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What Causes Sleep Apnea?

Mar 29, 2024sleep apnea

What Causes Sleep Apnea?

Sleep apnea is a common and serious condition in which breathing repeatedly stops for periods longer than 10 seconds during sleep. This disorder causes a decrease in oxygen levels in the bloodstream and periodically disturbs people’s sleep throughout the night.

Sleep apnea is usually caused by various factors and studies indicate a genetic predisposition. Sleep apnea usually presents itself in three main variations, each with different mechanisms and causes. These variations include:

  • Obstructive sleep apnea (OSA).
  • Central sleep apnea (CSA).
  • Mixed/complex sleep apnea.

Obstructive sleep apnea (OSA)

This variant is commonly found. Obstructive sleep apnea occurs during sleep when the muscles in the head and neck relax, causing compression on the adjacent tissue of the windpipe. As a result, the airflow is limited.

Central sleep apnea

The occurrence of this type of sleep apnea is caused by a malfunction in the brain. In normal circumstances, the brain regulates breathing continuously, including during sleep. Central sleep apnea occurs when the brain does not send the signals needed for respiratory muscles to function properly.

There are various factors that can contribute to the occurrence of central sleep apnea, such as:

  • Heart failure.
  • High altitudes can result in a notable decrease in blood oxygen levels in the bloodstream, leading to hypoxia.
  • Damage to the nervous system, especially in the brainstem (which controls respiration) or specific parts of the spinal cord, can have negative consequences.
  • CPAP (Continuous Positive Airway Pressure) therapy is a commonly used first-line treatment for obstructive sleep apnea. It effectively resolves the condition when consistently and regularly utilized.
  • Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, includes various nervous system disorders.

Mixed/complex sleep apnea

There is a type of sleep apnea that is defined by a combination of obstructive events and central episodes.

Risk factors

Sleep apnea is a condition that can impact individuals of all age groups, including children. However, there are specific factors that increase the chances of being impacted.

Obstructive sleep apnea

Risk factors that increase the likelihood of developing this specific type of sleep apnea include:

  • Excess weight: Excessive weight gain increases the chances of developing OSA since the buildup of fat deposits near the upper respiratory tract can obstruct breathing.
  • Neck circumference: Individuals with larger necks may experience a reduction in the width of their airway.
  • A narrowed airway: You may have a narrow passage in your narrow throat. The airway can become obstructed due to the enlargement of tonsils or adenoids, especially in children.
  • Being male: The prevalence of sleep apnea is higher in men, with men outnumbering women by two to three times. However, women are also at risk of the condition, particularly if they are overweight or have gone through menopause.
  • Being older: Older adults are more likely to have sleep apnea.
  • Family history: If any members of your family have sleep apnea, your chances of developing the condition may increase.
  • Use of alcohol, sedatives or tranquilizers: The mentioned compounds have the potential to worsen obstructive sleep apnea by causing muscle relaxation in the throat.
  • Smoking: People with sleep apnea who smoke have a higher risk of experiencing obstructive sleep apnea, compared to those who have never smoked. Smoking can increase inflammation and fluid buildup in the upper airway.
  • Nasal congestion: Obstructive sleep apnea is more likely to occur when someone has difficulties with nasal breathing, which can be caused by anatomical issues or allergies.
  • Medical conditions: Obstructive sleep apnea is more common among individuals with various health conditions and can pose a potential risk. Some examples are congestive heart failure, hypertension, high blood pressure, and type 2 diabetes. Additionally, there is an elevated probability of developing this disorder for individuals with polycystic ovary syndrome, hormonal imbalances, prior strokes, and chronic lung conditions such as asthma.

Central sleep apnea

There are multiple factors that can contribute to an increased risk of developing this type of sleep apnea:

  • Being older: Central sleep apnea presents a higher risk for individuals in the middle-aged and older age groups.
  • Being male: There can be a higher prevalence of central sleep apnea in men compared to women.
  • Heart disorders: Suffering from congestive heart failure increases the risk level.
  • Using narcotic pain medicines: Methadone and other long-acting opioid medications have been found to increase the risk of central sleep apnea.
  • Stroke: Central sleep apnea may be more likely to occur after experiencing a stroke.

How Is Sleep Apnea Treated?

The recommended treatment for sleep apnea will depend on the severity of the condition as diagnosed by your physician. In mild cases, changing your lifestyle might be sufficient. Your doctor may advise you to lose weight, stop smoking, or address any nasal allergies you may have.

If the remedies do not provide relief or if you have a moderate to severe form of sleep apnea, your physician will recommend alternative treatments:

Continuous positive airway pressure (CPAP): This device delivers air pressure through a face mask to treat obstructive sleep apnea and snoring during sleep. The air pressure exerted prevents the closure of your upper airway passages, surpassing the natural atmospheric conditions. If you feel uncomfortable with your CPAP mask, it is advisable to talk to your healthcare provider about other options to improve your sleep quality.

Other airway pressure devices: If the CPAP machine does not meet your needs, you may consider using an alternative device called auto-CPAP, which adjusts the pressure while you sleep. Another option to consider is BPAP units, which provide different levels of positive airway pressure to match your inhalations and exhalations. The pressure of breathing increases when you inhale and decreases when you exhale, allowing for greater flexibility in the body.

Oral appliances: There is another option available where you can use an oral appliance to help keep your throat open. While CPAP is generally considered more efficient, oral appliances offer the advantage of convenience. A dentist can help you find the right oral appliance for your needs.

Supplemental oxygen: If you have central sleep apnea, it may be necessary to use supplementary oxygen while you sleep. There are different types of oxygen and equipment that can help deliver it to your respiratory system.

Treatment for other medical issues: Untreated sleep apnea may be caused by heart or neurotransmitter irregularities, which can potentially lead to central sleep apnea. Addressing these underlying disorders not only provides an opportunity to manage their effects but also helps alleviate the symptoms of sleep apnea.

Adaptive servo-ventilation (ASV): The breath pattern recognition technology of this device enables it to adjust to your individual breathing while you sleep. The airflow machine effectively regulates your breathing pattern by applying pressure to eliminate any interruptions. ASV therapy may be more effective in treating complicated sleep apnea when compared to other positive airway pressure methods. On the other hand, individuals with central sleep apnea and advanced heart failure may find it less compatible.

Surgery: If other remedies are not effective, your doctor may suggest considering a surgical intervention. Typically, this intervention is recommended after trying another treatment for more than 3 months without success or if there is an uncommon issue related to the structure of the jaw. A range of surgical procedures includes:

Removing enlarged tonsils or adenoids through surgery and undergoing weight loss procedures can help reduce snoring and relieve symptoms of sleep apnea, contributing to its overall treatment of sleep apnea.

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