Causes of sleep apnea or sleep apnea
Sleep apnea is one of the most common diseases that affect humans, as its disorder leads to many health problems, as some people suffer from suffocation during sleep at night, which results from several reasons that doctors advise treating and avoiding to avoid any health complications. We will learn about them well through our article through the following points
What is sleep apnea?
Sleep apnea is a breathing disorder that causes a person to stop breathing for brief periods during sleep. Breathing is irregular with frequent stops and starts. The main types of sleep apnea are obstructive sleep apnea and central sleep apnea.
Obstructive sleep apnea (OSA) occurs when the throat or upper airway narrows or closes during sleep. This is the most common type of sleep apnea.
Central sleep apnea occurs when brain signals to the muscles that control breathing do not work properly.
Children with brain tumors are most at risk of developing sleep apnea among childhood cancer patients. Sleep apnea can make it difficult to get enough sleep or to get good quality sleep.
Poor quality sleep can cause problems with thinking, emotions, and behavior. Children may have trouble thinking, paying attention, or remembering, which can have a negative impact on school performance. Sleep apnea can also cause physical problems, such as heart problems, high blood pressure, and poor growth.
How common is obstructive sleep apnea?
Obstructive sleep apnea is a disorder that is more common in males. In Western countries, it affects about 4% of middle-aged men and about 2% of middle-aged women.
What are the risk factors for obstructive sleep apnea?
Anyone can develop obstructive sleep apnea, regardless of gender, age, or body type. If any of the following apply to you, you may be at higher risk of developing obstructive sleep apnea:
Obesity (the most significant risk factor)
Gender (more common in males)
Age (after age 40 for men and after age 50 for women)
Large neck size (more than 43 cm (17 inches) for men and more than 41 cm (16 inches) for women) – a large neck may contain more fatty tissue that can block your airways
Smoking
Sleeping pills
Excessive alcohol consumption
Having a family history of similar conditions
Possible genetic predisposition to jaw shape
Children who are obese (have higher and more severe rates of obstructive sleep apnea)
Types of sleep apnea
Sleep apnea is divided into 3 types according to the underlying cause as follows:
Obstructive sleep apnea
Obstructive sleep apnea is Obstructive sleep apnea is the most common type, and occurs when the airways become blocked due to the relaxation of the muscles at the back of the throat, preventing the normal flow of air in and out of the mouth and nose. The diaphragm and chest muscles work harder than usual to open the airway, which leads to snoring or body shaking.
Sleep apnea causes heart rhythm disturbances due to the lack of oxygen flow to the body's organs.
Central sleep apnea
This is the least common type and occurs when the brain temporarily stops sending nerve signals to the muscles that control breathing, and is often caused by a medical condition. People with this condition often suffer from sleep apnea without snoring.
Mixed sleep apnea syndrome
This is a rare combination of obstructive sleep apnea and central sleep apnea.
What are the symptoms of sleep apnea?
Some symptoms that indicate sleep apnea appear, including:
Make a loud snoring sound during sleep.
The patient stops breathing several times during sleep, as the patient's companion tells us.
Gasping for air during sleep.
Repeated waking up several times during sleep.
Dry mouth upon waking.
Morning headache.
Insomnia.
Feeling very sleepy during the day.
Difficulty concentrating and paying attention.
Easily irritable.
Mood swings.
Frequent need to urinate at night.
Loss of interest in relationships.
Symptoms of sleep apnea in children:
This disease may appear in children in the form of:
A decline in the child's academic level, due to the prevalence of sleepiness and inability to think.
Breathing through the mouth during the day, difficulty swallowing.
Movement of the ribs inward during breathing.
Sleeping at unusual times or positions, such as sleeping on the hands or knees, or with the neck stretched.
Increased sweating during sleep.
Learning and attention difficulties.
How is obstructive sleep apnea diagnosed?
Your specialist doctor may evaluate your condition based on the signs and symptoms you are experiencing, and may refer you to our Sleep Disorders Center for a sleep test. During this test, wires and sensors are attached to your head, face, chest, abdomen, legs and other organs to monitor your breathing, heart, brain activity, arm and leg movement and blood oxygen levels while you sleep.
