Apnea is involved with the respiratory and central nervous systems.
Therespiratory system allows a person to breathe in oxygen and excrete carbondioxide (Deepak 116). After entering the mouth or the nose, oxygen travels intothe pharynx, the larynx, and then the trachea. The trachea splits into twobranches which then split into smaller tubes called bronchioles. Hair-likeprojections called cilia cover the bronchioles and protect them from foreignparticles.
From the bronchioles, air enters tiny air sacs called alveoli, eachof which is surrounded by capillaries containing the blood that gathers oxygento be transported throughout the body and releases carbon dioxide so that it canbe exhaled. Contractions of the diaphragm cause the lungs to be inflated anddeflated. According to Janet Fricker, sleep apnea is “the periodic reductionor cessation of breathing caused by temporary oropharyngeal collapse duringsleep”; in other words, it occurs when a person literally stops breathingwhile asleep (Fricker 122). There are two main processes that produce sleepapnea. The first, known as central sleep apnea, involves the level of brainactivity during sleep.
The nighttime failure of the part of the brain thatcontrols breathing, located in the brain stem, results in unmonitored oxygenSumner 2 levels during sleep. When oxygen levels become too low and carbondioxide levels become too high, stimulation becomes strong enough to temporarilyawaken the brain to do its job. The brain triggers a snorting or sucking of airin order to restore the balance of oxygen and carbon dioxide in the body. Theepisodes recur as the brain returns to its sleep state (Coren 147-48). Thesecond form of sleep apnea, known as obstructive sleep apnea, is characterizedby a severe relaxation of the tongue, throat, and pharynx.
(Deepak 116). Thesevere relaxation of the tongue causes it to cover the opening to the trachea,stopping the flow of oxygen into the lungs. After ten to ninety seconds of anapnea respiratory centers alert the brain of its oxygen-deprived state, causingthe repeated sleep/wake cycle of the sufferer (Fricker 122). Sleep Apnea affectsabout 4 percent of middle-aged men and 2 percent of middle-aged women (Walling851). Symptoms of sleep apnea include loud snoring, gasping, and choking. Itcauses breathing problems that cause a person to cough and gasp as many asseveral hundred times a night (Pressman 65).
Because a build up of fatty tissuesin the mouth tends to flow over the opening of the trachea, it is most common inmiddle aged, overweight males (Coren 148). About sixty percent of sufferers areoverweight. However, it is not actual poundage but the thickness of the neckthat affects breathing. Men often develop thicker throat tissues and gather morefat in their abdomen, neck, and shoulders than women. Men with a neckcircumference of seventeen inches or more and women with that of sixteen inchesor more are most likely to have sleep apnea, as well as Sumner 3 those with adouble chin or a lot of excess fat around the waist. Sleep apnea will worsenwith age as throat tissues become looser and people gain weight.
(Barone 81). Many side affects can occur due to sleep apnea. Sufferers can awaken toheadaches, irritability, difficulty in remembering, and problems withconcentration (Barone 81). More serious problems can occur, such as drowsinessin the daytime, oxygen scarcity, and respiratory arrest while struggling tobreathe during sleep.
Because there is less oxygen going to the heart, it has towork harder; adrenaline is released and blood pressure rises rapidly. Repeatedbursts of nighttime blood pressure may cause hypertension during the day,leading to increased risk of heart attack, stroke, and heart rhythm disturbances(Barone 82). Diagnosing sleep apnea has become common only in recent years,since the disorder was not officially defined until 1965. Snoring, daytimefatigue, and a short attention span can be clues for diagnosis. If thesesymptoms persist for a prolonged period of time it may become necessary to beplaced under the care of a pulmonary specialist, or an ear, nose, and throatdoctor. Diagnosis is made possible by examinations of the nose, throat, and jaw.
It is also helpful for a sufferer’s mate to answer questions about snoring andsleep habits. The best way to make an accurate diagnosis and determine theseverity of the disorder is a polysomnography exam, usually involving anovernight stay in a sleep clinic. There specialists are able to monitor bloodoxygen levels, heart rate, body temperature, brain waves, and the number oftimes breathing stops. The sleep apnea rate, or the number of apneatic episodesper hour of sleep, determines the severity of the disorder.
