Untreated sleep apnea- who is at risk?

Most of us do not think that snoring is something to be overly concerned about- unless our bed partner is disrupted by it! However, frequent and loud snoring could be a sign of sleep apnea, a common and hazardous problem which leads to respiratory difficulties while asleep. Sleep apnea affects between 2-4 percent of the middle-aged population. Males, middle-aged and obese have the greatest risk of developing sleep apnea. In untreated sleep apnea, breathing may stop or be markedly reduced. With the stoppage in airflow, there is at least a 4% drop in oxygen in the blood which is a direct result of the reduction in the transfer of oxygen in the blood. At this point, you could be jolted out of your natural rhythm.

Sleep deprivation, nasal congestion and sleeping on your back can worsen sleep apnea. Also, our lifestyle is a factor that contributes to snoring. Drinking alcohol can worsen sleep apnea by reducing the activity of the upper airway and dilating muscles that prevent the airway from closing over during sleep.

As a consequence, you will be spending more time in light sleep and less time in the deep, restorative sleep that you will need to be energetic, mentally sharp, and productive the next day.

Untreated sleep apnea can lead to more severe health consequences. These are some examples.

• Increase the risk of high blood pressure, heart
  attack, stroke, obesity and diabetes

• Increase the risk of, or worsen, heart failure

• Irregular heartbeats

• Increase in chance of having work-related or
  driving accidents

How are you diagnosed?

If you suspect that you are having sleep apnea because of habitual snoring and choking episodes, you should visit a sleep specialist and obtain a detailed medical history and physical examination. Often, a sleep study will be conducted. Breathing, blood oxygenation level, snoring, brain activity and many other parameters are monitored. The sleep study will enable the doctor to diagnose and assess the severity of the condition.

How can you treat sleep apnea?

The basic objective of treating OSA and reversing all the complications is to prevent the upper airway from collapsing inwards during sleep. The various options available include:

• Continuous positive airway pressure (CPAP) therapy

• Upper airway surgery

• Oral appliances

• Lifestyles modifications

CPAP therapy is delivered from a machine which delivers air pressure through a mask placed over your nose while you sleep, just enough to keep your upper airway passages open to help patients with moderate to severe sleep apnea from snoring. Although CPAP is a preferred method of treating sleep apnea, some people find it cumbersome or uncomfortable.

Another option is wearing an oral appliance designed to keep your throat open. CPAP is more effective than oral appliances, but oral appliances may be easier for you to use. Surgical options have success rates rarely higher than 65% and often deteriorate with time.

In my opinion, success rate for all these procedures may not be 100% effective as they are often only between 50-70% effective. The most effective way is to modify your lifestyle. People who have sleep apnea are mostly overweight, partial weight loss (10%) may improve the condition and reduce the risk for more severe health consequences.

Resources

• www.sleepapnea.org -- American Sleep Apnea Association

• www.aasmnet.org -- American Academy of Sleep Medicine

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