What happens while this patient sleeps?
The respiratory muscles at the bottom of the throat begin to relax, which affects the airway, so the patient does not get enough air. The brain senses the inability to breathe, so it begins to wake you up and the airways open again.
This scene is repeated many times during the night, preventing
The patient does not get enough sleep, and it only takes a few seconds, so the patient does not remember it happening.
This type of sleep apnea is known as obstructive sleep apnea, which is the most common type among patients.
There is a second type of sleep apnea called central apnea, which means the brain is unable to issue commands to the breathing muscles, and it is less common than the previous one.
The patient can suffer from both types together in what is known as complex sleep apnea.
Risks of symptoms of obstructive sleep apnea
Excessive daytime sleepiness
Flucatory oxygen levels
Rapid heart rate
Chronic high blood pressure during the day
Increased risk of stroke
Increased risk of death from heart disease
Impaired glucose tolerance and insulin resistance
Impaired concentration
Mood swings
Increased risk of fatal car accidents
Causing sleep disturbance to your bed partner
Causes of suffocation during sleep
Enlarged nasal polyps: They are a reason for air not reaching the lungs and thus feeling suffocated.
Nasal septum deviation: It is the preferred side between the left and right sides of the nose, and sometimes a defect or deviation occurs in the nose, which causes obstruction of the flow of air through the airways that deliver air to the lungs.
Tonsillitis: This condition leads to severe enlargement of the tonsils, which impedes breathing and thus exposure to sleep apnea.
Brain problems: Here the problem is in the cognitive centers responsible for controlling the breathing process, as disturbances occur in these brain functions, which negatively affects the breathing process during sleep.
Excessive obesity: Some people suffer from excessive obesity, and thus the accumulated fat leads to suffocation during sleep and the inability to breathe normally, so it is necessary to maintain a harmonious body free of any fat.
Heart failure: One of the most dangerous heart diseases that negatively affects the breathing process due to general weakness in the heart muscle responsible for transporting oxygen through the blood to the body's organs.
High blood pressure: This disease disrupts many body functions, including respiratory disorders and severe suffocation.
Brain disorders: Cognitive centers are exposed to disorders, which negatively affects the brain, causing respiratory disorders.
Causes of central sleep apnea
Central sleep apnea is a type of sleep apnea, but it does not result from airway obstruction, but rather from a temporary cessation of nerve communication between the brain and the respiratory muscles. The causes of sleep apnea in this case are not yet known, but its occurrence may be associated with many factors, including: [2] [6] [7]
Medications: The use of some types of medications is one of the causes of sleep apnea, as they may lead to depression of the central nervous system, resulting in a temporary cessation of breathing during sleep. Examples of these medications include anti-anxiety drugs and opioids, such as hydrocodone and fentanyl.
Cheyne-Stokes breathing: This is a breathing pattern that can occur due to stroke, or in the late stages of organ failure, such as heart or kidney failure, and this pattern involves periods of increased breathing rate followed by periods of temporary cessation of breathing.
Sleeping at high altitudes: Causes of sleep apnea also include sleeping at high altitudes above sea level, more than 15,000 feet, and this condition often disappears upon returning to normal altitude.
Causes of sleep apnea in pregnant women
The causes of sleep apnea in pregnant women include many factors and changes that occur during pregnancy, including: [8]
Hormonal changes, as increased levels of some hormones can lead to swelling of the mucous membranes in the nose and increased feelings of congestion; which may cause snoring and temporary cessation of breathing during sleep.
Increased levels of progesterone, which may cause relaxation of the airway and then cause apnea.
Weight gain, which in turn leads to pressure on the airway.
Sleeping on your back, as sleeping on your back increases the chance of developing sleep apnea.
Types of sleep apnea
Central sleep apnea:
Occurs when your brain is unable to send the proper signals to the muscles responsible for controlling breathing.
Sleep apnea:
Occurs when your throat muscles relax and is a more common form of sleep apnea.
Complex sleep apnea syndrome:
Another name for this condition is central sleep apnea treatment. It occurs when someone has both central sleep apnea and obstructive sleep apnea.
