Sleep Apnea Is Much More than Snoring

Sleep apnea is often associated with snoring, which some may view as "amusing." However, jokes aside, it is clear that sleep apnea can lead to much graver consequences if neglected. Snoring should be better interpreted as an early warning of worse to come.

It is vital to treat sleep apnea as a chronic ailment, rather than make it a subject of amusement. It is now recognized as one of the factors leading to various metabolic disorders and insulin resistance, otherwise known as diabetes. It increases the risk of hypertension and cardiovascular ailments, like heart attack, atrial flutter, thrombosis, and stroke. It increases the risk of depression in both the person suffering from it and his or her bed partner. In short, untreated sleep apnea might be fatal, but it isn't that obvious, which is why it goes unnoticed in a large number of cases.

Sleep apnea leaves a person fatigued and decreases their level of concentration. Sleep apnea may also increase the risk of accidents if a person is involved in operating heavy machinery.

What about professional drivers? A large number of studies indicate that people who do not get proper sleep are at much higher risk of avoidable road accidents when compared to those without sleep disorders.

Another issue with sleep apnea is the difficulty in diagnosis. In fact, a large number of people living with sleep apnea remain undiagnosed. Moreover, it is a condition that is still not well defined. It would be difficult to say when a person has progressed from snoring to obstructive sleep apnea. Without consulting a specialist, the disorder is highly difficult to diagnose since the patient must be tested in controlled settings.

Common ways to recognize sleep apnea

Obstructive sleep apnea is a condition where the upper respiratory tract gets obstructed several times at night while sleeping. It happens due to certain anatomical defects in the upper respiratory tract.

If your partner or family members have been complaining about your snoring or talking about it, it is a reason to get tested. So, take things more seriously and avoid the development of other complications.

Snoring does not necessarily mean sleep apnea, but it may show the possibility of its presence. However, a person must also look out for the presence of other factors commonly found in those living with sleep apnea, like obesity and tonsillar hypertrophy. If a person consumes alcohol or smoke, then he or she is at higher risk of developing sleep apnea. It has also been found that smoking increases the risk of sleep apnea by threefold.

Apart from more noticeable signs, one must look for other symptoms that may be a better indicator of sleep apnea. For instance, the presence of morning headaches, feeling sleepy during the day (especially if the time spent in bed was more than seven hours), the presence of hypertension, diabetes, a decrease in sexual desire, heartburn or gastroesophageal reflux disease.

However, the golden-standard for the diagnoses remains with the sleep study or polysomnography. This is generally done in lab conditions, where a person is asked to sleep while wearing various sensors. There are sensors to measure respiration, heart rhythm, eye movement, oxygen saturation, brain activity, and much more. Some people may prefer polysomnography done at home with the use of portable equipment that measures fewer parameters.

Specialists of sleep disorders warn that there is a need to take sleep apnea more seriously as many of its complications may arise more quickly than most people tend to perceive. Moreover, considering that most of the treatment options for sleep apnea are riskless and highly beneficial, delaying the treatment has far more risks.

What kind of treatment may help?

There is no straightforward answer to this, as in each case's underlying causes may vary. This means that treatment would instead start with treating the underlying cause. Moreover, anatomical alterations in each case are unique, thus requiring individual approach. Sleep apnea treatment is not one size fits all.

Every treatment must start with lifestyle modifications, like reducing alcohol consumption and smoking, changing sleeping posture (sleeping on the side may help in many cases), doing regular exercise, reducing body weight.

Another highly effective method is the use of so-called Mandibular Advancement Devices (MAD). They help by changing the position of the lower jaw (mandible) and thus widening the upper respiratory tract. However, they work best when they are specially made for an individual by a specialist. There are many similar solutions sold on the internet, however, they have not been evaluated for effectiveness.

CPAP (continuous positive airway pressure) is perhaps the most tested method of treatment; it is highly beneficial in improving the quality of sleep. It is a device that works by providing air continually under small pressure, through a mask. It is an entirely safe method and is non-invasive, too. However, as one can guess, not everyone would like to wear a mask while sleeping. Compliance remains a primary concern with this treatment as well. As the evidence shows, perhaps half of the people would never use this device.

Finally, if nothing works, and there is a high risk of developing complications or sleep apnea continues to progress, surgery remains the only option. No surgical option may work in all circumstances. Only the specialist after the careful examination would be able to make a recommendation. In some cases, tonsillectomy may work, in others, there would be a need for broader plastic surgery. In some cases there may be a need for removing parts of bones. Surgery is a comparatively riskier option. However, it may give permanent relief from the problem in 75-100% of the cases.

Sleep apnea is a significant health concern, particularly due to the fact that it remains undiagnosed in more than 80% of cases. Keeping in mind the complications that undiagnosed sleep apnea can lead to, it is critical to recognize the condition early.

References

1. Dioguardi A, Al-Halawani M. Oral Appliances in Obstructive Sleep Apnea. Otolaryngol Clin North Am. 2016;49(6):1343-1357. doi:10.1016/j.otc.2016.07.005
2. Tregear S, Reston J, Schoelles K, Phillips B. Obstructive Sleep Apnea and Risk of Motor Vehicle Crash: Systematic Review and Meta-Analysis. J Clin Sleep Med. 2009;5(6):573-581.
3. Motamedi KK, McClary AC, Amedee RG. Obstructive Sleep Apnea: A Growing Problem. Ochsner J. 2009;9(3):149-153.