Sleep apnea is a cessation of breathing during sleep of at least 10 seconds. This can pose a threat to health if it occurs frequently. With the right research, one can see what the situation is and what the right solutions are.

Sleep apnea

Sleep apnea is a sleep disorder in which breathing stops for at least 10 seconds. If this occurs frequently (more than 10 to 15 times per hour), it is called a disease. About 4% of the population suffers from this.

Risk factors

There are two types of risk factors:

Unchangeable risk factors:

• age
• male gender
• heredity
• ethnicity

Modifiable risk factors:

• overweight
• smoking
• use of alcohol
• use of certain medications
• bad sleeping habits
• diseases of certain glands
• blockage of upper airways

Symptoms

• respiratory arrest during sleep
• morning headache
• snoring very loudly
• dry mouth
• frequent urination at night
• heartburn at night
• irregular heartbeat
• Excessive daytime sleepiness
• less alert during the day
• high bloodpressure
• swollen legs
• night sweats

If you have any of these symptoms, it does not mean that you suffer from sleep apnea. The chance is greater if you have several of these symptoms.

Forms

Three forms of sleep apnea can be distinguished based on the cause:

• Obstructive sleep apnea syndrome (OSAS): this form is the most common. The air supply at the throat becomes blocked because breathing stops for a moment.
• Central sleep apnea syndrome (CSAS): the breathing muscles do not receive enough stimuli from the brain. As a result, no breathing movements are performed.
• The mixed type: a combination of OSAS and CSAS

Implications

Overtiredness – concentration disorder

Sleep consists of three elements: very deep sleep, dream sleep and superficial sleep. During very deep sleep, the brain works very slowly and can recover well. During dream sleep, the brain works very quickly but prevents the muscles from contracting. During superficial sleep, one is usually calm and relaxed. With sleep apnea there is insufficient deep sleep and dream sleep. As a result, the brain cannot recover sufficiently and the muscles cannot relax enough. The continuity of sleep is also disrupted by waking up regularly. This leads to drowsiness and concentration problems.

Developing diseases

Every organ in our body needs sufficient oxygen. Due to sleep apnea syndrome, our lungs do not receive enough air (insufficient air also means insufficient oxygen in our blood). Too little oxygen in our blood means an oxygen deficiency in all organs and can promote the development of diseases (such as cancer).

Heart and vascular disease

Chronic oxygen deficiency in our blood also causes an oxygen deficiency in our heart. This can lead to all kinds of heart diseases such as cardiac arrhythmias, heart weakness and even a heart attack.

Diagnose sleep apnea

If the doctor suspects that you suffer from sleep apnea syndrome, he will refer you to a sleep clinic for further examination. Here the activity of the central nervous system is measured by means of electrodes. These are applied to the head, chin and temples. The signals are processed by a computer and this is how the different stages of sleep are seen. There is a microphone at the level of the chin. This is used to measure the snoring sound. The snoring sound in the room is also measured using a microphone and a decibel meter. This provides a lot of information in a thorough manner so that one can determine whether the snoring is related to apnea. If this is the case, one can also determine the type and how frequently the apnea occurs.After the sleep study, you will be referred to an ear, nose and throat specialist. This is a specialist in the upper respiratory tract. This doctor will perform an additional examination for physical abnormalities. First he looks in the nose and throat. The doctor looks at the tonsils, tongue, uvula and palate. The back of the tongue and palate are then looked at through a small tube that is inserted into the nose. The tube is inserted into the turbinate and then goes to the nasal cavity. The tongue appears with the laryngeal valve and vocal cords underneath. In this way an attempt is made to determine deviations. Based on these examinations and the sleep study, the doctor will propose treatment.

Therapy

Treatment depends on the underlying cause. The aim is to restore normal sleep patterns.In mild cases, attempts will be made to reduce or eliminate the variable risk factors: following a diet, stopping skirting, stopping certain medications, using sleeping pillows or other aids to promote side sleeping, using a nose spray.In most cases a nasal mask is used. Air is blown into the nose and throat through a nasal mask. This is done by means of a small compressor that stands next to the bed. The collapsing of the throat is prevented by creating excess pressure in the throat.Sometimes a special oral appliance can suffice. The device is slid over the teeth and holds the lower jaw forward while sleeping. The tongue stays in place better and sinks less easily into the throat.If the nasal mask is not tolerated, medical intervention can be considered. Removing the uvula, the tonsil arches and part of the throat mucosa wall is usually satisfactory for loud snoring, but usually less so for apnea. In the last two years there has been a new medical intervention that has been very successful. An implant is inserted during the operation. The tongue nerve is activated based on electrical stimulation. This prevents the pharynx from closing.