Diagnosis of sleep apnea
Based on your sleep history along with relevant signs and symptoms, your doctor will evaluate your condition. Your doctor may refer you to a sleep disorder center, where sleep experts can help determine if you need further evaluation. Nighttime monitoring of your breathing and other body functions is essential for evaluation while you are sleeping in a sleep center. You may also opt for a sleep test. Sleep apnea tests are-
Home sleep tests: There are some simple tests that your doctor may provide you to use at home to diagnose sleep apnea. Tests measure airflow, heart rate, breathing patterns, and blood oxygen levels. Your doctor will prescribe treatment without further testing if the results are abnormal. Although monitors don’t diagnose all cases of apnea, your doctor may recommend
Sleep analysis even with normal results on the initial test.
Nocturnal polysomnography: During this test, your doctor will connect you to devices that monitor your brain activity, heart, breathing patterns, lung activity, blood oxygen levels, and arm and leg movements while you sleep.
Your doctor may refer you to an ear, nose, and throat specialist to rule out a blockage in your throat or nose if you have obstructive sleep apnea. To look for causes of central sleep apnea, you may need to be evaluated by a cardiologist (heart doctor) or a neurologist (a doctor who specializes in the nervous system).
Treatment of sleep apnea with lifestyle changes
In mild cases, sleep apnea can be treated at home by making some lifestyle changes. These changes may also help reduce sleep apnea episodes and improve overall sleep quality in moderate to severe cases.
The following are the most prominent lifestyle changes that help treat sleep apnea:
Weight loss: Losing excess weight helps alleviate the symptoms of sleep apnea, as being overweight or obese, especially in the neck area, makes breathing more difficult.
Changing sleeping positions: It is recommended to avoid sleeping on your back, as it may cause the jaw, tongue, and soft tissues to retreat toward the throat, which leads to narrowing the airway: therefore, it is preferable to sleep on one side to keep the airway open.
Exercise: Exercising helps treat sleep apnea by reducing episodes of apnea and boosting energy during the day. Aerobic exercise, resistance exercises, and yoga also help strengthen the airway muscles and improve breathing.
Quit smoking: Smoking may increase swelling and bloating of the upper airway, which may worsen apnea.
Avoid drinking alcohol or taking sleeping medications: Alcohol and sleeping medications can reduce the strength of the muscles in the back of the throat, thus impeding airflow.
What are the treatments for obstructive sleep apnea?
Preventive treatments: In mild cases, your doctor may recommend that you simply make some lifestyle changes, such as losing weight, quitting smoking, and avoiding alcohol and sleeping pills. For some people, using tennis balls or special pillows to sleep on their side may be recommended, especially if they get obstructive sleep apnea when they sleep on their back. If you have nasal allergies, your doctor will recommend treating these allergies.
Mechanical therapy: Positive airway pressure (PAP) therapy is the best initial treatment for most people with obstructive sleep apnea. This treatment involves fitting patients with a mask that is placed over their nose or sometimes both their nose and mouth. Using a special blower, the machine gently pumps air through the mask. The air pressure is adjusted to be enough to prevent the upper airways from collapsing during sleep. There are different types of devices depending on the patient's problems, such as: continuous positive airway pressure, automatic positive airway pressure, and bilevel positive airway pressure.
Mandibular advancement devices: These are devices for patients who suffer from mild or moderate cases of obstructive sleep apnea. Dental devices or mandibular advancement devices help prevent the tongue from blocking the throat and/or bringing the lower jaw forward and keeping the airway open during sleep.
Surgery: Surgical procedures may help people with obstructive sleep apnea and other people who suffer from snoring but do not have obstructive sleep apnea. There are many types of surgeries for this condition, such as tonsillectomy, adenoidectomy, palate lift, tonsil and uvula removal, and sleep disorder surgery. Some of these procedures can be performed as simple outpatient procedures.
1. Continuous positive airway pressure (CPAP):
This device is used in moderate and advanced cases. The idea of this device is based on supplying the patient with air with a higher pressure than the surrounding air that reaches the patient through a mask worn during sleep, which supports the patient's airway, so it remains open.
