I definitely won’t fall asleep on this thing.

Updated:  15 April 2014

I first heard of sleep apnea about 10 years back, but never gave it a second thought until 2 years ago when an in-law and now a sibling had been diagnosed and treated for this condition.  I was also told within the last 6 months from a good friend of mine while on a walk a childhood buddy of ours had died in his sleep from this condition.  It is my understanding his early and unnecessary death occurred for lack of following medical treatment protocols.

I refer to this disorder as an insidious angel of death, why?    Because this is a serious health condition and if ignored can kill without warning!  Our childhood friend was around 47 years of age and left his loved ones before his time.  Since this disorder has such a high risk potential for fatality and emotional pain to family and friends, I felt it was high time to write on this topic.

First let’s understand the definition of apnea.  It is the temporary suspension of respiration, or without breathing.  Sleep apnea when diagnosed is commonly referred to as OSA (Obstructive Sleep Apnea), or complex apnea.  OSA is the anatomical obstruction blockage and/or central nervous system problem that causes the airway to become obstructed.  Regardless of sleep apnea cause, it increases the risk of heart failure by way of coronary heart disease for lack of oxygen when breathing is interrupted.  As oxygen levels decrease in the blood, carbon dioxide levels increase.

This condition creates a jumpy nervous system and blood pressure spikes that stresses the heart walls and disturbs heart rhythm.  Over time, this reoccurring condition puts you at risk of a heart attack.  This is not only bad for your heart, but nearly every organ and tissues of the human body creating high risk for many other types of illness and disease.

Okay, let’s break this down a little bit more so we can really understand the mechanics of how obstruction occurs.  As the soft palate at the back of the throat collapses during sleep those that suffer from sleep apnea begin to snore and apparently struggle to breath. The obstructive collapse for instance in the neck area while relaxed and during sleep is not able to keep a clear airway passage.  Obstructive soft tissue problems typically occur at the base of the tongue, tonsils and nasal cavity areas.

There is also sleep apnea caused by the central nervous system where the brain is not registering the lungs to breath with regular consistency.  When diagnosed with sleep apnea where obstruction is not the cause, it is understood the problem stems from the central nervous system.  The central system cause of sleep apnea is “not” well understood by researchers why the brain begins to inconsistently regulate breathing during sleep.

Regardless of whether sleep apnea is caused from an obstructive or neurological problem, lack of oxygen during sleep causes internal disease in the following ways.  When one is awakened abruptly from sleep to catch their breath, adrenaline increases blood pressure which is also believed to contribute to vascular problems.  And with blood pressure surges, one than can also become more at risk for blood clots, stroke, arrhythmias, diabetes hypertension and memory loss.

Sleep apnea may also trigger seizures in the absence of epilepsy, or trigger seizures that were treated well in the past by medications.  In the long run the primary damage caused by this sleep disorder is due to unstable blood pressure regulation and adequate oxygen to the heart and brain.  Sleep apnea has the same risk factors on health as risks associated with heavy smoking.

Sleep Study Tests Show the Following Results:  While asleep, those with sleep apnea unknowingly experience episodes where they stop breathing.  This can occur 5-50 times per hour and up to 300 times during regular sleep.  But if the “non breathing” episodes only last seconds or less, this does not appear to have a significant health risk to the body.  But if one is sleeping and averages 30 “non breathing” episodes per hourly average where breathing stops up to 10 second intervals minimum between breaths, this is where serious health risk increases and incremental/accumulative damage to the heart occurs.  While loved one(s) and friends assume you simply have a bad, loud obnoxious snore, this could in fact be an indicator of something far worse than irritating those around you.  And also be aware, just because you snore does not mean you have sleep apnea.  Only a sleep study test can prove this for sure.

High Risk Indicators:  Those that are obese tend to have a lot of fatty tissue and low muscle tone around neck area.  Obesity creates the anatomical characteristics of obstruction potential for impingement, pressing down, or blockage of the airway while lying down.  Also males between 40-70 years of age and diagnosed with sleep apnea have a 68% higher risk of “coronary heart disease” than those without it.  And men that have been diagnosed with OSA have a 58 percent greater risk of “cardiac failure” than those without.  Women don’t appear to suffer from this condition, but science agrees more studies on women are recommended.   The common times of sudden death appear to occur mostly between the hours of midnight to 6am.

What to look for:  Listen for loud snoring and/or those that fall into the obese category. If both breathing and snoring stops while the chest and body attempt to breath, this is classic of obstructive sleep apnea syndrome.  When breathing starts you’ll note a gasp for air and snoring begins again.

Other Recommendations and Medical Treatment

1. Diagnostic tests: Oximetry or polysomnography – If you have insomnia consider asking your doctor to be referred to a Level 3 sleep study where your breathing, oxygen flow, heart rate and chest/abdomen expansion are monitored overnight.
2.  CPAP (Continuous Positive Airway Pressure) This is mask worn while sleeping that injects air into the respiratory system without interruption of obstructing air flow to the body.  How it works: The device blows positive pressure into the nose to keep the airway from collapsing.
3. Sleep at 30 degree elevated level helps to keep gravity pulling down on weakened tissues around the neck area from obstructing airway.
4. Decrease weight, stop smoking, chewing tobacco.
5. If you are diabetic your odds of OSA increase 3-fold. Seek treatment and follow your doctor’s advice for diabetes.
6. Avoid alcohol, muscle relaxants, chronic opiate use.  The presence of sleep apnea without an obstructive component appears to be a common symptom for those that abuse opiates.
7. For those with OSA and are candidates for surgery to alter the airway may be your solution to getting away from CPAP dependency.  I.e., Throat, base of tongue and facial skeleton surgery can correct the anatomical obstruction cause.
8. Check on medications and other treatment for complex sleep apnea that include unknown central nervous system cause, e.g., Acetazolamide to lower blood pressure and encourage respiration.

References

1. http://www.medindia.net/news/Risk-of-Heart-Disease-Increases-With-Obstructive-Sleep-Apnea-71310-1.htm
2. http://www.vancouversun.com/health/Treating+sleep+deprivation+begins+with+proper+diagnosis/3295105/story.html
3.   http://www.webmd.com/sleep-disorders/sleep-apnea/news/20050323/sleep-apnea-makes-wee-hours-sudden-death-time
4.   http://en.wikipedia.org/wiki/Sleep_apnea

 Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2010 Copyright.  All rights reserved, MirrorAthlete Publishing @: www.mirrorathlete.org,  Sign up for your Free eNewsletter.