Have you ever awoken in the dead of night struggling for air? If this is the case, you could be having sleep apnea – a common sleep problem. In a nutshell, it’s a sleep condition in which your breathing haphazardly pauses for a while and resumes during the night. It doesn’t seem very appealing, does it?
Many people are aware of the most frequent kind of sleep apnea, obstructive sleep apnea: it is often neglected that a person may have other types of apneas. Although sleep apnea is fairly prevalent and can vary in severity, it typically goes undetected and, if left untreated, can have serious health consequences.
If you think you might have this illness, you should absolutely have it checked out. This article discusses what you should know about the three main types of sleep apnea. We’ll go through the manifestations, causes, and treatments for each of the three forms of sleep apnea.
What All Sleep Apnea Types Have in Common?
People with apnea experience such episodes often during sleep, leading them to partially awaken numerous times at night as they battle to breathe. Such incomplete arousals from sleep may occur hundreds of times a night in those with severe sleep apnea.
Since these awakenings are usually short, sleep apnea sufferers could be entirely ignorant that their sleep is erratic. However, the episodes can disrupt the sleeping pattern and stop people having sleep apnea from sleeping deeply and restfully. That’s why, despite obtaining a full night’s sleep, people with sleep apnea often feel extremely tired and drowsy the next day.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most frequent kind of sleep apnea. Obstructive sleep apnea begins with the muscles in the base of the neck relaxing. This relaxation induces your airway to contract as you inhale, lowering your blood oxygen levels. In an attempt to restore the airway, the body may often momentarily awaken at this point.
Even if you don’t recall getting up, this cycle may repeat throughout the night, impairing your ability to get a good night’s sleep.
When your brain detects a lack of oxygen, it sends a signal to your body to awaken enough to reopen your airway, which may cause you to struggle for breath during the night. Simply defined, obstructive sleep apnea occurs when there is insufficient air in your lungs throughout the nighttime, and your mind wakes you up for breathing.
We don’t know how many people suffer from obstructive sleep apnea, but evidence suggests it affects up to 20% of adults. And it looks like the prevalence is rising with time. Obesity, genetic history of OSA, hypertension, prolonged nasal congestion, asthma, diabetes, and constricted airways are all risk factors for OSA.
Certain drugs and alcohol consumption can also cause OSA. Obstructive sleep apnea affects more males than women, and it is more frequent in women after menopause.
Symptoms of OSA
Other obstructive sleep apnea symptoms include:
- Among the most evident indicators of possible OSA is loud, disturbing, and frequent snoring.
- A blockage causes frequent breathing pauses. While the body’s respiratory system battles through the obstruction, these cessations are frequently followed by gasping or choking noises.
- Frequent sleep disruptions produce excessive daytime tiredness.
- Morning headaches are caused by a lack of oxygen in the circulation flowing to the brain as a result of erratic breathing during the night.
- Obstructive sleep apnea patients generally experience restless nights because their brains and bodies are continually woken throughout the night, preventing them from entering the restful stages of non-REM and REM sleep.
- A person’s mental health might be harmed by a lack of regular, high-quality sleep. Short-tempered people with obstructive sleep apnea are more likely to be depressed in the long run.
Treatment Options For OSA
The blockage that clogs the airway must be removed in order to treat this type of sleep apnea. Changing your sleeping posture might be enough at times. Others find that decreasing weight, stopping smoking, or increasing their physical activity might help them feel better.
The following are some medical procedures that may be beneficial:
- Continuous positive airway pressure (CPAP): A CPAP machine keeps the airway open by continually blowing air into the throat through a mask worn over the nose (or the nose and mouth). It keeps a person’s upper airway open while they sleep by “stenting” it with pressured air.
- Surgery: By removing extra tissue or remodeling the airway, surgery can treat structural abnormalities in the mouth and upper airway.
- Oral appliances: By stopping the tongue from slipping back on the soft palate, some gadgets can assist in maintaining the airway open.
- Medicines: If daytime drowsiness remains despite proper therapy, several medications may assist, but they may not fix the core problem. The medication modafinil, for example, has been authorized by the Food and Drug Administration (FDA) for those who feel extreme drowsiness despite using a CPAP machine.
Central Sleep Apnea
Central sleep apnea (CSA) is distinguished from obstructive sleep apnea in that it is not caused by a physical obstruction of the airways.
The brain is the main problem with central sleep apnea. The same oxygen depletion and sleep disruptions that obstructive sleep apnea produces are caused by a malfunction in the brain’s signal transmission to the muscles that govern breathing.
Because this demographic is more prone to having issues or sleep habits that expose them to central sleep apnea, central sleep apnea is more common in those over 65.
