Sleep Apnea: Causes, Symptoms & Treatment

You might have heard wives complaining about their husbands snoring and their friends laughing about it. Usually this situation is caused by a medical condition called Sleep Apnea, and it is time to take it seriously.This occurs when you stop breathing in sleep due to any blockage unless your brain triggers a survival reflex that wakes you just enough to start breathing. This reflex helps maintain your blood oxygen level but disrupts your natural sleep cycle. Lack of proper  sleep for days adds to the stress on major organs like the heart and central nervous systems, eventually having fatal consequences if not treated.

What is Sleep Apnea? 

To understand this condition better, you need to have a basic understanding of the human sleep cycle. You begin this cycle with light sleep and gradually move to deeper sleep, slow wave sleep and finally to REM sleep (rapid eye movement sleep) as the night goes on. The last stage is when you start dreaming. The severity of the disorder (mild, moderate, severe) depends on the number of disruptions happening per sleep cycle. “Apnea” or complete block of airflow and “Hypopnea” or low oxygen flow can both cause this condition. 

Types of Sleep Apnea

The 3 major types of sleep apnea are: 

1. Obstructive Sleep Apnea (OSA) is the most common sleep disorder where your throat or upper airway muscles relax and narrow the windpipe or completely close it. Some common causes of OSA are obesity, hormone imbalances, asthma or large tonsils. It is common among older men and post-menopausal women. Snoring interrupted by moments of silence is often a symptom of OSA. However, snoring does not necessarily indicate obstructive sleep apnea. 

2. Central Sleep Apnea (CSA) occurs when signals from the brain controlling breathing activity are disrupted. In normal circumstances, the brain controls all the organs that make sure you continue while you are sleeping. In a  person with CSA, the brain stops sending signals to the breathing-related muscles. Some of the causes of CSA can be heart failure, low oxygen levels, nervous system damage, etc.

3. Treatment-Emergent Central Sleep Apnea is a condition that manifests while the patient is using continuous positive airway pressure  treatment for OSA. This is usually a combination of both obstructive sleep apnea and central sleep apnea.

What are the Usual Causes of Sleep Apnea?

Sleep Apnea causes can be categorised depending on the types mentioned above. 

Causes of Obstructive Sleep Apnea  

1. Excess weight gain or obesity can increase tissue or muscle pressure on the airway and obstruct the smooth flow of air causing obstructive apnea. OSA can in turn play havoc with metabolism and contribute to more weight gain.
2. Structural deviations like an underbite,  unusually small jaw, large tongue and tonsils, and large neck circumference can also cause obstructive sleep apnea.
3. Genetic anomalies that cause Down Syndrome or Prader-Willi syndrome that affect the growth of head and neck muscles can also give rise to this condition.
4. Use of alcohol can also lead to you developing this problem. This is because alcohol cause the muscles in your throat to relax, which can lead to breathing obstruction during the sleep cycle.

Causes of Central Sleep Apnea 

1. Congestive Heart Failure or other heart problems where heart muscles are unable to pump enough oxygenated blood to the lungs and brain, can cause CSA.
2. A decrease in oxygen levels at high altitudes can also be responsible for central sleep apnea.
3. A damaged central nervous system, specifically parts of the spinal cord and brain stem can be responsible for this kind of apnea. Certain neurological conditions like Lou Gehrig’s disease can lead to CSA as well.
4. Sometimes treatment of obstructive sleep apnea with constant CPAP (a machine used to normalise breathing while you sleep), may give rise to Central Sleep Apnea.  

What are the Symptoms of Sleep Apnea?

The sleep apnea symptoms vary between adults and children.. The obstructive sleep apnea symptoms and central sleep apnea symptoms overlap making it difficult to diagnose the specific type. Some of the common symptoms which make it easier to spot sleep apnea in adults are: 

1. You will be fatigued even after a full night's sleep
2. Feeling drowsy and sleepy throughout the day happens in severe cases
3. Snoring is a common feature of sleep apnea. However, not all cases have snoring as their symptoms
4. Waking up with a severe headache in the morning may be a sign of sleep apnea
5. Night sweats, feeling restless and waking up short of breath in the middle of the night are some of the indications of this disorder
6. Unusual breathing pattern as in Cheyne-Stokes breathing which happens in central sleep apnea. It causes alternate deeper and shallower breathing and breathing stops finally for a few seconds and then the cycle continues again. 

