Apnea refers to the temporary cessation of breathing, a condition where the body stops inhaling and exhaling air. This pause in respiration can last for seconds to minutes, disrupting the body’s normal gas exchange. Understanding apnea is important due to its prevalence and potential health impacts.
Understanding Apnoe
When breathing stops, the body’s physiological balance is disturbed. Oxygen levels in the bloodstream decrease (hypoxemia), while carbon dioxide levels increase (hypercapnia). This imbalance signals the brain’s respiratory control centers to resume breathing.
The brain responds by briefly rousing the individual from sleep, often without them fully remembering the awakening. This allows the airway to reopen and breathing to restart, sometimes accompanied by gasping or snorting. Repeated episodes of low oxygen can stress the cardiovascular system, potentially increasing the risk of high blood pressure, heart disease, and stroke.
Types of Apnoe
Apnea manifests in different forms, with the most common being related to sleep. Obstructive Sleep Apnea (OSA) occurs when the muscles supporting the soft tissues in the throat relax excessively during sleep. This relaxation causes the airway to narrow or completely close, blocking airflow. Snoring is a common sign of OSA, often punctuated by periods of silence followed by gasps for air.
Central Sleep Apnea (CSA), in contrast, involves a breakdown in the brain’s signals to the muscles that control breathing. The brain fails to send commands, leading to a temporary absence of respiratory effort. CSA is less common than OSA and is often linked to underlying medical conditions like heart failure or stroke. Mixed sleep apnea is a combination of both obstructive and central mechanisms.
Recognizing and Diagnosing Apnoe
Recognizing apnea can be challenging, as many individuals are unaware of their breathing disruptions during sleep. Common signs suggesting sleep apnea include loud and frequent snoring, observed pauses in breathing by a bed partner, and gasping or choking sounds during sleep. Individuals may also experience excessive daytime sleepiness, difficulty concentrating, morning headaches, or irritability.
If apnea is suspected, consulting a healthcare professional is important for diagnosis. The primary diagnostic tool is polysomnography, or a sleep study. This test typically involves an overnight stay at a sleep center or can be done at home. Sensors monitor brain waves, blood oxygen levels, heart rate, breathing patterns, eye movements, and leg movements while the individual sleeps. The collected data helps determine the presence and severity of apnea, quantified by an Apnea-Hypopnea Index (AHI) score, which indicates the number of breathing disturbances per hour.
Treatment Approaches for Apnoe
Treatment for apnea, particularly sleep apnea, often begins with lifestyle modifications. Losing excess weight can significantly reduce symptoms in many individuals, as fat deposits around the neck can obstruct the airway. Avoiding alcohol and sedatives, especially before bedtime, is also recommended because these substances can relax throat muscles and worsen breathing. Adopting a consistent sleep schedule and sleeping on one’s side instead of the back can also help keep the airway open.
Medical devices are frequently used. Continuous Positive Airway Pressure (CPAP) therapy is a widely recognized treatment for obstructive sleep apnea. A CPAP machine delivers a continuous stream of pressurized air through a mask worn during sleep, acting like a pneumatic splint to keep the airway open. Oral appliances, custom-fitted by a dentist, reposition the jaw or tongue forward to prevent airway collapse. These devices are often effective for mild to moderate cases.
Surgical interventions may be considered if other treatments are not effective or tolerated. Procedures can target various areas, such as removing excess tissue from the palate or tonsils, repositioning the jaw, or stimulating nerves that control tongue muscles. Nasal surgeries, like septoplasty or turbinate reduction, can also improve airflow and make CPAP use more comfortable. Emerging therapies, such as myofunctional therapy to strengthen oral and facial muscles, are also being explored.