Sleep Apnea: Symptoms, Types, Treatment and Risk Factor

Sleep apnea is a sleep related disorder which is associated with impaired ventilation during sleep and disruption of sleep. Obstructive sleep apnea ( OSA) and central sleep apnea are two such disorders which cause sleep- related breathing disorders. Both of them share some risk factors and physiologic bases but also have unique features. Obstructive sleep apnea ( OSA) is the more common disorder among the two which causes daytime sleepiness and impaired daily function. OSA can cause hypertension and is associated with cardiovascular disease in adults and behavioural problems in children. Central sleep apnea can occur as a primary disorder, as a response to high altitude , or secondary to a medical condition like heart failure or medications like opioids. CSA causes frequent awakenings and daytime fatigue and increased risk for heart failure and atrial fibrillation.

Sleep Apnea Types

Obstructive Sleep Apnea/hypopnea Syndrome

OSA is caused due to relaxation of pharyngeal muscles lead to the closure of airway during the sleep. There is loud snoring along with periods of apnea.

Central Sleep apnea

CSA is less common than OSA, may occur alone or more often in combination with obstructive events in the form of mixed apneas. There is basically no urge to breath in CSA patient. It occurs when the part of brain that controls breathing does not function properly. There is increased hypersensitivity to PCO2 which leads to an unstable breathing pattern causing hypoventilation alternating with apnea.

Also Read: Sjogren's Syndrome: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Sleep Apnea Symptoms

OSA symptoms

• Daytime somnolence
• Non- restorative sleep with frequent awakenings
• Morning headaches
• Affective and cognitive symptoms
• Erectile dysfunction can also occur
• Hypoxemia causes increasing Erythropoietin (EPO) which leads to increased RBC and hematocrit.

CSA symptoms

• Frequent night awakenings
• Daytime fatigue
• Underlying risk factors

Also Read: Proctitis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Sleep Apnea Risk factors

OSA Risk Factors

• Snoring
• Excessive daytime tiredness
• Observed apneas or choking/gasping 
• High blood pressure
• BMI>35kg/m2
• Age>50
• Neck size: Men>17 inch, women >16 inch
• Male gender

CSA Risk Factors

• Opioids
• Idiopathic
• Stroke
• Hypoxia ( Breathing at high altitude)
• Congestive heart failure - Increases the risk as causes prolonged circulation delay between pulmonary capillaries and carotid chemoreceptors.
• Oxygen to a COPD patient
• Congenital disorder

Also Read: Xerostomia (Dry Mouth): Causes, Symptoms, Diagnosis, Treatment and Complications

Sleep Apnea Diagnosis

OSA diagnosis

OSA diagnosis is made on the basis of nocturnal and daytime symptoms and sleep study findings. Diagnosis requires patients to have:

• Either symptoms of nocturnal breathing disturbances like snoring, gasping) or daytime sleepiness or fatigue that occurs despite sufficient opportunity to sleep and is unexplained by other medical problems. 
• Five or more episodes of obstructive apnea or hypopnea per hours of sleep during sleep study.
• Nocturnal Polysomnography is used to diagnose disease along with clinical features of 5 or more obstructive respiratory events of apnea or hypopneas per hour is diagnostic.

CSA diagnosis

• The overlying disease and clinical features will diagnose the disease.
• There will be no airflow and no respiratory effort.

Also Read: Ramsay Hunt Syndrome: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Sleep Apnea Complications

• Systemic hypertension
• Pulmonary hypertension
• Right Heart Failure

Also Read: The Wolff-Parkinson-White (WPW) Syndrome

Sleep Apnea treatment

OSA Treatment

• Weight reduction 
• Avoidance of sedatives and alcohol
• Avoidance of supine posture during sleep
• Uvulopalatopharyngoplasty and Nasal CPAP ( For severe OSA)
• CPAP is the standard medical therapy with the highest level of evidence for efficacy. Delivered through a nasal or nasal-oral mask, works as a mechanical splint or hold the airway open, thus maintaining airway patency during sleep.

CSA Treatment

• BIPAP
• Treatment of an underlying cause
• Supplimental oxygen can reduce the frequency of central apnea mainly in patients with hypoxemia.

Also Read: Heartburn: Causes, Symptoms, Diagnosis, Treatment and Complications

Download the PrepLadder app now and unlock a 24-hour FREE trial of premium high-yield content. Access Video Lectures, digital notes, QBank, and Mock Tests for FREE to ace your NEET PG preparation. Elevate your study experience and gear up for success. Start your journey with PrepLadder today!