Sleep Apnea: Causes, Symptoms And Treatments

Sleep apnea can be a very serious sleep disorder if left untreated. Sufferers of this medical condition start and stop breathing irregularly, and in some cases, this disorder can cause more severe health issues. It’s estimated that roughly 26% of adults between the ages of 26 and 70 have some form of sleep apnea, and can even be present in some children.

If left untreated, it can increase the risk of conditions like high blood pressure, heart disease including heart attacks, type 2 diabetes, liver problems, and complications during surgical procedures. 

It’s very important to seek treatment if you suspect you may have untreated sleep apnea.

There are different types of this condition, and occasionally, the symptoms may overlap. However, it can be treated once properly diagnosed by a specialist.
 

Obstructive sleep apnea (OSA)

Obstructive sleep apnea is the most common form of this sleep disorder. It occurs when muscles in the throat relax, and block the airway passages. When this happens, the brain will wake the body up so that the muscles tense back up and airflow can continue.

People with this type of sleep apnea often find themselves feeling very drowsy during the day, because their brain is consistently waking them up at night — sometimes, up to 30 times an hour. In fact, this is usually how patients will first find out about their condition. Constant grogginess, inability to reach deep REM sleep despite changing sleep positions, and snoring are usually the main symptoms of sleep apnea.

However, each patient’s symptoms (as well as their sleep apnea treatment plan) will vary based on the cause of the issue.

Causes of obstructive sleep apnea may include:

• Obesity, which can add pressure to the neck and air passages.
• High blood pressure.
• Swollen tonsils, or other swelling that constricts the airway.
• Consistent use of alcohol, sleep sedatives, muscle relaxers, or other tranquilizers.
• Smoking, which can cause a buildup of fluid and irritation.
• Other risk factors include being male, having a thicker neck with a larger circumference, a family history of sleep apnea, and underlying healthy conditions.

Signs of sleep apnea:

OSA symptoms can vary greatly between person to person. Generally, anyone with this condition will be tired and groggy during the day. They may not know why, because sometimes they don’t even remember waking up throughout the night. However, drowsiness may not be the only symptom. Other obstructive sleep apnea symptoms may include:

• Consistent, loud snoring.
• Waking up frequently throughout the night.
• Poor sleep quality.
• Sore throat.
• Dry mouth in the mornings.

 

Central sleep apnea (CSA)

Central sleep apnea (CSA) is another type of this sleep disorder, although it is more rare. Although the symptoms may be similar to OSA, the underlying issue is very different. In OSA, the throat muscles relax and block the airway. With CSA, the breathing pauses are caused by something very different, and are usually neurological or induced.

Central sleep apnea causes:

• The brain isn’t telling the respiratory system to automatically function.
• A stroke or heart failure.
• Sleeping at a high altitude.
• The use of opioids or other sleep sedatives, muscle relaxers, or tranquilizers.
• Underlying heart conditions.
• Treatment of obstructive sleep apnea with a continuous positive airway pressure (CPAP) machine, which can result in treatment-emergent central sleep apnea.

Signs of central sleep apnea:

Again, the symptoms of central sleep apnea can often overlap with those of OSA. But because the causes are so different, it’s very important to receive a proper diagnosis from a sleep specialist. A treatment plan is also contingent upon being diagnosed properly.

Symptoms may include:

• Waking up frequently throughout the night.
• Breathing pauses while sleeping.
• Morning headaches.
• Poor sleep quality.
• Excessive daytime sleepiness.

One thing to note is that loud snoring is not usually found in sufferers of CSA. Additionally, it’s very common for a partner or family member to notice the pauses in breathing while the patient is sleeping. Usually, a partner noticing the breathing pauses is what triggers an appointment with a sleep specialist.
 

How to diagnose sleep apnea

Oftentimes, a family member will notice that the sleep apnea sufferer stops breathing while sleeping. Other times, someone with sleep apnea will notice some of the above symptoms. Once sleep apnea is suspected, it’s time to schedule a consultation with a sleep specialist. 

The specialist will conduct a sleep study, and will usually monitor oxygen levels in the study participant. They may also conduct a physical exam, to determine whether the sleep apnea is obstructive, or central. 

The sleep study is usually conducted with a sleep test, although with recent technological advancements, the study participant may be able to take the test at home. Home sleep tests will monitor and measure a variety of things, including blood oxygen levels, breathing patterns, heartbeats, and more. For a more detailed sleep study, the patient may be required to go to a sleep center for a nocturnal polysomnography. 

After the study, the sleep specialist may refer the patient to other specialists to rule out any other causes. Depending on the options of other specialists, like an ENT or cardiologist, the patient may be diagnosed with OSA or CSA. Afterwards, the specialist will then walk the patient through treatment options.
 

Treatments of sleep apnea

For central sleep apnea a sleep specialist may recommend a CPAP machine, and/or additional treatments for the underlying cause. However, there’s an additional option for patients diagnosed with obstructive sleep apnea.

Oral appliance therapy is a great alternative to the CPAP machine. With a customized oral appliance, your jaw will be supported in a forward position while you sleep, maintaining an open upper airway. 

Oral appliance therapy is also very highly recommended by many sleep professionals because they are more comfortable than a CPAP machine. Because it’s so quiet, easily portable, and very easy to clean, many patients find that the oral appliance is a better option to treat their obstructive sleep apnea.

Here at Bear Brook Dental Care, Dr. Kiwon Lee has worked with hundreds of patients with sleep apnea. Dr. Lee is an American Board of Dental Sleep Medicine (SBDSM) Diplomate. ABDSM is the leading national organization for dentists who treat snoring and obstructive sleep apnea with oral appliance therapy. Earning Diplomate status from the ABDSM is a unique honor recognizing special competency in dental sleep medicine. Bear Brook Dental Care takes great pride in having a knowledgeable staff and resources to provide top-tier services for their patients.

You can find more information on sleep apnea here, and you can watch Dr. Lee explain more about sleep apnea on this segment of CBS Channel 2 “American Health Front.”