Sleep is essential to life; it is one of several components, including food and water, which keep the living alive. However, a significant percentage of the human population has considerable difficulty reaching and maintaining Stage IV within their sleeping patterns, the stage that allows the mind and body to fall into a deep and restorative sleep, otherwise known as REM sleep. At the core of this difficulty is a condition known as obstructive sleep apnea, a “serious, potentially life-threatening condition that is far more common than generally understood” (Sleep Apnea). Indeed, obstructive sleep apnea can be very dangerous if it is not properly detected and treated.
What is Sleep Apnea? Research findings indicate that nearly eighteen million Americans suffer with the dangerous and exhausting effects of sleep apnea, in which “certain mechanical and structural problems in the airway cause the interruptions in breathing during sleep” (Sleep Apnea). It is important for the student to know that telltale signs of a potential problem include loud snoring, obesity, high blood pressure and a physical blockage of the nose, throat or upper airway. Its prevalence appears to be genetic to some degree; however, its appearance in overweight patients also indicates that its composition is rooted in both genetics and environment.
Sleep apnea occurs in two separate modes: central and obstructive, with central sleep apnea being less common between the two. The brain fails to send proper signals to the breathing muscles as a means by which to commence respirations during sleep in central sleep apnea. Obstructive sleep apnea, on the other hand, is significantly more Common, transpiring at the point when air is obstructed from flowing into or out of the nose or mouth, “characterized by repetitive episodes of upper airway obstruction that occur during sleep, usually associated with a reduction in blood oxygen saturation” (Obstructive Sleep Apnea). It is important for the student to know that an apneic event may take place up to twenty or thirty times per hour – sometimes even more – followed by a noted episode of snoring. Important to note is the fact that snoring, in and of itself, is not indicative of sleep apnea; rather, it is but one telltale symptom (Sleep Apnea). Sleep apnea may occur during the inherent relaxation associated with sleep, when the tongue and throat muscles soften and inevitably block the airway. This relaxation goes even further when the soft palate muscles and uvula (fleshy tissue) sag over the airway as well, creating the “labored and noisy” (Sleep Apnea) so readily associated with the condition. It is important for the student to know that there are times when this blockage causes breathing to stop entirely. Interestingly, those who suffer with sleep apnea do not realize it, inasmuch as another person typically hears the startling noises and suggests that there is a problem. The sufferer may display frequent episodes of falling asleep on the job, giving work associates the clue, as well. “People with sleep apnea usually aren’t even aware they have a problem and may not believe it when told” (Sleep Apnea). Inasmuch as sleep apnea is potentially life threatening, it is imperative that the sufferer seeks immediate diagnosis and treatment. Early recognition and treatment of obstructive sleep apnea is a critical step not only in getting a more restful night’s sleep, but also in avoiding the potential complications of irregular heartbeat, high blood pressure, heart attack and stroke. Sleep apnea is more prevalent in men and young African-Americans; however, it has been diagnosed during all life stages. It is important for the student to know that attaining proper diagnosis of obstructive sleep apnea includes consultation with a primary care physician, pulmonologist, neurologist and/or other specially trained physician in order to obtain a definitive diagnosis and begin appropriate treatment. Although diagnosing obstructive sleep apnea is not a necessarily easy task, inasmuch as there are myriad other reasons for fitful sleep, modern medicine has devised a series of tests performed at sleep centers that are designed to effectively evaluate the extent to which sleep apnea is the cause (Sleep Apnea).