Central sleep apnea can be caused by a variety of conditions, including heart failure, stroke, Parkinson’s disease, brain infection, or even sleeping at higher altitudes or taking a large dosage of opiates.
Symptoms of CSA
- During sleep, you may experience pauses in breathing or erratic breathing.
- Awakenings due to shortness of breath
- Excessive sleepiness during the day
- Chronic Fatigue
- Headaches in the morning
- Sleep Deprivation
- Concentration issues
- Mood shifts
- Snoring (snoring isn’t as common as in OSA patients)
Treatment Options For CSA
The most common treatment for central sleep apnea is to address the underlying issues that are generating the apnea in the first place.
The following are some medical procedures that may be beneficial:
- Continuous positive airway pressure:
(CPAP) is a term that refers to the pressure that is used to keep the airway open (CPAP). Using CPAP therapy, like OSA, is one of the earliest treatments for CSA. Sleep apnea patients wear a breathing mask when sleeping with a CPAP machine. During sleep, the mask delivers just enough steady air pressure to the patient’s airways to prevent tissue from collapsing (causing breathing pauses and snoring).
- Bilevel positive airway pressure:
(BPAP) is similar to continuous positive airway pressure (CPAP), but it varies the amount of air provided based on whether the patient is breathing or exhaling. An electronic sensor informs the BPAP to pump additional air through the mask during inhalation in order to remove the apnea-causing blockage. As a result, the air pressure is lowered when the user exhales. This reduction is beneficial to sleep apnea patients who struggle to breathe out under the continual pressure of a CPAP machine.
- Ventilation with adaptive-servo technology (ASV):
The adaptive-servo ventilation system monitors breathing and changes airflow via the mask to mimic the patient’s usual breathing pattern if they are awake.
This modification can be done promptly when the ASV senses that the person is not breathing properly (as in central sleep apnea, whenever the brain fails to instruct the body to breathe). ASV regulates the pressure once the person exhales or returns to a regular breathing rhythm.
Certain drugs have been used to promote breathing in persons with central sleep apnea, like acetazolamide (Diamox) or theophylline. If positive airway pressure treatment fails to work, medications may be provided.
- Stimulation of the Phrenic Nerve:
It is a novel FDA-approved treatment for adults with moderate to severe central sleep apnea. Phrenic nerve stimulation is a pacemaker-like gadget that activates the phrenic nerve in the chest to send impulses to the diaphragm that regulates breathing.
While you sleep, it analyzes respiratory signals and aids in the restoration of regular breathing patterns. It is not necessary to wear a mask because the gadget is implanted and switches on automatically during sleep.
Mixed Sleep Apnea
Obstructive and central sleep apnea symptoms are combined in mixed sleep apnea (MSA) also known as Complex Sleep Apnea. In some people who are currently using CPAP equipment to treat obstructive sleep apnea, PAP therapy can trigger symptoms of central sleep apnea. This phenomenon has been seen in sleep labs for a long time but has never been investigated.
One type of sleep apnea may be more prevalent than the other, implying that someone may have more obstructive sleep apnea or more central sleep apnea.
Symptoms of MSA
- Awakenings from sleep that are only a few minutes long
- Weariness during the day
- Headaches, dry mouth
- Sleeplessness or poor sleep quality
Treatment Options For MSA
For mixed sleep apnea, the best treatment choices are still being developed. CPAP machines, set at the lowest feasible pressure setting, are still one of the best therapies for keeping the airways clear of blockages while preventing the development of CSA symptoms.
BiPAP machines and adaptive servo-ventilation devices are used in some circumstances when CPAP fails, as they can better regulate ventilation (source). Bilevel positive airway pressure devices can tackle the obstructive aspect and also regulate ventilation amid central apneas by inducing breaths (timed breaths) during episodes of central apneas.
Adaptive servo ventilators have proven to be effective since they can analyze breath-to-breath and adjust their settings accordingly.
Although both BiPAP and ASV machines have proved to enhance treatments for mixed sleep apnea when compared to CPAP machines, there is currently no ideal treatment for mixed sleep apnea.
The Bottom Line
Understanding the underlying causes of sleep apnea, whether obstructive, central, or mixed, is critical in selecting the best treatment approach for you. An overnight sleep study that looks at your breathing while you sleep is a good place to start.
Sleep apnea, if left untreated, can lead to major health concerns like heart disease, obesity, dangerous daytime weariness, eye and vision difficulties, and mood and psychological disorders.
People who suffer from sleep apnea are 30 percent more likely than those who do not have a cardiac arrest or die from a heart attack. So if you or somebody you care about is having sleep apnea symptoms, see your doctor immediately.