Sleep Apnea

What is Sleep Apnea? Diagnostic Methods Treatment Options Sleep Apnea Videos

Sleep apnea is a common term for breathing problems that are experienced during sleep.

The most common form, known as Obstructive Sleep Apnea (OSA), affects at least 9% of the adult population. During sleep, most muscles in our bodies relax completely, but muscles of the airways maintain some tone in order to keep the airways open and allow us to breathe. For people with Sleep Apnea, however, this is not the case.

Their airway muscles relax too much, causing one of the two incidents:

A partial blockage of the airways causing a partial reduction of the airflow to the lungs (hypopnea)
A complete blockage of the airways causing a complete interruption of the airflow to the lungs (apnea)

Both types of incidents lead to a reduction in blood oxygen levels, which causes immediate detrimental consequences on the normal functions of the brain and the heart. The mean number of such incidents per hour is used to assess the severity of one's apnea.

What is Sleep Apnea?

Sleep Apnea (meaning "no breath") is a sleep disorder, characterized by repetitive breathing pauses during sleep that last from 10 seconds to several minutes.

These interruptions in breathing can occur up to hundreds of times a night, causing sleep interruption and repeated falls in blood oxygen levels. This results in poor sleep quality and may lead to a variety of serious health consequences. Sleep Apnea is one of the leading causes of excessive daytime sleepiness. Many people suffering with Sleep Apnea are unaware of their condition and remain undiagnosed.

There are 3 main types of Sleep Apnea:

Obstructive Sleep Apnea (OSA)
Central Sleep Apnea (CSA)
Mixed Apnea

The severity of Sleep Apnea is measured by number of apneas and hypopneas occurring per 1 hour. The numeric index (AHI) may be mild (5-15 events/hour), moderate (15-30 events/hour) or severe (30+ events/hour).

Obstructive Sleep Apnea

(OSA) is the most common form of apnea, and occurs when the muscles controlling the soft tissues of the throat, such as the tongue and soft palate, relax and collapse. This causes the upper airways to be partially or completely blocked while asleep. Loud snorts or snoring with elements of gasping for breath and choking may terminate periods of silence caused by OSA.

Sleep Apnea Signs and Symptoms

Snoring
Pauses in breathing (Person may be unaware-usually reported by the bed partner)
Gasping or choking during sleep (Person may wake themselves up)
Daytime sleepiness, chronic fatigue, not feeling refreshed in the morning
Dry or sore throat upon awakening
Fragmented/Restless sleep
Morning headaches
High Blood Pressure (hypertension)

Other Sleep Apnea Common Signs and Symptoms

Mood swings, irritability, depression
Poor concentration, decreased attention, memory loss
Lack of energy and decreased performance at work
Sexual dysfunction; decreased libido
Large neck size
Being overweight or obese
Frequent urination at night (nocturia)
Impaired alertness while driving
History of heart attack or stroke

Health Risks of Untreated Sleep Apnea

Heart disease/Heart attack/Stroke
High Blood Pressure
Diabetes
Fatigue-related Motor Vehicle and Work accidents
Impotence
Death

Who is at Risk

Sleep Apnea occurs in both sexes, all age groups, including children but is more common in men.

1 in 5 adults has at least mild Sleep Apnea
42 million Americans have Sleep Apnea
80% of these are unaware of their condition and remain undiagnosed
25% of men and 9% of middle-aged women suffer from Sleep Apnea

The Risk of having Sleep Apnea is higher with the following:

Male or post-menopausal female
Being overweight or obese
Large neck size (more than 17" for men and 16" for women)
Large tonsils, tongue or uvula
History of High Blood Pressure, Diabetes, Stroke or Heart Attack
Excessive use of alcohol, sedatives and antihistamines
Family history of Sleep Apnea

If you think you may have a Sleep Apnea or are experiencing any of the above symptoms, we recommend that you see your physician immediately.

If you require help in arranging a Sleep Study, please Contact Us

Diagnostic methods

How is Sleep Apnea Diagnosed?

Sleep Apnea diagnosis starts with completing a Sleep Apnea Screening Test, that includes clinically recognized surveys:

Sleep Apnea Symptom Test
Epworth Sleepiness Scale (ESS) Interactive Questionnaire
Berlin Interactive Questionnaire

If you scored positive, or you think your loved ones may have Sleep Apnea, you should talk to your doctor and discuss further investigations. If you require help in arranging a Sleep study, please Contact Us.

