WISHING YOU ALL A VERY HAPPY 2025
Friends till a few days back I was unaware of one health condition, it was only when one of my colleague wrote in the WhatsApp group that he was suffering from this health condition. I am talking about a sleep disorder called SLEEP APNEA.
What is Sleep Apnea?
Sleep apnea is a type of sleep-related breathing disorder, a group of sleep disorders characterized by abnormal breathing patter during sleep. People with sleep apnea repeatedly have reductions or pauses in breathing for brief periods while they sleep. Although these lapses cause a person to awaken periodically and reduce sleep quality, sleepers may not fully wake up and remain unaware that their nighttime breathing is abnormal. There are types of Sleep apnea, categorized by the cause of sleep disruptions.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) occurs when the airway at the back of throat becomes constricted or blocked during sleep, which may cause snoring as air is prevented from passing through normally. In response to the airway obstruction, a person usually wakes up, engages the muscles in the throat and takes several gasps or deep breaths, often accompanied by sounds like snorting or choking. OSA is the most common type of sleep apnea. It is estimated to affect 10 to 30% of adults.
Central Sleep Apnea
Central sleep apnea (CSA) involves disruption in the communication between the brain and the muscles that control breathing. As a result, breathing may become shallower and have temporary pauses. The prevalence of CSA is low compared to OSA. It is estimated that less than 1% of the people have this condition.
Symptoms of OSA
These include
- Excessive daytime sleepiness.
- Loud snorting that is often punctuated by gasping or choking sounds.
- Headaches in the morning that may persist for several hours after waking up.
- Dry mouth upon awakening.
- Restless sleep with periods of wakefulness during the night.
- Increased need to get up from bed to urinate.
Certain symptoms of OSA may not be noticeable, unless noticed by the bed partner.
Symptoms of CSA
These include
- Abnormal breathing patterns, such as breathing that slows down, speeds up, and pauses during sleep.
- Excessive daytime sleepiness.
- Nighttime awakenings.
- Sudden shortness of breath or chest pains at night.
- Morning headaches and difficulty in focusing.
Causes of OSA
In people with OSA, the muscles in the back of the throat relax during sleep, reducing space for air to pass through. Snoring occurs as the airways narrows, and when airway is obstructed, a person fails to get enough oxygen. The lack of oxygen causes partial or complete awakenings in order to restore airflow. These disruptions happen repeatedly during sleep.
Causes of CSA
CSA arises because of problem in how the brain communicates with muscles responsible for breathing. For people with CSA, a part of the brain called brain stem fails to properly recognize carbon dioxide levels in the body during sleep. This leads to repeated episodes of breathing that is slower and shallower than it should be.
How is Sleep Apnea Diagnosed?
It includes with a person’s symptoms and overall health, as well as physical examination. This is designed to detect signs of sleep apnea and identify risk factors. A sleep study is necessary to diagnose OSA or CSA. The most dependable sleep study is called polysomnography, which is conducted during an overnight stay at specialized sleep lab.
Treatments for OSA
Positive airway pressure (PAP) therapy is a treatment offered to almost all people with OSA. PAP therapy keeps the airway open with pressurized air that is pumped from a machine through a hose and mask worn on the face. There are different types of PAP devices available, your doctor will guide you accordingly. In December 2024, the USA Federal drug Authority (FDA) approved weight loss drug Zepbound to treat moderate to severe OSA in patients with obesity. For some severe cases, a surgery is recommended to remove tissue in throat and expand the airway is also an option.
In certain patients of OSA, lifestyle changes are also recommended like: reducing BMI by losing weight, Getting regular exercise which may decrease OSA symptoms even without weight loss, altering sleeping position to avoid back sleeping, and reducing alcohol consumption.
Treatments for CSA
It mainly focuses on addressing the medical issue causing abnormal breathing. However if the symptoms are CSA are persistent or severe, the treatment may include the use of PAP devices to promote steadier breathing during sleep. Other possible treatments include supplement oxygen therapy or use of medication that can speed up person’s breathing.
Other breakthrough for sleep apnea patients
A health research organization in UK have developed an app controlled stimulator that zaps nerves in the tongue so that patients can breath uninterrupted while sleeping. This neuro stimulator is surgically inserted, and its electrodes are put in contact with the hypoglossal nerve which makes the tongue move. An external activation chip is attached under the chin at night with an adhesive patch. The chip stimulates the nerve while sleeping, which prevents the tongue from falling back and blocking the upper airway.
A company in the USA has come up with the Remede implant, a pacemaker-like device specifically made for CSA patients. This device sends small electrical currents to the diaphragm to stimulate normal breathing rhythms. A cardiac electro physiologist implants the battery-powered device under skin of the upper chest in a minimally invasive procedure. The first implant took place in the USA in Dec 2023. This system has clinically proven proven ti improve patients with CSA.
Living with Sleep Apnea
Follow these steps
- Work closely with doctor
- Take proper care of treatment devices
- Avoid high risk activities long driving, operating heavy machinery etc.
- Consider changing sleeping position
- Minimise alcohol consumption
- Inform other doctors ( if you any other ailment) about sleep apnea.
Waiting for your comments/feedbacks on this blog.
Anil Malik
Mumbai, India
2nd January 2024