Apnea/Sleep Apnea; Causes, Symptoms, Diagnosis, Treatment Apnea or sleep apnea is a temporary cessation of breathing, especially during sleep or suspension of breathing. During apnea, there is no movement of the muscles of inhalation, and the volume of the lungs initially remains unchanged. Depending on how blocked the airways are (patency), there may or may not be a flow of gas between the lungs and the environment; gas exchange within the lungs and cellular respiration is not affected. Voluntarily doing this is called holding one’s breath. Types of Apnea/Sleep Apnea Obstructive sleep apnea (OSA) – The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep. Positional sleep apnea – Positional sleep apnea is a form of obstructive sleep apnea that occurs when a patient sleeps on their back, but not when they sleep on their side Complex sleep apnea syndrome – also known as treatment-emergent central sleep apnea, occurs when someone has both obstructive sleep apnea and central sleep apnea Central sleep apnea – Unlike OSA, the airway is not blocked, but the brain fails to signal the muscles to breathe, due to instability in the respiratory control center. Mixed sleep apnea – is a combination of obstructive sleep apnea and central sleep apnea. Often the central apnea will occur first, followed by an obstructive apnea or hypopnea . Unlike OSA, central sleep apnea (CSA) does not physically block the upper airway; central apneas occur when the brain “forgets” to tell the body to breathe. Central sleep apnea is caused by a malfunction in the brains respiratory centre. Causes of Apnea/Sleep Apnea Sleep apnea can affect anyone, even children. But certain factors increase your risk of sleep apnea Muscular changes – When people sleep, the muscles that keep the airway open relax, along with the tongue, causing the airway to narrow. Normally, this relaxation does not prevent the flow of air in and out of the lungs, but in sleep apnea, it can. Physical obstructions – Additional thickened tissue or excessive fat stores around the airway can restrict the airflow, and any air that squeezes past can cause the loud snoring typically associated with OSA. Brain function – In central sleep apnea (CSA), the neurological controls for breathing are faulty, causing the control and rhythm of breathing to malfunction. CSA is usually associated with an underlying medical condition, such as a stroke or heart failure, recent ascent to high altitude, or the use of pain relief medication. Obstructive sleep apnea Excess weight – People who are obese have four times the risk of sleep apnea that people who are a normal weight people do. Fat deposits around your upper airway may obstruct your breathing. But not everyone who has sleep apnea is overweight. Neck circumference – People with thicker necks may have narrower airways. For men, the risk increases if neck circumference is 17 inches (43 centimeters) and larger. In women, the risk increases if neck circumference is 15 inches (38 centimeters) or more. A narrowed airway – You may have inherited a naturally narrow throat. Or, tonsils or adenoids may become enlarged and block the airway, particularly in children with sleep apnea. Being male – Men are twice as likely to have sleep apnea. However, women increase their risk if they’re overweight, and their risk also appears to rise after menopause. Being older – Sleep apnea occurs significantly more often in older adults. Family history – If you have family members with sleep apnea, you may be at increased risk. Use of alcohol, sedatives or tranquilizers – These substances relax the muscles in your throat. Smoking – Smokers are three times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking may increase the amount of inflammation and fluid retention in the upper airway. This risk likely drops after you quit smoking. Nasal congestion – If you have difficulty breathing through your nose — whether it’s from an anatomical problem or allergies — you’re more likely to develop obstructive sleep apnea. Central sleep apnea Being older. Middle-aged and older people have a higher risk of central sleep apnea. Heart disorders – People with congestive heart failure are more at risk of central sleep apnea. Using narcotic pain medications – Opioid medications, especially long-acting ones such as methadone, increase the risk of central sleep apnea. Stroke – People who’ve had a stroke are more at risk of central sleep apnea or treatment-emergent central sleep apnea. Symptoms of Apnea/Sleep Apnea Waking up with a very sore or dry throat Loud snoring, which is usually more prominent in obstructive sleep apnea Episodes of breathing cessation during sleep witnessed by another person Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea Awakening with a dry mouth or sore throat Difficulty staying asleep (insomnia) Excessive daytime sleepiness (hypersomnia) Attention problems Irritability Occasionally waking up with a choking or gasping sensation Sleepiness or lack of energy during the day Sleepiness while driving Morning headaches Restless sleep Forgetfulness, mood changes, and a decreased interest in sex Recurrent awakenings or insomnia Diagnosis of Apnea/Sleep Apnea EEG (electroencephalogram) – to measure and record brain wave activity. EMG (electromyogram) – to record muscle activity such as face twitches, teeth grinding, and leg movements, and to determine the presence of REM stage sleep. During REM sleep, intense dreams often occur as the brain undergoes heightened activity. EOG (electro-oculogram) – to record eye movements. These movements are important in determining the different sleep stages, particularly REM stage sleep. Nocturnal polysomnography – During this test, you’re hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep. Home sleep tests – In some cases, your