Investigations may include a referral for a Full Sleep Study-PSG (Polysomnography) conducted in an accredited Sleep Disorder Clinic, or an easy to use In-Home Sleep Apnea Screening Study using a portable monitoring device to provide a preliminary Sleep apnea diagnosis.

Full Sleep Study (PSG)

Polysomnography (PSG) is an overnight test covered through OHIP, that involves a comprehensive recording of the bio-physiological changes occurring during sleep.

Polysomnography (PSG) is the gold-standard in testing used to assess sleep quality, diagnose Sleep Apnea, and rule out other types of sleep disorders which may cause sleep disruptions and negatively affect ones health.

A PSG test is a complete evaluation of an individual's sleep that monitors and objectively measures:

Brain wave activity (EEG)
Eye movements (EOG)
Legs and Chin muscle activity (EMG)
Heart rate/rhythm (ECG)
Respiratory effort/Nasal Airflow
Blood oxygen levels (SpO2)
Body position
Snoring

A set of monitoring devices and electrodes will be safely attached using either gentle adhesive or a gel paste that can be easily removed with soap and water the next morning. All sensors are applied only to the surface of the skin. The sleep test is non-invasive, easy and painless. The set-up process for the study takes about 30 minutes.
You will be given a set of questionnaires assessing your sleep habits and medical history. Patients will be asked to go to bed around 10-11 P.M. and are usually released by 6-7 A.M. The entire visit to the Sleep clinic is similar to spending a night in a hotel and takes about 10 hours in total.
Your sleep study will be thoroughly analyzed by a physician specializing in Sleep Medicine. Based on the findings, the sleep doctor will provide you with specific recommendations and treatment options. A copy of the report will also be sent to your primary care physician.

In-Home Sleep Apnea Screening Study

An In-Home Sleep Apnea Test may be considered if:

You want to have an immediate screening test for Sleep Apnea in the comfort of your home
Your physician wants to pre-screen for Sleep Apnea and determine the urgency for a Full Sleep Study (PSG)
A simple and easy-to-use portable monitoring device will be provided to you by our Respiratory Therapist.

Portable monitoring will objectively measure:

Respiratory effort/Nasal Airflow (Breathing patterns)
Heart Rate and Blood Oxygen Saturation levels (SpO2)

The device is FDA approved and widely used around the world for Sleep Apnea screening. Please keep in mind, An In-Home Sleep Apnea Screening test has its limitations and is not a substitute for a Full-Sleep Study (PSG) performed at a Sleep Disorder Clinic.

The results of an In-Home Sleep Apnea Test will provide a preliminary diagnosis of Sleep Apnea and help your physician to determine if you are a likely candidate for an immediate Full Sleep Study (PSG) at a Sleep Disorder Clinic.

Treatment options

Continuous positive airways pressure (CPAP)

CPAP is the most effective treatment of Sleep Apnea. CPAP treatment involves a small device, which supplies a constant stream of air through a hose into a special mask.

Oral devices

Oral dental appliances are specially designed by dentists with expertise in treating OSA. These dental appliances keep the lower jaw extended forward as the patient sleeps.

Weight loss

Sleep apnea severity is strongly associated with excess weight and obesity. Losing weight, among all of its other health benefits, will dramatically improve the symptoms of Sleep Apnea.

Surgery

Surgical intervention may help in some cases. Surgery is most successful for people with adenoids, enlarged tonsils, nasal polyps, or facial deformations such as a deviated nasal septum or small jaw. Surgical intervention can enlarge the airways or tighten the airway muscles (depending on its nature). While surgery can dramatically reduce the severity of Sleep Apnea, for most people it is only a temporary measure as their Sleep Apnea symptoms return with time.

Lifestyle changes

Avoiding alcohol before bedtime reduces the severity of Sleep Apnea. Some medications, such as sleeping pills and muscle relaxants should also be avoided due to their exacerbating effects on symptoms. Talk to your physician to see whether the medications you are taking are contributing to your Sleep Apnea symptoms.

Benefits of successful treatment

Reduce the risk of stroke,
heart and blood pressure
problems

Decrease blood glucose
levels by decreasing
insulin resistance

Reduce feelings of
daytime fatigue and
sleepiness

Decrease oxidative stress
and inflammation in the
body

Improve the patients and
their bed partners quality
of life

Better sleep equals better life

Poor sleep negatively affects health, brain function and overall quality of life. Assistive sleeping devices help to provide a positive outlook and allow the body to naturally heal during sleep.
If you are suffering with poor sleep or your CPAP therapy is inadequate, we are here to help.

Request a consultation -OR- 905-763-6333