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Obstructive sleep apnea

Obstructive sleep apnea is caused by blockage of the upper airway during sleep. The blockage happens when the muscles supporting the soft palate in the back of your throat relaxe. Due to the airway obstruction, your body is deprived of oxygen. The brain detects the lowering oxygen level in the blood and wakes you up briefly by engaging the muscles in the throat, to get you to breathe consciously and forcefully.

The following risk factors affect your chances of getting obstructive sleep apnea:

• Weight: Obesity tends to be linked to obstructive sleep apnea. According to the American Sleep Apnea Association, an obese individual is about 7 times more likely to get sleep apnea than a normal weight individual.

• Tonsils: Patients with large tonsils have a higher risk.

• Age: Older people tend to be at higher risk than younger people.

• Sex: Men tend to be at higher risk than women.

• Smoking: Smoking increases your risk of getting sleep apnea.

Central sleep apnea

In some people, the body simply stops breathing for a short period of time, and there is no airway blockage. This cessation of breathing is due to the failure of the brain to send signals that regulates the breathing muscles which controls the breathing patterns.

Central sleep apnea is observed commonly in patients with central nervous system dysfunction due to the following medical conditions:

• ALS

• Stroke

• Heart, kidney or lung disease

Other risk factors for this type of sleep apnea include:

• Age: Older people tend to be at higher risk than younger people.

• Sex: Men tend to be at higher risk than women.

People who suffer from sleep apnea have the following symptoms:

• Daytime sleepiness

• Inability to stay focused

• Loud snoring

• Gasping for air during sleep

• Dry mouth / sore throat when waking up in the morning

• Headaches

Lifestyle changes

For mild sleep apnea, one of the preliminary treatment options includes lifestyle adjustments that can involve the following:

• Weight loss

• Exercise

• Alcohol: Limit or stop alcohol consumption, since alcohol is a depressant and can cause the airway to collapse during sleep.

• Smoking: Quit smoking to improve lung condition and reduce chances of developing nasal conditions and infections.

• Sleep position: Some people only develop sleep apnea when sleeping on their backs. As such, one way is to use a wedge pillow to help them sleep on their sides. Use of positional therapy has also been known to be effective to keep patients sleeping on their backs.

• Fix sinus problems/nasal congestion: Use breathing strips or nasal sprays.

Exercises for the mouth and facial muscles

This is also known as orofacial therapy. These designed exercises strengthen the muscles that control the tongue, upper airway, and lips, so they are in the correct position to keep the airway open and promote normal breathing.

Breathing devices

Breathing devices that provide positive airway pressure can be used to help patients with obstructive sleep apnea. Patients simply put on a mask that is connected to a machine over their nose and/or mouth. The machine pushes forced air through the nose and/or mouth, maintaining air pressure within the upper airway and keeping it open during sleep. There are several types of positive airway pressure breathing devices:

• Continuous positive airway pressure (CPAP): This is the most common positive airway pressure device. In the continuous positive airway pressure therapy, the machine is set at one single air pressure.

• Bilevel positive airway pressure: Unlike the continuous positive airway pressure device, this device uses a higher air pressure setting during inhalation, and a lower pressure setting during exhalation.

Oral devices

Aside from positive airway pressure breathing devices, some devices that you wear in your mouth can also help to keep the airway open during sleep.

• Mandibular advancement devices: These are mouthpieces that hold the jaw in the correct position to keep the upper airway open.

• Tongue retaining devices: Unlike the mandibular advancement devices, these are mouthpieces that hold the tongue in a forward position, thus preventing it from obstructing the upper airway.

Surgery

Surgical procedures are often used when all other treatment options are ineffective. Below are some surgeries that aim to increase the size of the upper airway:

• Adenotonsillectomy: This procedure removes the tonsils and adenoids.

• Maxillary/mandibular advancement surgery: Thisprocedure moves your upper jaw (maxilla) and lower jaw forward to increase the size of the upper airway.

• Uvulopalatopharyngoplasty (UPPP): This is a procedure to remove soft tissue on the back of the throat and palate.

Stimulants

Together with other treatments, stimulants can be prescribed to treat excessive sleepiness due to sleep apnea. The following stimulants are FDA approved:

Weight loss drugs

Together with diet and exercise, weight loss drugs can be prescribed to help obese patients lose weight, treating sleep apnea.

Allergy and asthma medication

If allergy or asthma is the cause of airway obstruction in sleep apnea, the following medication can help:

Insomnia

Insomnia is a sleep disorder in which the patient is having difficulty falling sleep or maintaining sleep. Sleep apnea disrupts normal sleeping pattern and can cause insomnia.