Obstructive Sleep Apnea
Rachel S. Huska
Illinois Valley Community College
Abstract
Obstructive sleep apnea is a condition that so many people suffer from throughout the world. There are several symptoms that may not only lead to the conclusion of this condition but many other possible conditions as well. There are several causes, more specifically, one main cause with several other factors that can play a big part. The other factors are not surprising when it comes to breathing. After thinking about it, they can actually be very obvious and self-explanatory to most. Scientists are always developing new treatment strategies for well-known conditions like this one. At this point, they are able to be categorized into two groups, surgical and non-surgical. Those two categories can be broken down into so many options, with some being combined to give the patient the best chance of recovering from the difficulty breathing while sleeping. Finally, the case study shows proof and explains the life of just one person suffering from the condition that is experienced all over the world.
Obstructive Sleep Apnea
Sleep apnea is suffered by about one in every five adults, as well as one to three percent of children (Obstructive Sleep Apnea, 2017). While some of those affected only have mild sleep apnea and often are not aware of their condition, others suffer heavily and have to pay serious attention to it. Not every sleep apnea sufferer has the serious symptoms and factors that will be discussed later on, but some do suffer from severe cases of the condition. Though there are different types of sleep apnea, obstructive sleep apnea is one of the most common and can be serious (Mayo Clinic Staff, 2017). The condition can be broken down into what it is, the symptoms that can be experienced, treatment options, and how one man has lived his life with obstructive sleep apnea.
Obstructive sleep apnea takes place when the upper airway is obstructed several times throughout a period of sleep (Diagnostic and Statistical Manual of Mental Disorders: Vol. 5, 2013, pg. 379). It can happen when the airway is blocked by relaxed throat muscles (Mayo Clinic Staff, 2017). Other problems that can be responsible are a large tongue, large tonsils, or extra tissue in the back of the throat casing the diaphragm and chest muscles to work more than they should. When there is not enough oxygen being supplied, the brain is alerted and the person will wake up. The condition not only prevents the person to have enough oxygen to breath, but the organs throughout the body are not supplied with the amount of oxygen they need to function properly. When it becomes very serious, the person may experience a minute to a minute and a half of not breathing which can happen several times throughout the sleeping period (Obstructive Sleep Apnea, 2017). Although the patient is asleep when the lack of breathing occurs and may not be aware of waking up so abruptly, there are other symptoms that they or their partner may notice to reach the concern of sleep apnea.
Several symptoms can be experienced when dealing with obstructive sleep apnea, although experiencing a couple of these does not mean that the individual suffers from sleep apnea. A doctor will take further precautions when it is suspected to be occurring. Partners and family members sleeping within the same home may notice the changes in breathing throughout the night while the actual individual suffering does not. Several factors are included, some being snoring with breaks within breathing, headaches when waking up, going to the bathroom several times throughout the night and chest pain at night (Obstructive Sleep Apnea, 2017). According to the Diagnostic and Statistical Manual of Mental Disorders: Volume 5, several sleep apnea sufferers also experience dry mouth, heartburn, insomnia and nocturia. High blood pressure is also found in about sixty percent of the obstructive sleep apnea sufferers (pg. 379). A couple more symptoms include snoring at a loud volume and sweating throughout the night (Mayo Clinic Staff, 2017). The Mayo Clinic Staff lists a few observations that can be made by a partner or roommate that can indicate the idea of visiting a doctor. These include snoring so loud that the other person wakes up, coughing and struggling to breathe causing an abrupt jump out of sleep, continuous breaks in breathing throughout the night, and severely struggling to stay awake throughout the day while at work or driving (2017). Even though the symptoms may not indicate obstructive sleep apnea, it is important to consult a professional if concerns are present with breathing while sleeping.
There are several aspects that can be considered when finding the cause of obstructive sleep apnea. In most cases, the cause of the condition is due to other factors going on with the body. The overall cause, as mentioned earlier, is the over-relaxation of the muscles in the back of the throat. In result, the airway gets smaller and in some cases closes, preventing normal breathing. The muscles that relax are there to support certain parts of the mouth and airway including the tongue and tonsils. The abnormal breathing can happen for ten to twenty seconds at a time and can happen all night long. With the decreasing oxygen levels, the body will normally wake up, sometimes gasping or coughing, to allow the normal breathing process to begin again (Mayo Clinic Staff, 2017). Another smaller cause, only in some cases, along with other possible causes is being overweight. The Mayo Clinic Staff states that about fifty percent of the obstructive sleep apnea sufferers are overweight (2017). When there is excess tissue around the airway, it can get even smaller along with the muscles relaxing; therefore, causing the person to have an abnormal breathing pattern in their sleep. The windpipe will struggle to stay open with the extra fat surrounding it (What Causes Sleep Apnea? 2012). Though these causes may seem untreatable, there are treatment options to attempt to fix or at least help the condition.