This device is one of the most common methods for treating sleep apnea, and is usually well received and adapted by patients after a while. There are several versions of this device, for example, there is a device that can automatically adjust the air pressure during sleep, known as (Auto-CPAP). There is also a device that can change the pressure level, increasing when inhaling, and decreasing when exhaling in what is known as Bilevel Positive Airway Pressure (BPAP).
2. Oral devices:
Your dentist can help you by designing a special device for you to wear during sleep, which helps keep the airway open. These devices are easier to use, but the lead remains for the continuous positive airway pressure device to treat this problem.
There are several designs of devices that are placed in the mouth, and the way these devices work varies, so the patient may need to try several types until he reaches the most efficient and effective type.
3. Oxygen devices:
Devices that deliver oxygen may be useful in cases of central apnea as a complementary treatment, and these devices work through a mask worn by the patient.
4. Ventilators:
Some modern devices have appeared to treat this disease by recording the patient's breathing pattern while awake and storing it, and when the patient goes to sleep, these devices simulate the patient's natural breathing pattern and prevent apneas from occurring, these devices are suitable for patients with complex apnea.
Positive airway pressure device
Continuous
Continuous positive airway pressure (CPAP) is the gold standard and most effective treatment for obstructive sleep apnea, as the device delivers a steady stream of air through a tube to a mask placed over the nose. [1] [3] [5]
Air pressure helps keep the airway open, preventing breathing from stopping, and it also helps improve sleep quality, reduce or stop snoring, and reduce daytime sleepiness.
It is recommended to follow the following instructions when using a sleep apnea treatment device:
Choose the appropriate mask size.
Choose a device with a built-in humidifier to prevent dry mouth and throat.
Use a full-face mask instead of a nasal mask if you have nasal congestion.
Maintain cleanliness of the device by cleaning the tube, mask, and humidifier basin regularly.
Use nasal pillows and chin straps to keep the mouth closed, reduce throat irritation, and dry mouth.
Bilevel positive airway pressure (CPAP)
This device is used to treat sleep apnea in men and women who cannot adapt to a continuous positive airway pressure (CPAP) device, as well as to treat central sleep apnea. This device automatically adjusts airflow during sleep, providing greater pressure when inhaling and less when exhaling.
Automatic positive airway pressure (APP) device
The APAP device works by supporting the airway to keep it open during sleep, and it also adjusts the amount of airflow during sleep according to the individual's needs.
A doctor may recommend using this device to treat sleep apnea in cases that did not respond to the CPAP device or caused problems when using it.
Treatment of sleep apnea with medications
The use of medication contributes to treating sleep apnea caused by some diseases, such as sinusitis, nasal congestion, as well as heart failure, and hypothyroidism.
Examples of medications that may contribute to treating sleep apnea include the following:
Nasal steroid sprays.
Topical nasal decongestants, such as oxymetazoline and phenylephrine, should not be used for more than 5 days.
Medications that increase alertness, such as modafinil and armodafinil, increase alertness during the day in people with sleep apnea.
3) Surgical treatment for daytime apnea
Removing some tissue from the upper throat: Removing this tissue along with removing the tonsils and adenoids can treat snoring in some patients. Doctors resort to this solution when oral appliances or continuous positive airway pressure devices are not suitable for the patient. Radio waves can also be used to reduce the size of these tissues as a treatment for mild to moderate cases of sleep apnea.
Rhinoplasty: Septoplasty to correct a deviated septum can help treat apnea attacks.
Tonsillectomy: Tonsillectomy helps treat sleep apnea in children caused by enlarged tonsils.
Removal of excess tissue: Excess tissue in the uvula or soft palate is reduced using radiofrequency.
Uvulopharyngoplasty: Excess tissue in the soft palate or back of the throat is removed to widen the airway.
Rhinoplasty: Nasal surgeries to treat sleep apnea include correcting a deviated septum or other nasal deformities that may cause obstruction.
Maxillary and mandibular advancement: This is an invasive surgery used to treat severe sleep apnea; in which the lower facial structures are moved forward to widen the airway.