Rates of fifteen orfewer indicate only mild sleep apnea, Sumner 4 may not even be consideredclinically significant. Rates of fifteen to thirty indicates moderate sleepapnea, and rates of thirty or more disturbances per hour indicate severe sleepapnea (Pressman 204). While effective for determining treatment, polysomnographycan cost approximately two thousand dollars, but is usually covered byinsurance. A second option is a home monitoring device, costing about half asmuch as lab observations but not usually covered by insurance (Barone 84).
Continuous positive airways pressure (CPAP) is the most commonly recommendedtreatment for sleep apnea. It was first described in 1981 by University ofSydney, Australia researcher Colin Sullivan (Fricker 122). CPAP stops snoringand allows the sufferer to breathe without colapsation of the throat (Stradling201). It consists of an airflow generator, tubing, and a mask that goes over thenose. Air is supplied at slightly above atmospheric pressure, holding theairways open (Fricker 122). Many patients find CPAP masks to be uncomfortable,but without them would relapse into their pretreatment state within onlytwenty-four hours (Stradling 201).
Studies indicate reductions in daytimedrowsiness and general health improvements as a result of CPAP, but have notshown improvements in morbidity, mortality, or quality of life (Walling 851). Along with CPAP treatment, personal health measures can be taken in order tohelp reduce the symptoms and risk of sleep apnea. Dr. Richard Millman of theSleep Disorders Center at Rhode Island Hospital suggests avoiding alcohol andsleeping pills near bedtime because they slow breathing , laying on one sidewhile sleeping, and using Sumner 5 nasal strips while suffering from congestion(Barone 84). Smoking is also a major contributor to sleep apnea because it canswell the throat tissues and worsen the already low oxygen levels that accompanyit.
Since being overweight is a leading cause of sleep apnea as well as manyother health problems, it is a good idea to be as physically fit as possible. Even a ten percent weight loss can affect the number of apneatic episodes thatoccur each night (Barone 84). Though CPAP is the most commonly recommended andutilized treatment of sleep apnea, there are other options. Oral devices similarto a retainer can be used to reposition the tongue and jaw. These are effectivebecause moving the jaw forward also pulls the tongue forward, reducingobstruction of the trachea.
However, these devices can be expensive and may notbe covered by insurance. Surgery is a last resort option. Uvulopalatopharyngoplasty, or UPPP (UP3 ) widens the airway by reducing the sizeof the uvula, the soft palate, or both. UP3 has only a fifty percent successrate, is very expensive, and involves a painful recovery. Laser-assisteduvulopalatoplasty, or LAUP, utilizes lasers to remove excess throat tissue.
Itis less expensive and painful than UP3, but it may require several treatments (Barone84). Sleep apnea does not have to control a sufferer’s life. It is importantto realize that the affects of sleep apnea on a person’s respiratory systemcan be devastating. Being able to identify the causes, health effects, andtreatment of sleep apnea can help to prevent problems before they arise. Theconstant drowsiness, headaches, and incessantly loud snoring affect work habits,overall health, and even cause problems between married Sumner 6 couples whocannot sleep in the same bed together due to snoring.
Because some people maynot even realize that they are suffering from obstructive sleep apnea, it isimportant to be aware of the symptoms and steps necessary to confront theproblem. Avoiding smoking, alcohol, and excessive weight gain are valuablefactors for prevention, as well as basic principles of good health. Psychologists study sleep disorders such as sleep apnea in order to understandtheir effect on sleep as a state of consciousness. Consciousness is defined as astate of awareness.
Going to sleep does not mean that a awareness ceases;instead, sleep changes the type of consciousness that is experienced. Sleep isalso necessary to maintain a balance of the body’s functions and to allow thebody to rest and restore itself. Prolonged periods of sleep deprivation for anyreason result in fatigue, irritability, and inefficiency throughout the day. Being able to identify and treat sleep apnea and other sleep disorders providesmore restful and fulfilling sleep, allowing for a productive and satisfyinglifestyle.
