management of sleep apnea

                                     Management of sleep apnea

Sleep apnea

Sleep apnea means when a person suddenly stops breathing again and again during sleeping. Basically, it is a serious and common sleep disorder. If someone snores loudly and feel tired, every time, and unknowingly stop breathing again and again throughout the sleep, these are the indications of sleep apnea.

If the respiratory arrest for more than 10 seconds or 10 seconds, we call it a sleep apnea Snoring is considered a main symptom of sleep apnea, and risk factors are age, family history and obesity With each episode of sleep apnea blood pressure, cholesterol and sugar level increase. Oxygen in the brain begins to decrease.

Sleep apnea affects about 100 million people worldwide,20% of women and 30% of men, it can occur at any age. There are mainly  two types of sleep apnea,

1. Obstructive sleep apnea (OSA)   2. Central sleep apnea (CSA)

1. The obstructive sleep apnea is the most common and prevalent type, and is characterized by a blockage of airflow because of tongue and tissue collapsed during deep sleeping.

2. Central sleep apnea is a very serious type of sleep apnea, the nervous system fails to signals the muscles to breathe.In a result of this, the brain and the rest of the body may not get oxygen.

Symptoms of sleep apnea

The patient may appear sleepy or even fall asleep during the evaluation. The oropharynx is frequently found to be narrowed by excessive soft tissue folds, large tonsils, pendulous uvula, or prominent tongue. 

Nasal obstruction by a deviated nasal septum, poor nasal airflow, and a nasal twang to the speech may be observed. Below are some more basic signs and symptoms  of sleep apnea,

• Loud snoring  

• Restless sleep  

• Sudden breathing obstruction during the sleep  

• Fatigue   

• Bull neck appearance

• Depression  

• Morning headache  

• Irritability  

• Mood swings 

• Day time sleepiness  

• poor  memory & poor concentration   

• Impotence

Causes of sleep apnea 

Sleep apnea is mainly caused by the blockage of the throat and upper trachea, caused by soft excess tissues around the neck and throat. Most of these can be treated by removal, especially by losing weight. 

Sleep apnea a sleep disorder, patients stop breathing during sleeping, there  are some of the common reasons given below,

• Obesity  

• Big neck  

• Hypothyroidism 

• Drinking alcohol & smoking  

• High blood pressure  

• Enlarged tonsils 

Side Effects of sleep apnea

Sleep apnea is very dangerous, if left untreated, maybe lead to complications, some severe complications of sleep apnea are below,

• Stroke  

•  Anxiety  

• High blood pressure 

• Heart attack   

• Arrhythmia 

• Premature death 

• Lack of concentration  

• Diabetes 

Laboratory investigations

Mostly pulmonologists or ENT specialists diagnosis based on physical examination, but in some cases some tests are necessary. 

Erythrocytosis ( increase in red blood cell) is common. Thyroid function tests (serum, TSH, FT) should be collected to eliminate hypothyroidism.

Treatment 

Sadly to say, there is no cure for sleep apnea, although there is the treatment for the symptoms. Patient with sleep apnea is admitted in a hospital for a night for a sleep study, after the sleep study, the patient's treatment is decided according to what kind of treatment needs. Nowadays continuous positive airway pressure (CPAP) therapy is a frontline and common treatment for sleep apnea patients, it is highly effective.

In this (CPAP) method uses a mask that fits over nose and mouth, the machine slowly blows oxygen into your throat. The pressure from the air helps keep the airway open during sleep.

Nasal continuous positive airway pressure (nasal CPAP) at night is curative in many patients. Polysomnography is frequently necessary to determine the level of CPAP (usually 5-15 cm H, O) necessary to abolish obstructive apneas.

 For mild or moderate obstructive sleep apnea, Polysomnography is important to evaluate the effects of oxygen therapy. Mechanical devices inserted into the mouth at bedtime to hold the jaw forward and prevent pharyngeal occlusion have modest effectiveness in relieving apnea; however, patient compliance is not optimal. 

Uvulopalatopharyngoplasty (UPPP), is a procedure containing of surgery of pharyngeal soft tissue and removal of approximately 15 mm of the free edge of the soft palate and uvula, is helpful in about  50% of selected patients. It is more effective in evaluating snoring than apneic episodes.

Surgery: Mostly surgery is effective in treating snoring, but less effective in obstructive sleep apnea. Children with snoring or sleep apnea have enlarged tonsils & adenoids or both. In 80% of these cases, surgical of these tissues cures sleep-breathing problem  

Management of sleep apnea 

Sleep apnea can't be cured completely but can be controlled using different useful therapies. Lifestyle modifications are important to normaling breathing. People can control sleep apnea through changes in lifestyle. Patients with sleep apnea should avoid antidepressants and sleeping pills, and sleep on the side .

Avoid smoking and alcohol. Daily exercise and yoga are very important, regular exercise can increase energy level strengthen heart, don't sleep immediately after dinner.

Lose weight if someone is overweight, try to maintain healthy body weight by measuring BMI. Live a positive life, stay away from worries. You may have heard many people say that if we are sleeping with snoring then it is a sign of restful sleep, this is wrong, such people must consult a doctor once.