doctor may provide you with simplified tests to be used at home to diagnose sleep apnea. These tests usually involve measuring your heart rate, blood oxygen level, airflow and breathing patterns. ECG (electrocardiogram) – to record heart rate and rhythm. Nasal airflow sensor to record airflow. Snore microphone to record snoring activity. Severity Test of Apnea/Sleep Apnea Home Sleep Apnea Testing (HSAT) can be done in place of the laboratory study. The number of apnea episodes that occur every hour determines sleep apnea severity: Normal – 0-5 apnea episodes per hour. Mild sleep apnea – 5-15 apnea episodes per hour. Moderate sleep apnea – 16-30 apnea episodes per hour. Severe sleep apnea – 31+ episodes per hour. Treatment of Apnea/Sleep Apnea Throat exercises Press your tongue flat against the floor of your mouth and brush top and sides with a toothbrush. Repeat brushing movement five times, three times a day. Press the length of your tongue to the roof of your mouth and hold for three minutes a day. Place a finger into one side of your mouth. Hold the finger against your cheek while pulling the cheek muscle in at same time. Repeat 10 times, rest, and then alternate sides. Repeat this sequence three times. Purse your lips as if to kiss. Hold your lips tightly together and move them up and to the right, then up and to the left 10 times. Repeat this sequence three times. Place your lips on a balloon. Take a deep breath through your nose then blow out through your mouth to inflate the balloon as much as possible. Repeat five times without removing balloon from your mouth. Gargle with water for five minutes, twice a day. Lightly hold your tongue between your teeth. Swallow five times. Repeat this five times a day. Therapies of Apnea/Sleep Apnea Treatment for associated medical problems Possible causes of central sleep apnea include heart or neuromuscular disorders, and treating those conditions may help. For example, optimizing therapy for heart failure may eliminate central sleep apnea. Supplemental oxygen Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs. Adaptive servo-ventilation (ASV) This more recently approved airflow device learns your normal breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to normalize your breathing pattern and prevent pauses in your breathing. ASV appears to be more successful than other forms of positive airway pressure at treating complex sleep apnea in some people. Continuous positive airway pressure (CPAP) This method, also used in obstructive sleep apnea, involves wearing a pressurized mask over your nose while you sleep. CPAP may eliminate snoring and prevent sleep apnea. As with obstructive sleep apnea, it’s important that you use the device as directed. If your mask is uncomfortable or the pressure feels too strong, talk with your doctor so that adjustments can be made. Bilevel positive airway pressure (BiPAP or BPAP) Devices can be used for those who are unable to adapt to using CPAP, or for central sleep apnea sufferers who need assistance for a weak breathing pattern. This device automatically adjusts the pressure while you’re sleeping, providing more pressure when you inhale, less when you exhale. Some BiPAP devices also automatically deliver a breath if it detects you haven’t taken one for a certain number of seconds. Surgery of Apnea/Sleep Apnea Nasal surgery Correction of nasal problems such as a deviated septum. Uvulopalatopharyngoplasty (UPPP) A procedure that removes soft tissue on the back of the throat and palate, increasing the width of the airway at the opening of throat. Mandibular maxillomandibular advancement surgery Surgery to correct certain facial problems or throat obstructions that contribute to sleep apnea. Complications of Apnea/Sleep Apnea Sleep disorders have also been associated with a number of complications and other conditions. motor vehicle accidents impaired cognition and difficulty focusing metabolic syndrome mood changes hypertension stroke glaucoma memory troubles chronic fatigue decreased quality of life increased risk of mortality headaches dry mouth or sore throat after sleeping with the mouth open Home Remedies of Apnea/Sleep Apnea Chamomile Tea One of the simplest natural home remedies for sleep apnea is a cup of chamomile tea before you go to sleep. The substances found in chamomile are believed to help the nerves relax, which makes it easier for us to sleep Prepare dried chamomile flowers and boiling water. Take 2 spoons of chamomile into a glass of water. The mixture should be covered and steeped in about 5 minutes. Then, you will strain the mixture and pour raw honey to improve the flavor. Consume the tea every night. Lavender The second natural home remedy for sleep apnea is lavender, as it can be used to cope with its symptoms efficiently. With soothing quality, lavender is powerful enough to remove the obstruction in your throat which prevents you from having a good sleep. You can take advantage of lavender oil in many ways. Mix some drops with boiling water and breathe in before you hit the sack. Alternatively, you can pour several drops of lavender oil into your pillow. Almond Among the best natural home remedies for sleep apnea, we need to mention almond. This small ingredient can supple the body with a high amount of magnesium that enables the muscles to relax more. As a result, the body will feel more comfortable and sleep becomes easier. Furthermore, the biological clock of your body can be put under control with the help of almonds. To get the best results, on a daily basis, you ought to consume almonds which are soaked in water for one night. Honey The sweetness of honey is beneficial for the sleep apnea treatment. The fact is that it can be considered as one of the most effective natural home remedies for sleep apnea and you