Sleep Apnoea
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Sleep Apnea (Apnoea)

General Information

Sleep Apnoea is an illness which causes a person to stop breathing many times during each night's sleep. In severe cases, the number of times a person stops breathing can be over 100 times in an hour; sometimes the period of apnoea (no breathing) can be up to 3 minutes long! Anyone can develop Sleep Apnoea at any age. It is a serious and sometimes life-threatening illness which appears to affect males more frequently than females. In some cases, the symptoms reach maximum severity very quickly, in others the symptoms are more gradual.

There are two main types of Sleep Apnoea:

Central Sleep Apnoea (CSA) is a relatively rare nervous system disorder. When a person suffering from this type of Sleep Apnoea falls asleep, the diaphram (the muscle separating the chest and abdominal cavity which helps move air in and out of the lungs) stops moving because the brain fails to send the proper impulses through the nerves to move the diaphram. Breathing stops!

Obstructive Sleep Apnoea (OSA) is far more common. In OSA, there is an abnormal loss of tone (healthy elasticity) in the muscles of the tongue, throat and larynx during sleep. As a result, the throat collapses and air flow is completely (apnoea) or partially (hypopnoea) blocked. the diaphram continues to contract with progressively more force until a partial or complete wakening occurs, and normal breathing is resumed.

Some persons have a combination called Mixed Sleep Apnoea.

Apnoeic episodes cause the oxygen content of the blood to drop and carbon dioxide levels to rise. This means the heart, brain and other vital tissues are periodically deprived of oxygen. Furthermore, blood pressure rises and the heart slows. The elevated blood pressure may eventually remain elevated during the day as well.

Sleep Apnoea is suspect as a cause of many deaths which occur during sleep.

If you suspect you might have Sleep Apnoea, review the following:

One of the most obvious indicators is extremely loud, heavy snoring, often interrupted by gasps and long pauses in breathing. Just because you snore does not necessarily mean you have sleep apnoea! Apnoea snoring is almost always puntuated by periods of no breathing at all, or gasping for air. If you think you might have Sleep Apnoea, check with your doctor!

Other symptoms MAY include:

It is important not to ignore these symptoms as possible consequences are heart attacks and strokes. Many sufferers of Sleep Apnoea think they are "champion" sleepers, able to sleep anywhere anytime, and not aware of their frequent awakenings during sleep. Make no mistake: sleep apnoea can be very dangerous.

There are a number of factors which appear to work together to cause Sleep Apnoea. Many cases are the result of obesity - which results in excessive fatty tissue in the throat area, a short neck and heavy jaws. These factors can work together to cause a collapse of the airway. Many sufferers of Sleep Apnoea have a history of chronic nasal congestion, nasal surgery, polyps, nasal deviation, enlargement of the tongue, tonsils or an abnormal jaw structure. Associated conditions include hypothyroidism and disorders of the pituitary gland. Any underlying cause or associated condition should be treated first. See your family Doctor - you may be referred to an Ear, Nose, Throat Specialist. A referral to a sleep lab must be done by a physician. Overnight testing (polysomnography) may be conducted to determine if there is a problem.

Behavioral interventions to promote weight loss are important. It is best that there be no alcohol intake at all. Alcohol relaxes the muscles of the throat, making it more difficult to breathe during sleep. Caution should be exercised in taking sedatives, due to the fact they depress respirations (breathing). It is important not to drive while you are sleepy.

Depending on the cause of the Apnoea, certain surgical treatments may be tried - Uvulopalatoplasty (UPP) and Laser Assisted Uvulaplasty (LAUP ) being the two most common. Neither are absolute cure-all by anyone's reckoning, the best estimate of success for UPP being around 50%. While LAUP is sometimes effective in reducing snoring, its effectiveness in treating apnoea is questionable. As with any surgery, careful consideration and consultation with you doctor is called for. Some people have successfully used a dental appliance, when the cause appears to be jaw structure.

The most common treatment for Sleep Apnoea is nasal CPAP. CPAP stands for Continuous Positive Airway Pressure. Air is supplied via a small machine, through a hose, at a prescribed pressure, into the nose via a mask fitting over the nose. This device keeps the airway open while a person sleeps, preventing it from collapsing. A newer model called BIPAP (Bi-level Positive Airway Pressure), delivers a higher pressure during inspiration and a lower one during expiration. The good news is that CPAP seems to work fairly consistently for most people. While it is not the most comfortable or appealing thing to wear while sleeping, many people swear by it and most generally agree that the benefits are worth it.

For even more information on sleep apnoea and snoring, DEFINITELY check out The Phantom Sleep Page (Apnea, snoring & other sleep problems. For a quiz that can help identify obstructive sleep apnea, Free questionnaire for sleep apnea for an article that views snoring as a warning of sleep apnea.

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