Hypoglossal nerve stimulation: This is a modern technique in which a sensor is surgically implanted to send signals to the nerves that control the tongue to contract the muscles of the tongue and throat, and move the tongue and palate forward to keep the airway open during sleep.
Treatment of sleep apnea with herbs
Essential oils have become popular in recent years as a natural treatment that helps relieve sleep problems, including sleep apnea, as they work to improve sleep quality.
Herbal oils work to enhance the production of endorphins and serotonin in the body, which in turn stimulates the production of melatonin (the sleep hormone).
Herbal treatment for sleep apnea includes the following:
Wild mint
Wild mint is the most common herbal treatment for treating sleep apnea, due to its calming effects. Wild mint calms the nerves and reduces anxiety attacks from the central nervous system that cause you to suffer during sleep. This herb is also used to treat depression, anxiety, and stress, all of which may contribute to sleep apnea. However, it is preferable to consult a doctor before resorting to wild mint to treat sleep apnea, or any other herbal treatments.
Passion flower
Passion flower is primarily used as a pain reliever, due to its ability to reduce inflammation of the muscles and nerves. It has also been found to have the ability to relax the mind, nerves, and muscles, which helps you relieve sleep apnea to some extent. It works directly on the central nervous system and relaxes the mind and body, thus promoting rest and good sleep. Passion flower supplements should be used according to the advice of a doctor.
Lemon Balm
Lemon balm is an amazing medicinal herb belonging to the mint family, which helps calm and relax the mind and body. This herb is often used as an antispasmodic
, and treat headaches, and relieve many pains. Lemon balm tea is used to improve mood and help you sleep better, by calming and relaxing tense muscles and irritated nerves. To treat sleep apnea, you can drink 3-4 cups of lemon balm tea throughout the day.
Eucalyptus (camphor): Eucalyptus oil helps to relieve mucus in the sinuses and airways; which facilitates the breathing process during sleep.
2- Honey:
Honey contains anti-inflammatory properties, as it reduces throat swelling. It also helps reduce snoring because it acts as a lubricant or lubricant for the throat.
Half an hour before going to bed, drink a cup of warm water with a tablespoon of honey added to it and repeat this recipe daily. You will notice that you do not complain of sleep apnea the night you decide to apply this recipe and take it before bed.
3- Cinnamon:
Cinnamon is another way to treat sleep apnea. Cinnamon has analgesic properties and helps solve breathing problems. By applying this recipe immediately before bedtime, add a spoonful of cinnamon powder to a cup of lukewarm water and drink it daily. You can take it before bedtime or even during sleep, as it helps solve this problem at any time you take it.
4- Garlic:
Garlic contains anti-inflammatory properties, reduces large tonsils and opens the airways to facilitate breathing. Eat 2-3 cloves of garlic daily, followed by a cup of water. Also, add garlic to all daily meals.
5- Lavender oil:
Lavender helps solve the problem of sleep apnea as it prevents throat muscle blockage. Lavender oil has a soothing and analgesic nature. Put a few drops of lavender oil on a towel and place it under the pillow while sleeping, or you can add lavender oil to boiling water and then inhale the rising steam.
6- Chamomile:
Chamomile contains chemical compounds that help relax muscles and nerves and cause numbness, which helps sleep. Drink a cup of water with chamomile before bedtime. Add 2 tablespoons of chamomile oil to a cup of hot water and leave it for 5 minutes, then drink it
7- Epsom salt bath:
An Epsom salt bath before bed helps relax the muscles and the body in general, which makes you feel comfortable and then want to sleep. Add Epsom salt to the warm bath water, then lie in the water for 20 minutes
9- Almonds:
Almonds contain a high percentage of magnesium, a mineral that helps relax the muscles and in deep sleep. It is recommended to eat a handful of almonds every day to help treat the problem of sleep apnea.
10- Turmeric milk:
Milk promotes sleep, and turmeric contains anti-inflammatory properties. Turmeric works to relieve inflammation of the respiratory system, which facilitates the process of breathing during sleep. Boil a cup of milk with a tablespoon of turmeric added to it, then leave it aside to cool and drink it 30 minutes before going to bed