Sleep apnoea or apnea is a serious sleep disorder in which you have periods of shallow breathing or pauses in breathing while you sleep. "Apnoea" is a Greek word, which means "without breath." Sleep apnoea is primarily characterized by snoring and feeling tired despite getting a full night sleep and is more commonly seen in men than in women.
Conditions which may cause or lead to central sleep apnea include:
It is difficult to differentiate between obstructive sleep apnoea and central sleep apnoea. They have similar signs and symptoms, making the type of sleep apnoea difficult to determine. The most common signs and symptoms of obstructive and central sleep apnoeas are:
If sleep apnoea is left untreated, it can increase the risk of, or worsen, high blood pressure and heart disease and may make arrhythmias or irregular heartbeats more likely. It also increases the risk of stroke, obesity and diabetes. It increases the chance of having work-related or driving accidents caused by falling asleep at work or at the wheel. It can cause, or worsen, depression and other ailments.
You need to consult your doctor if you experience, or if your partner notices, the following:
A board-certified sleep medicine physician has the training and expertise in diagnosing and treating sleep apnoea. You will need to provide the sleep medicine physician details of your symptoms and whether they began when you gained weight or stopped exercising. The physician may ask you to keep a sleep diary for two weeks to help him see your sleep patterns. This includes the time you went to bed each night, when you woke up in the morning and how many times you woke up each night. This information is important in making a correct diagnosis and treating your sleep problem.
An objective test may be needed before your physician can make a diagnosis. Objective evaluation of sleep apnoea falls into two categories: Polysomnography and limited channel monitoring.
A Polysomnogram (PSG) is considered the gold standard for diagnosing sleep
apnoea. This type of sleep study requires you to sleep overnight in a sleep laboratory while being monitored by a sleep technician. This study records brain waves, eye movements, chin muscle activity, air flow from the nose and mouth, chest and abdominal movement, blood oxygen levels, heart rate and rhythm and leg movements through the use of a combination of electroencephalogram (EEG), electrooculogram (EOG), electromyogram (EMG) and oximetry. This study is the more expensive option and is usually recommended for more complex cases because it provides the most complete information.
A limited channel monitoring records physiologic signals that are mostly focused on breathing and blood oxygen levels. The amount of information collected is lesser than those collected during polysomnography. This test, however, is less expensive and allows you to sleep in the comfort of your own home. The small testing equipment is less complicated to use and the sleep centre staff will show you how to set it up yourself. After the test, you can take the small monitor back to the sleep centre or send it by mail. This type of sleep study is also utilized for followup testing of people with OSA.Another way to assess if you are at risk of sleep apnoea is to take a self-evaluation test, the STOP-BANG survey. However, you must see your primary physician or sleep medicine physician to get a proper diagnosis. To access the self-evaluation test, please visit http://healthysleep.med.harvard.edu/sleep-apnea/diagnosing-osa/self-evaluation.
Uvulopalatopharyngoplasty (UPPP) is the most common surgery performed to treat sleep apnoea. It removes excess tissue from the sides of the throat behind the tongue, shortens the soft palate and removes the uvula to make the airway wider.
Tonsillectomy and adenoidectomy (T&A) surgery, on the other hand, is often performed on children who have enlarged tonsils and adenoids that cause their sleep apnoea.
Nasal surgery, such as removal of nasal polyps or turbinates or straightening of deviated septum, may not completely eliminate OSA, but it may improve breathing and may facilitate better CPAP use.
Maxillomandibular advancement (MMA) surgery can be an effective surgical treatment for sleep apnoea. By moving the upper and lower jaws forward, the airway can be enlarged. The results of this operation suggest that the improvement rate is greater than for UPPP. However, this surgery is more complicated than UPPP and has greater risk and longer recovery period.
As for central sleep apnoea, treatments may involve treating existing conditions that cause the apnoea, such as heart failure and stroke.Resources:Sleep
https://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/ http://www.sleepapnea.org/learn/sleep-apnea.html http://www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/definition/con-20020286/ https://www.ncbi.nlm.nih.gov/pubmed/1735286/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628457/ http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea/ http://www.sleepeducation.org/essentials-in-sleep/sleep-apnea/ http://healthysleep.med.harvard.edu/sleep-apnea/diagnosing-osa/testing/