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.
Under the circumstances, it is usually the person sharing the same bed or room who comes to the rescue. He or she notices the first signs and calls for help. One of the most significant signs of this disorder is loud and persistent snoring which gets noticed first. There are intermittent pauses in the snoring followed by gasping and choking during sleep.
The snoring is further accentuated when the individual is resting on his or her back. Other signs of the illness eventually show up and they are rapid and unexplained weight gain, excessive daytime sleepiness, and headaches in the morning, forgetfulness, concentration problems, irritability, depression, mood swings or personality changes, need for frequent urination at night, etc.
What exactly causes the onset?
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.
The all important nexus
The relationship between the condition and body weight is critical. Though obesity triggers the onset, weight gain becomes part of the spread of the disorder and appears both as a symptom as well as one of the consequences of the disorder. Aim before initiating any therapy is to break this dangerous nexus between sleep apnea and weight gain, or else, no treatment can be expected to be effective. Thus losing weight is usually the first recommendation from any doctor treating the condition.
Nasal blockage caused by anatomical defects like deviated nasal septum can also trigger the onset. Partial or complete blockage of the nasal passage due to septal deviation can hinder normal flow of air and cause snoring, which when neglected worsens into sleep apnea.
How is the condition diagnosed and treated?
There has to be some good reasons behind this appalling statistical information: in the US, 5 to 10% of adults suffer from obstructive sleep apnea, of which only 10% have been screened for diagnosis. The disorder not only remains undiagnosed but there are high chances of it being misdiagnosed as well. This is because many features are representative of other sleep disorders creating diagnostic confusion.
For example, excessive daytime sleepiness is an indicator of several illnesses including narcolepsy, hypersomnia, insomnia, etc. For ensuring correct diagnosis doctors recommend certain lab-based diagnostic tests like polysomnography, Multiple Sleep Latency Test (MSLT), etc. These tests diagnose the type of illness, the severity as well as measure the degree of daytime sleepiness.
What is narcolepsy? It is a disorder of the central nervous system marked by recurrent daytime sleep attacks and daytime naps. Narcolepsy as well as hypersomnolence can be detected with the help of MSLT results. Narcoleptics usually fall asleep faster than patients of other sleep disorders who go to sleep gradually.
Polysomnogram interpretation usually paves the way for sleep apnea treatment as the scores reveal the severity of the condition, based on which the therapy choices are made. When the sleep apnea symptoms are between mild and moderate, doctors prefer CPAP, lifestyle changes etc. But when the scores indicate that the condition is more serious, surgery might be the most preferred option.
Under the circumstances, it is usually the person sharing the same bed or room who comes to the rescue. He or she notices the first signs and calls for help. One of the most significant signs of this disorder is loud and persistent snoring which gets noticed first. There are intermittent pauses in the snoring followed by gasping and choking during sleep.
The snoring is further accentuated when the individual is resting on his or her back. Other signs of the illness eventually show up and they are rapid and unexplained weight gain, excessive daytime sleepiness, and headaches in the morning, forgetfulness, concentration problems, irritability, depression, mood swings or personality changes, need for frequent urination at night, etc.
What exactly causes the onset?
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.
The all important nexus
The relationship between the condition and body weight is critical. Though obesity triggers the onset, weight gain becomes part of the spread of the disorder and appears both as a symptom as well as one of the consequences of the disorder. Aim before initiating any therapy is to break this dangerous nexus between sleep apnea and weight gain, or else, no treatment can be expected to be effective. Thus losing weight is usually the first recommendation from any doctor treating the condition.
Nasal blockage caused by anatomical defects like deviated nasal septum can also trigger the onset. Partial or complete blockage of the nasal passage due to septal deviation can hinder normal flow of air and cause snoring, which when neglected worsens into sleep apnea.
How is the condition diagnosed and treated?
There has to be some good reasons behind this appalling statistical information: in the US, 5 to 10% of adults suffer from obstructive sleep apnea, of which only 10% have been screened for diagnosis. The disorder not only remains undiagnosed but there are high chances of it being misdiagnosed as well. This is because many features are representative of other sleep disorders creating diagnostic confusion.
For example, excessive daytime sleepiness is an indicator of several illnesses including narcolepsy, hypersomnia, insomnia, etc. For ensuring correct diagnosis doctors recommend certain lab-based diagnostic tests like polysomnography, Multiple Sleep Latency Test (MSLT), etc. These tests diagnose the type of illness, the severity as well as measure the degree of daytime sleepiness.
What is narcolepsy? It is a disorder of the central nervous system marked by recurrent daytime sleep attacks and daytime naps. Narcolepsy as well as hypersomnolence can be detected with the help of MSLT results. Narcoleptics usually fall asleep faster than patients of other sleep disorders who go to sleep gradually.
Polysomnogram interpretation usually paves the way for sleep apnea treatment as the scores reveal the severity of the condition, based on which the therapy choices are made. When the sleep apnea symptoms are between mild and moderate, doctors prefer CPAP, lifestyle changes etc. But when the scores indicate that the condition is more serious, surgery might be the most preferred option.
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