Treatments can be approached by either non-surgical or surgical options. There are several further options between those two categories. Examples of non-surgical treatments are lifestyle changes, mouthpieces and breathing devices. The changes throughout daily life come from the symptoms and causes of the obstructive sleep apnea. Those who are overweight should try to lose at least a small amount of weight, and those who smoke should work on quitting. A simpler option is attempting to sleep on one’s side instead of back to help keep the airway open throughout the night. Mouthpieces are devices that can be molded to fit the patient’s mouth by dentists and orthodontists (How Is Sleep Apnea Treated? 2012). The purpose of the mouthpiece is to move the tongue forward and adjust the lower jaw to prevent the obstruction (Obstructive Sleep Apnea, 2017). The third non-surgical option is a breathing device known as continuous positive airway pressure. The machine consists of a mask; some cover the patient’s nose and mouth while others cover only the nose. Throughout the night, the machine will consistently blow air into the nose or throat to keep the airway open and breathing even (How Is Sleep Apnea Treated? 2012). Though those are just the non-surgical options, for some the surgical may be more realistic.
While some individuals may be against surgery, others may rather do surgery for a faster treatment. The purpose of the surgery is to widen the breathing passages and the doctor may decide on the type of surgery according to the cause of the sleep apnea (How Is Sleep Apnea Treated? 2012). The first option when it comes to surgery is maxillomandibular advancement. Within this procedure, the jaw is moved forward so that the tongue and palate are moved forward to prevent the obstruction being caused by those two structures. The hyoid bone is a bone in the neck that sits above the Adam’s apple, not connected to any other bone. The hyoid suspension would involve attaching the bone to the Adam’s apple to help clear the airway. Additionally, genioglossus advancement can be done. This surgery involves tightening one of the tendons of the tongue, moving it forward and preventing it from falling into the airway and being the obstruction (Obstructive Sleep Apnea, 2017). These are only a few of the several options that can be provided by the doctor or physician.
Out of all of the sleep apnea sufferers, a fifty-five year old man was brought to the doctor by his wife to investigate shortness of breath that he was experiencing. He often felt winded after walking up a flight of stairs. He had a lot of different things throughout his medical history. He experienced asthma as a child but has not had any difficulty with it since then. He smoked for about ten years but quit ten years prior to the study. Throughout the more recent medical history, he deals with high blood pressure, diabetes that is not serious enough for insulin, and hyperlipidemia. His recent symptoms other than shortness of breath have included sleeping away most of the weekend, napping after work on weekdays and experiencing loud snoring throughout his restless nights. He also admits to falling asleep during meetings and others wake him up when his snoring begins. His sleep schedule involves going to bed around eleven each night and getting up for work at seven. Several times throughout the night he has to make trips to the bathroom, and struggles to get out of bed once seven o’clock comes around. Though he does not take any scheduled naps throughout the week, his weekends consist of sleeping in and napping in the afternoon. Each day he drinks about two cups of coffee in the morning and many sodas during the day. When the doctor does an exam, his blood pressure and oxygen saturation are on normal terms. When they did a test called a polysomnography, he woke up several times throughout and experienced many periods of difficult breathing. His oxyhemoglobin saturation went much lower than it should at one point, and stayed in a range of thirteen percent. With the results of the test, he and his doctor decide on a treatment mentioned earlier, a continuous positive airway pressure machine. He used it for three months, with some discomfort and intolerance to it. While using, he had watched his diet and exercised, resulting in a ten pound weight loss. With the help of a humidifier, he consistently uses the machine for five hours a night and reports that it has helped with the drowsiness that he was experiencing throughout the day (Shafazand, MD, MS, S., & Shah, MD, N. 2014, August). Even without further information about this study, it is obvious that there are treatments to at least help obstructive sleep apnea.
Obstructive sleep apnea is a very interesting condition with several aspects to look at it from. With all of the research and studies out there, it is clear that this is a well-known condition and scientists are getting somewhere with their work. The symptoms, causes and treatments are very thoroughly explained with extra detail and clear presentation of improvement within our society.
References
Diagnostic and Statistical Manual of Mental Disorders: Vol. 5. Diagnostic and statistical manual of mental disorders (5th ed.). (2013). Arlington, VA: American Psychiatric Association.
How is sleep apnea treated? (2012, July 10). Retrieved November 12, 2017, from National Heart, Lung, and Blood Institute website: https://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/treatment
Mayo Clinic Staff. (2017). Obstructive sleep apnea. Retrieved October 30, 2017, from Mayo Clinic website: https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090
Obstructive sleep apnea. (2017). Retrieved October 30, 2017, from Oral and maxillofacial surgeons: The experts in face, mouth and jaw surgery website: https://myoms.org/assets/uploads/documents/Ebook_Obstructive_Sleep_Apnea_R.pdf
Shafazand, MD, MS, S., & Shah, MD, N. (2014, August). Obstructive sleep apnea case study. Retrieved October 30, 2017, from American Thoracic Society: We Help the World Breath website: https://www.thoracic.org/professionals/clinical-resources/sleep/sleep-modules/resources/adult-osa.pdf
What causes sleep apnea? (2012, July 10). Retrieved November 12, 2017, from National Heart, Lung, and Blood Institute website: https://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/causes