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Sleep apnea

life science Maturity 7-9 Next article →

Sleep apnea is a serious sleep-related breathing disorder. It causes repetitive pauses in breathing or periods of shallow breathing. These events often cause the upper airway to collapse during sleep. Such disruptions lead to poor ventilation and broken sleep patterns.

Apnea2Min
Apnea2Min

Because sleep is interrupted, many people feel very tired during the day. This condition is often chronic, meaning it lasts for a long time. It can affect a person's health, mood, and even their safety while driving.

There are three main ways to categorize this disorder. Obstructive sleep apnea (OSA) is the most common type, accounting for 84% of cases. In OSA, breathing is interrupted by a physical blockage of airflow. Central sleep apnea (CSA) accounts for 0.9% of cases. In CSA, the brain fails to send the proper neurological signals to inhale. Finally, 15% of cases are classified as mixed sleep apnea.

Obstructive sleep apnea works through a complex mechanical process. It often involves a narrow or collapsible upper airway. During sleep, the pharyngeal dilator muscles may function ineffectively. This can cause the airway to narrow or close completely.

Airway obstruction
Airway obstruction

When the airway is blocked, carbon dioxide builds up in the bloodstream. This state is called hypercapnia. At the same time, oxygen levels in the blood may drop. This drop in oxygen is known as hypoxemia.

ObstructiveApnea
ObstructiveApnea

To fix this, chemoreceptors in the blood signal the brain. The brain then wakes the person up to clear the airway. Once breathing resumes, oxygen levels return to normal, and the person falls back asleep.

Central sleep apnea involves a different mechanism. It is often driven by sleep-related hypoventilation or post-hyperventilation hypocapnia. The most common cause of CSA is hypocapnia following heart failure. This happens when there are brief failures in the ventilatory control system. In other cases, sleep-related hypoventilation occurs due to a malfunction in the brain's drive to breathe. This can be caused by diseases like stroke or severe kyphoscoliosis.

CentralApnea
CentralApnea

Doctors use specific measurements to diagnose and track the severity of OSA. They often perform an overnight sleep study in a lab. For OSA, they calculate the apnea-hypopnea index (AHI). This index is the total number of breathing pauses and shallow breathing episodes lasting over 10 seconds. That sum is divided by the total hours of recorded sleep. For CSA, doctors look at respiratory effort. They measure this by checking esophageal pressure or the movement of the chest and abdomen.

Sleep apnea is a massive global health issue. A 2019 analysis found it affects between 936 million and 1 billion people aged 30 to 69. This is roughly 1 in 10 people in that age group. Among the elderly, the prevalence can reach 30%. Men are roughly twice as likely to have the condition as women. Risk factors include obesity, age over 40, and a large neck circumference. Other factors include enlarged tonsils, a narrow upper jaw, or a family history of the disorder.

If left untreated, sleep apnea can lead to many systemic health problems. It is associated with hypertension, cardiovascular disease, and stroke. It can also increase the risk of type 2 diabetes, heart failure, and atrial fibrillation. There is even a connection to neurodegeneration. Sleep apnea is linked to increased beta-amyloid protein and white-matter damage. These are key indicators of Alzheimer's disease. However, using treatment like CPAP may help reverse some of these risks to brain structure.

There are several ways to manage and treat the condition. Lifestyle changes can include losing weight, quitting smoking, or avoiding alcohol. Some people also find relief by sleeping on their side. A common medical treatment is the CPAP machine, or continuous positive airway pressure.

Cpapanwender
Cpapanwender

This device helps keep the airway open during the night.

CPAP device on a nightstand
CPAP device on a nightstand

While CPAP improves many outcomes, long-term use can be difficult. In 2017, only 15% of potential patients in developed countries used CPAP. In some cases, doctors may recommend surgery to modify the throat area.

UPPP. 4 figures.
UPPP. 4 figures.
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🖼️ Images & Media (9)
File:ObstructiveApnea.png
ObstructiveApnea.png
File:New_no_obstruction.png
New_no_obstruction.png
File:Airway_obstruction.png
Airway_obstruction.png
File:Apnea2Min.jpg
Apnea2Min.jpg
File:CentralApnea.png
CentralApnea.png
File:Cpapanwender.jpg
Cpapanwender.jpg
File:CPAP device on a nightstand.jpg
CPAP device on a nightstand.jpg
File:Cautérisation des parties molles - apnée du sommeil.svg
Cautérisation des parties molles - apnée...
File:UPPP. 4 figures..png
UPPP. 4 figures..png
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