can easily find it no matter where you live. Honey is also a great prevention for snoring, which may make you embarrassed in many situations Moreover, honey can support you greatly if you intend to lose weight. As obesity is one of the main causes for sleep apnea, losing some weight is a great idea to get rid of sleep apnea soon. Take one spoon of honey into warm water. Consume the water before you hit the sack every day. Turmeric With anti-inflammatory quality, turmeric is claimed to fight against the inflammation that can take place in your respiratory system This will reduce the times you stop breathing at night. When mixing it with warm milk, you have one of the best natural home remedies for sleep apnea. Get a spoon of powdered turmeric into milk. They should be steeped in only a few minutes. You can pour a spoon of raw honey. Consume the mixture at least half an hour before you go to bed. Peppermint From simple ways to fall asleep, you can get another natural home remedy for sleep apnea, like the case of peppermint. It can also stop you from snoring, which may disturb many people at night. You can use either peppermint oil or peppermint tea to get rid of sleep apnea. Crush some peppermint leaves first and put them into boiling water. They had better be covered and steeped in more or less than 10 minutes before being strained. Consume the tea with or without honey. Cardamom Known as a great spice in cooking, cardamon now is getting more and more attention as one of the best natural home remedies for sleep apnea. It works as efficiently as drugs in soothing your throat and respiratory system. This enables you to breathe more easily, even during the sleep. Prepare powdered cardamon and take 1-2 spoons of it into warm water. Consume the mixture half an hour before you hit the sack every night. Quit Smoking The unwanted effects of smoking on our lungs are well-known. And you should know that there is a close connection between your respiratory system and sleep apnea.Therefore, if you want to get rid of sleep apnea which is caused by the obstruction, you need to give up smoking immediately. Banana Banana is such a nutritious fruit and a lot of people, including me, love it. It has been well-known for many amazing health benefits, including weight loss. However, it would be a flaw if we forgot that banana actually provides many minerals to enhance our muscles and nerves. For this reason, it is one of the best natural cures for sleep apnea. Epsom Salt Simple as it might look, epsom salt is actually among top natural cures for sleep apnea. This practise was even suggested by naturopathic practitioners to overcome sleep apnea. To explain, epsom salt contains a plenty of magnesium which helps to relax sore muscles. Cinnamon Cinnamon has a wonderful sedative nature. This is why it appears as a great tip on how to stop sleep apnea. For years, people have commonly used it to get rid of many problems related to our breathing system. How to do: Get a cinnamon stick in boiling water. You can pour grated ginger as well Continue to boil them in a few minutes and then, get them strained Pour honey before drinking it The ideal time for this sleep apnea relief is also before you go to bed at night. Walnuts In spite of its smallness, walnut is another great sleep apnea relief. It provides a significant number of compounds and antioxidants which have positive effects on the quality of your sleep. The best time to use this new sleep apnea treatment is before you go to bed. Indian Gooseberry Indian gooseberry is the next among top solutions for sleep apnea that we would like to embrace. This ingredient is packed with a lot of vitamins; however, among them, vitamin C plays the most important role in the sleep apnea cures. It has wonderful effects on the immunity and against infections. How to do: Get one teaspoon of its powder into warm water Drink it once per day If possible, you can replace water with honey to speed up obstructive sleep apnea treatment even more. Garlic The anti-inflammatory quality of garlic is absolutely necessary for the sleep apnea treatment. It is also a great home remedy for tonsils which helps you stay away from snoring. You can chew some garlic cloves raw before eating anything. Then, have a cup of water to get rid of sleep apnea quickly. Lose Weight Reports showed that sleep apnea is seen more frequently in obese people. As a result, one of the most effective natural home remedies for sleep apnea is to lose weight. You can combine exercises with diet to get the best results. Avoid Alcohol Like cigarettes, alcohol puts our health at risk. Alcohol should be applied over the skin in some cases to cure some specific problems, and it shouldn’t be taken in the body under any circumstance. It will worsen some symptoms of sleep apnea, such as snoring. If you do not want to waken your partner at midnight by the sound of your snoring, you’d better quit alcohol Olive Oil Olive oil is one of the most popular natural home remedies for sleep apnea. It can help the nasal passage open to improve the air flow into the body. Besides, if you use olive oil regularly, you will be free from worries about swelling in the throat. Take ½ spoon of olive oil into about a spoon of raw honey. Consume the mixture before you go to bed. Elevating Your Head The position of your head when you sleep has great impacts on whether you suffer from sleep apnea or not. It is recommended that you place some pillows to keep your head up during the sleep to get rid of sleep apnea and its uncomfortable symptoms. References https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549693/ https://www.ncbi.nlm.nih.gov/pubmed/17625094 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096276/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731026/ Show More