A few symptoms prevalent among children are: 

1. Children may perform poorly at school due to a lack of focus, and be hyperactive which is very similar to symptoms of Attention deficit hyperactivity disorder 
2. Loud snoring while sleeping can be another symptom of children for sleep apnea
3. Bedwetting and frequent arm and leg movements while sleeping may be because of sleep apnea 
4. Children may also have night sweats and heartburn like in adults if they suffer from this disorder
5. Children may sleep in unusual positions or keep their necks extended while asleep

Sleep Apnea Treatment

Since there is no permanent cure, some sleep apnea treatments should become a part and parcel of your daily routine to reduce the severity of its impact on your long-term health.

A few possible ways of treatments are : 

1. Conservative or Non-medical Treatments: These are usually methods used for obstructive sleep apnea treatment. They may not cure apnea but can control and reduce apnea to a point where no symptoms become severe. A significant decrease in body weight and healthy fitness habits can improve this condition. Change in sleeping positions with sleeping aids may also help. Over-the-counter products like nasal sprays and adhesive strips improve breathing and help in cases of mild sleep apnea. Consulting a doctor to reduce opioid medicine may help resolve central sleep apnea. 

2. Positive Airway Pressure (PAP) and Adaptive Ventilation: These are devices attached to your nose and mouth which push pressurised air down your windpipe and lungs preventing the soft tissue in your airtube from blocking the air passage. The best-known PAP machine is the Continuous Positive Airway Pressure (CPAP) machine which you will find in a variety of styles and modes suiting your needs.  

3. Nerve Stimulators: In this process, the hypoglossal nerves under the tongue are attached to a stimulator which prevents your tongue from pressing backwards, as it happens in obstructive sleep apnea. The current in the stimulator is strong enough to hold back your tongue but mild enough to make it comfortable. The phrenic nerves in the diaphragm, which are the muscles under the lungs, can also be attached to stimulators to help in central sleep apnea. 

4. Surgery: Sleep apnea surgery of the nose, mouth, and throat often helps in the treatment. Somnoplasty uses radiofrequency(RF) to remove soft tissue around the upper part of the airpipe.Tonsillectomy is most helpful in children with obstructive sleep apnea.Uvulopalatopharyngoplasty or the removal of tear-shaped muscle, Uvula at the back of your mouth can also widen the pathway. Jaw surgery and Nasal surgeries also help in rectification of any structural defect causing sleep apnea. 

Alternate Home Remedies for Sleep Apnea

Sleep Apnea home treatment involves lifestyle changes and self-care practices, which can be highly effective in fighting obstructive sleep apnea.Moderate amount of weight loss coupled with regular exercise can go a long way in managing this condition.  Avoiding alcohol and some anti-anxiety or sleeping medication can improve your obstructive sleep apnea. Try to improve your sleeping posture by sleeping on your side and keeping a pillow to prevent sleeping back on your stomach. In case of congestion or cold keep your nasal passages free by using saline nasal spray or anti allergies. However, some medicines are recommended only for short-term use. Do consult your doctor for all such medication. 

Wrapping-up!

You might have numerous questions in mind like, can sleep apnea kill you? Or is sleep apnea dangerous? Research has found that obstructive sleep apnea increases the risk of sudden death, especially in people above the age of 60. If untreated, OSA can upset normal cardiovascular and neural functioning leading to sudden cardiac arrest. The best possible way of treatment is the CPAP method which doctors prefer over surgery as it is the most effective treatment worldwide. 

You must be wondering if your health insurance coverage CPAP? In India coverage depends on the type of policy and severity of the condition, but it needs to be declared as a pre-existing condition. So, be careful and diligent while applying for coverage and try the simple remedies which might be more helpful in the long run. 

>> Also Read: Sleep Paralysis: Symptoms, Causes & Treatment

Disclaimer: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.