both men and women.

Obstructive sleep apnea is primarily a function of the jaw overbite and retropositioning of the mandible. The presentation of this condition
becomes more prominent in overweight people.

Central sleep apnea is a different condition related to lack of awakening of the brain as an obstruction of the airway happens or the brain just stops breathing spontaneously. During episodes of central sleep apnea the brain does not get a signal to initiate breathing when there is lack of oxygen and obstruction of the airways.

Presentation

Snoring and pauses in the breathing with excessive daytime sleepiness are the most common symptom of sleep apnea. Sleepiness is measured by the sleepiness score located on this website.

In individuals having sleep apnea patient obstructs their airways while sleeping and more prominently on their back due to retropositioning of the jaw and obstruction of the airflow. This leads to snoring and snorting noise and it may not always wake up the person completely, but it is enough to cause a disruption in your sleep, which is documented during EEG monitoring in a sleep study. This is what causes the person to be excessively sleepy during the daytime because of interrupted sleep pattern.

The person having obstructive sleep apnea syndrome may not always recognize the symptoms, but it is more commonly noted by the family members. The obstruction of the airways does not have to be complete andthe pauses do not have to be complete pauses excessive airway pressure is adequate to cause similar symptoms.

Patient most commonly present with waking up non-refreshed, sleepiness during the daytime, grinding of the teeth, excessive weight gain, poorly controlled hypertension, memory difficulties and increased chances of having cardiovascular events such as heart attack and stroke.

Treatment

People who snore should start off by using positional therapy and Sona Pillow ® or Super Pillow TMs, both of these patented products promote positional therapy which has been shown to be an effective measure of assisting in the correction of snoring and obstruction of the airways.

Other modalities of treatment are CPAP therapy (continuous positive airway pressure) which consists of a specialized air compressor which pushes in air and keeps the airways open but requires a mask which is placed over the nose and/or mouth. The exact pressure of CPAP has to be determined by performing a sleep study. This therapy is cumbersome, difficult to tolerate, expensive and hard to utilize.

Other measures utilized may be surgical correction which is quite invasive.  Occasionally, weight loss and positional therapy may improve symptoms substantially.  Potential medical and social consequences of sleep apnea Heart attack and worsening of heart failure and breathing difficulties, all related to the cardiovascular abnormalities associated with sleep apnea.  Stroke risk factor is substantially increased in people who have obstructive sleep apnea syndrome and correction is recommended by the AASM the American Academy of Sleep Medicine and AAN the American Academy of Neurology and needs to be evaluated and addressed as an underlying cause.  Excessive daytime somnolence, leading to increased work injuries and car accidents.

Obesity and weight gain which person cannot lose, this occurs because the excessive daytime somnolence/sleepiness and the lack of nighttime uninterrupted sleep does not let your basal metabolic rate to get up to an active awake status. So it is not just the amount of food that you’re consuming and the calories, but the sleep interruptions which lead to suppressed basal metabolic rate and thus weight gain.

Bruxism (grinding of teeth) is a major sign and side effect of snoring and sleep apnea because the body tries to protect itself from retropositioning of the jaw and obstructing the airways by trying to clench the teeth and keep the mandible forward. This leads to tooth decay, TMJ pain (temporomandibular joint/jaw), loss of teeth and grinding of the teeth.

Poor control of blood pressure occurs as you are trying to breathe against an obstructive airway during your sleep which leads to the heart working harder. This is the main cause of cardiovascular risk factors associated with sleep apnea.  Lower social economic status is statistically associated in people with sleep apnea because of lack of productivity, difficulty attending school because of sleepiness and tiredness and other metabolic dysfunctions. That is why one of the questions we ask our patient’s suspected of sleep apnea is what they able to attend school and take early morning classes in college, or did they always opt for later classes.

Dementia has obstructive sleep apnea syndrome as a frequent underlying cause. Short-term memory is consolidated during your non-REM sleep at night, which is interrupted if you are having snoring and sleep apnea. This is manifested by tossing and turning and frequently waking up at night. Anxiety and panic attacks are aggravated by excessive sleepiness and may even be manifested at night in which people wake up suddenly short of breath and tachycardic because of an apneic event.

All material on this site is copyrighted and is not to be copied or reproduced in any manner without the express written permission of Remarkable Life USA.  All individuals who suspect that they may have sleep apnea should consult with their physician as sleep apnea is a serious medical condition.