Department

Sleep Apnea

Sleep apnea also called sleep disordered breathing, is a sleep disorder characterized by pauses in breathing or periods of shallow breathing during sleep. Each pause can last for a few seconds to several minutes and may happen frequently during the night. In the most common form, this follows loud snoring. There may be a choking or snorting sound as breathing resumes. As it disrupts normal sleep, those affected are often sleepy or tired during the day.

There are three forms of sleep apnea: obstructive (OSA), central (CSA), and a combination of the two called mixed.

OSA is the most common form. In OSA, breathing is interrupted by a blockage of airflow, while in CSA breathing stops due to a lack of effort to breathe. People with sleep apnea are often not aware they have it. Often it is first observed by a family member.

Sleep apnea is diagnosed with an overnight sleep study called Polysomnography.

• Obstructive sleep apnea (OSA): The more common of the two forms of apnea, is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
• Central sleep apnea (CSA): Unlike OSA, the airway is not blocked, but the brain fails to signal the muscles to breathe, due to instability in the respiratory control center.

OSA in Indian males varies from 4.4% to 19.7% and in females it was between 2.5% to 7.4% from various studies.

Signs of OSA in someone sleeping can include

• Loud snoring
• Noisy and laboured breathing
• Repeated short periods where breathing is interrupted by gasping or snorting.

Risk factors for sleep apnea include

• Being overweight.
• Being over the age of 40.
• Having a large neck size (17 inches or greater in men and 16 inches or greater in women).
• Having large tonsils, a large tongue, or a small jaw bone.
• Having a family history of sleep apnea.
• Gastroesophageal reflux, or GERD.
• Nasal obstruction due to a deviated septum, allergies, or sinus problems.

Left untreated, sleep apnea can result in a growing number of health problems, including

• High blood pressure
• Stroke
• Heart failure, arrythmias, and heart attacks
• Diabetes
• Depression

A polysomnography -- or sleep study -- is a multiple-parameters test that electronically transmits and records specific physical activities while you sleep. The recordings are analyzed to determine whether or not you have sleep apnea or another type of sleep disorder.

During a sleep study, surface electrodes will be put on your face and scalp that will send recorded electrical signals to the measuring equipment. These signals, which are generated by your brain and muscle activity, are then recorded digitally. Belts will be placed around your chest and abdomen to measure your breathing. A oximeter probe will be put on your finger to measure the amount of oxygen in your blood.

Other Tests and Equipment Used for Sleep Apnea

• EEG (electroencephalogram) to measure and record brain wave activity.
• EMG (electromyogram) to record muscle activity such as face twitches, teeth grinding, and leg movements, and to determine the presence of REM stage sleep.
• EOG (electro-oculogram) to record eye movements. These movements are important in determining the different sleep stages, particularly REM stage sleep.
• ECG (electrocardiogram) to record heart rate and rhythm.
• Nasal airflow sensor to record airflow.
• Snore microphone to record snoring activity

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