Sleep or wakefulness disorders are not uncommon in the US. Or else, official statistics would not have confirmed 50-70 million adults suffering from them. Of the many sleep disorders that Americans suffer from, obstructive sleep apnea is most common, affecting 1 in 4 adults. Strangely, despite its high prevalence, it is a condition that remains undiagnosed most of the time as revealed by the National Sleep Foundation Sleep in America 2005 Poll, because most of the sleep apnea symptoms show up during sleep.
The first signs are noticed by the person sharing the same bed or room. One of the first signals of the disorder setting in is loud and persistent snoring. What alarms most witnesses is intermittent pauses in breathing, coupled with frequent gasping and choking during sleep.
As the bed partner notices, the snoring gets worse when the patient is lying on his or her back. With time, many of the signs come to the notice of the patient. These include excessive daytime sleepiness, rapid and unexplained weight gain, morning headaches, forgetfulness, concentration problems, irritability, depression, mood swings or personality changes, need for frequent urination at night, etc.
Why does the condition happen?
Of all the causes for the onset of the condition, being overweight is perhaps the most important. Accumulation of extra fat can narrow the windpipe and cause obstruction during breathing. Additionally, obesity affecting the breathing muscles (tongue, throat, soft palate, neck) makes them weak and flaccid, making them vulnerable to collapse and block the air passage during breathing while asleep.
Breaking the critical link
Body weight is closely linked with onset and development of sleep apnea. While obesity helps in the onset, weight gain, during the course of the illness, becomes both a symptom as well as a consequence of the disorder. Unless the link between sleep apnea and weight gain is broken, no treatment can be effective. Weight loss is therefore the first recommendation from doctors treating the condition.
Other than obesity, the condition could be triggered by snoring arising out of anatomical defects blocking the nasal passage. Deviated nasal septum is a common example of such nasal blockage that obstructs normal airflow. The result is snoring, which when neglected, worsens into sleep apnea.
What about diagnosis and treatment?
While 5 to 10% of the US population is affected by obstructive sleep apnea, only 10% have been screened for diagnosis. Not only remaining undiagnosed, but the condition can also be misdiagnosed. This happens because several features of this illness could also represent other sleep disorders.
Let us take the instance of excessive daytime sleepiness. This is a common feature indicating not just sleep apnea but narcolepsy, hypersomnia, insomnia, as well. To clear any diagnostic confusion, doctors prefer lab-based tests like polysomnography and Multiple Sleep Latency Test (MSLT). These tests not only clarify the nature of the illness but also the severity and degree of daytime sleepiness.
What is narcolepsy? It is a disorder characterized by sudden sleep attacks and frequent daytime naps. MSLT results are helpful in diagnosing this disorder as well as hypersomnolence. When the time taken to fall asleep is quicker than normal, the condition is narcolepsy.
Severity as revealed by polysomnogram results decides the course of sleep apnea treatment. When the sleep apnea symptoms range between mild and moderate, CPAP therapy, lifestyle changes, etc are prescribed. However, for more severe conditions, surgery may be the best option.
The first signs are noticed by the person sharing the same bed or room. One of the first signals of the disorder setting in is loud and persistent snoring. What alarms most witnesses is intermittent pauses in breathing, coupled with frequent gasping and choking during sleep.
As the bed partner notices, the snoring gets worse when the patient is lying on his or her back. With time, many of the signs come to the notice of the patient. These include excessive daytime sleepiness, rapid and unexplained weight gain, morning headaches, forgetfulness, concentration problems, irritability, depression, mood swings or personality changes, need for frequent urination at night, etc.
Why does the condition happen?
Of all the causes for the onset of the condition, being overweight is perhaps the most important. Accumulation of extra fat can narrow the windpipe and cause obstruction during breathing. Additionally, obesity affecting the breathing muscles (tongue, throat, soft palate, neck) makes them weak and flaccid, making them vulnerable to collapse and block the air passage during breathing while asleep.
Breaking the critical link
Body weight is closely linked with onset and development of sleep apnea. While obesity helps in the onset, weight gain, during the course of the illness, becomes both a symptom as well as a consequence of the disorder. Unless the link between sleep apnea and weight gain is broken, no treatment can be effective. Weight loss is therefore the first recommendation from doctors treating the condition.
Other than obesity, the condition could be triggered by snoring arising out of anatomical defects blocking the nasal passage. Deviated nasal septum is a common example of such nasal blockage that obstructs normal airflow. The result is snoring, which when neglected, worsens into sleep apnea.
What about diagnosis and treatment?
While 5 to 10% of the US population is affected by obstructive sleep apnea, only 10% have been screened for diagnosis. Not only remaining undiagnosed, but the condition can also be misdiagnosed. This happens because several features of this illness could also represent other sleep disorders.
Let us take the instance of excessive daytime sleepiness. This is a common feature indicating not just sleep apnea but narcolepsy, hypersomnia, insomnia, as well. To clear any diagnostic confusion, doctors prefer lab-based tests like polysomnography and Multiple Sleep Latency Test (MSLT). These tests not only clarify the nature of the illness but also the severity and degree of daytime sleepiness.
What is narcolepsy? It is a disorder characterized by sudden sleep attacks and frequent daytime naps. MSLT results are helpful in diagnosing this disorder as well as hypersomnolence. When the time taken to fall asleep is quicker than normal, the condition is narcolepsy.
Severity as revealed by polysomnogram results decides the course of sleep apnea treatment. When the sleep apnea symptoms range between mild and moderate, CPAP therapy, lifestyle changes, etc are prescribed. However, for more severe conditions, surgery may be the best option.
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