Updated: Oct 28, 2021
By OnSky Medical Team
Sleep apnea is a serious type of sleep disorder in which the sufferer has episodes of complete pauses in breathing while sleeping. People with sleep apnea may stop breathing repeatedly, sometimes hundreds of times during the night, depriving the brain of enough oxygen.
This disorder has become quite common today, affecting quality of life and leading to serious health problems and even death. However, only about 10 percent of cases are diagnosed and treated because most patients do not know they have sleep apnea since the condition occurs only while they are asleep.
In addition, if your doctor is not a sleep specialist, they may not recognize this syndrome for timely detection and effective treatment.
Three types of sleep apnea
· Obstructive Sleep Apnea (OSA) occurs when your throat muscles intermittently relax and block your airway during sleep. The prevalence of OSA in the general adult population ranges from two to nine percent. OSA may be four times as likely in men and seven times more likely in those who are overweight (BMI > 30). Severe OSA increases the risk of death in middle-aged men.
· Central Sleep Apnea (CSA) is the condition in which the brain fails to ask the respiratory muscles to activate. This occurs in cases of brain damage due to pre-existing medical conditions (such as heart failure or neurological disease), leading to an imbalance in the respiratory control center during sleep.
· Mixed Sleep Apnea (MSA), also known as complex sleep apnea, is characterized by a combination of symptoms of central and obstructive sleep apnea.
OSA, the most common type of apnea, includes episodes of partial or complete closure of the upper airways during sleep that lead to apnea (defined as pauses in breathing >10 seconds). Obstructions can result from the tongue or tissues in the back of the throat being too large, abnormalities of the jawbone, etc.)
Anatomical risk factors of OSA, which can be common in obese individuals, include:
1). Pharynx "obstructive" due to short or receding lower jaw
2). Larger tongue root, or amygdala
3). Round head shape and short neck
4). Neck circumference > 43 cm (> 17 inches)
5). Thick wall of throat
6). Thick subpharyngeal fat
Other identified risk factors include postmenopausal status, aging, and alcohol or sedative use. Family history of OSA accounts for 25-40 percent of cases, and a person’s risk is proportional to the number of people in their family with the disease.
Symptoms suggestive of sleep apnea
Snoring accompanied by apnea, asphyxiation
Waking up many times during the night
Need to urinate several times during the night
Decreased memory, decreased concentration
Abnormalities in the maxillofacial region
If you have signs of suspected sleep apnea, you should see a respiratory specialist clinic for advice. Your doctor may conduct more in-depth sleep testing, specifically polysomnography. This test will help confirm if you have sleep apnea, and if so, the type of apnea. To detect other conditions such as heart failure, chronic respiratory diseases, neurological diseases or hormone diseases, your doctor may order additional tests, such as:
Clinical examination of respiratory system
Clinical examination of ear, nose and throat
Polysomnography: This is a test conducted by a sleep specialist that determines your apnea-hypopnea index (AHI), a scale that identifies the number of apneas and hypopneas measured per hour of sleep and helps determine the seriousness of your sleep disorder.
How to treat sleep apnea
There are many treatment methods, and depending on the patient’s symptoms, consultation with other specialists such as Ear-Nose-Throat, Cardiology, Neurology, or Endocrinology may be required. A combination of methods should be considered for best treatment results:
Continuous positive airway pressure
Wearing a jaw brace
Most cases of sleep apnea that remain undiagnosed and untreated are usually associated with hypertension, atrial fibrillation, and other arrhythmias or heart failure. At worst, undetected sleep apnea that causes excessive sleepiness during the day may result in death from motor vehicle or other accidents.
Importance of detection
Regardless of the cause, sleep apnea needs to be detected and treated promptly to avoid causing serious health effects that could lead to reduced quality of life or even death. Although polysomnography is the gold standard for the most comprehensive sleep assessment, it requires an overnight clinic stay. For elderly and high-risk patients who need to assess sleep quality continuously over several days, a device that helps monitor sleep breathing at home may be more convenient for detection.
OnSky Health provides a unique device called SkyPad that helps monitor sleep and health status in general. This industry-first device can also contact family members in an emergency situation, providing assurance for the patient and family. As a result, patients and their family members can react and intervene promptly, as well as detect early risks of many other complex diseases.