There are different ways of treatment. Individual patients require individual treatment, inasmuch as any two cases are not necessarily the same, with determinants typically being one’s medical history, physical examination and polysomnography results. This test, which records a variety of body functions that occur during sleep, is one of the primary methods of detecting obstructive sleep apnea so that the most appropriate treatment can be applied. Treatment may include behavioral therapy, physical/mechanical therapy or surgery. The common school of thought with regard to obstructive sleep apnea and medications is that they are not especially effective; however, Klonopin may be prescribed to those who experience muscle twitching for its calming properties. It is important for the student to know that while oxygen may be prescribed, it addresses neither the apneic events nor the overwhelming daytime sluggishness, inasmuch as “the role of oxygen in the treatment of sleep apnea is controversial, and it is difficult to predict which patients will respond well” (Sleep Apnea). Individual treatment is essential to the overall impact any course will have upon the sufferer, particularly when obesity is the determined culprit. It is important for the student to know that those who are overweight have more of a tendency to have breathing difficulties in both waking and sleeping hours. As such, these suffers are typically placed upon a diet and encouraged to lose the extra pounds that instigate their episodes of obstructive sleep apnea. “Weight loss reduces the duration and frequency of apnea in adults and may offer a more attractive long-term solution to sleep apnea than either of the surgical interventions” (Willi et al 61; Suratt et al 631-637). By far, the most common treatment is what is called continuous positive airway pressure (CPAP), which is used during sleep to provide the throat with a steady stream of air by way of a mask and pump. In essence, this treatment is effective in keeping the air passage clear from blockages. It is important for the student to know that severity of circumstances determines whether or not this particular treatment is advised, with a certain percentage of people having no other choice but to take the surgical route. The surgical options for obstructive sleep apnea include a tracheotomy, where the trachea is cut into in order to address the blockage. However, this option is reserved for those who suffer with severe cases, and then it is not always the most readily accepted choice. “While the most effective treatment for severe, obstructive sleep apnea is a tracheotomy, many people decline to have the operation because they loathe the idea of having a quarter sized opening in their neck” (Mini Tracheotomy More Tolerable Treatment For Severe Obstructive Sleep Apnea).
If left untreated there are many things that may happen to your body. There are a number of detrimental issues related to obstructive sleep apnea, not the least of which include depression, high blood pressure, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep at work, on the phone, or while driving. Heart attack and stroke risks have been known to increase, as well. Additionally, research findings have indicated that sudden infant death syndrome (SIDS) is sometimes associated with sleep apnea. “In children, developmental delay, learning difficulties, decreased school performance, and behavioral disorders, including hyperactivity alternating with excessive sleepiness, are often seen, especially in older children” (Obstructive Sleep Apnea). Normal sleep patterns run in a four-step cycle, with Stage I being that of the hazy transitional period between consciousness and sleep. This period lasts approximately ten minutes until Stage II commences, lasting another fifteen minutes or so. Stage III is recognizable by “high-amplitude delta activity” (Murray 303) that ultimately turns into Stage IV. Stage IV, which typically begins an hour and a half after the initial sleep pattern has begun, is the stage in which sleep apnea sufferers are least likely to reach and/or fully maintain. It is important for the student to know that existing experiments have determined that physiological standards within the sleeping subject have “changed abruptly” (Murray 303) in the forty-five minutes that follow the onset of Stage IV. Indications of this are that the EEG reading is maladjusted and the eyes flit from one side to the other in a rapid fashion, which is indicative of REM sleep. Clearly, those with sleep apnea that have difficulty entering or staying within Stage IV indicates fragmented or disturbed sleep patterns. As a result, researchers are “becoming increasingly aware of the adverse effects of sleep deprivation” (Weck 12) due to obstructive sleep apnea.
Mini Tracheotomy More Tolerable Treatment For Severe Obstructive Sleep Apnea. 19 November 2000
Murray, John B. “Children’s dreams.” Journal of Genetic Psychology 156, (1995): 303(10).
Obstructive Sleep Apnea. 19 November 2000 http://www.asda.org/
Sleep Apnea. 19 November 2000 http://www.4woman.org/faq/apnea.htm
Suratt PM; et al. “Changes in breathing and the pharynx after weight loss in obstructive sleep apnea.” Chest 92 (1987): 631-637.
Weck, Egon. “Why aren’t you asleep yet? A bedtime story.” FDA Consumer 23, October 1989: 12(4).
Willi, Steven M.; et al. “The effects of a high-protein, low-fat ketogenic diet on adolescents with morbid obesity: body composition, blood chemistries, and sleep abnormalities.” Pediatrics 101, (1998): 61.