What Is Sleep Apnea?

     Sleep apnea, which occurs as a result of upper respiratory tract obstructions during sleep, causes sleep disruption and a decrease in sleep quality. Snoring, cessation of breathing during sleep, daytime sleepiness and cognitive disorders are among the symptoms of sleep apnea. Sleep apnea, which can cause metabolic and vascular diseases such as diabetes, hypertension, obesity, is among the causes of sudden death during sleep. On the other hand, patients define apneas occurring during sleep as “waking up from suffocation”. Pulmonologist Neslihan Çelik Olgay Olgayinfore-med us about sleep apnea;

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     What Is Sleep Apnea?

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     Obstructive sleep apnea syndrome or sleep apnea as it is known among the people, is a syndrome characterized by recurrent upper airway obstructions during sleep and a decrease in blood and oxygen values.

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     Who Gets Sleep Apnea?

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     Reported to be 4 percent in men and 2 percent in women, sleep apnea is very common in men aged 40-65 years.

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     What are the causes of sleep apnea?

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     Sleep apnea is frequently encountered in individuals with central obesity, that is, those whose weight generally accumulates around the waist and who gain apple-type obesity. It is known that 40-60% of sleep apnea patients are obese. Also, it is stated that sleep apnea can be seen in individuals without obesity. In addition, the short and thick neck and the measurement of neck circumference over 43 cm in men and over 40 cm in women are also important risk factors for sleep apnea. Conditions that cause mechanical obstruction such as large tonsils and sagging palate that cause obstruction in the upper airway can also be counted as causes of sleep apnea.

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     Symptoms of sleep apnea?

•      Snoring

•      Daytime napping

•      Cognitive impairment

•      Character and personality changes

 

     Almost all patients with sleep apnea syndrome have complaints of snoring. Snoring is an indication of narrowing of the upper airways. Although severe and persistent snoring is the leading symptom of the syndrome, other symptoms must be present along with snoring. The most important symptom of sleep apnea is the cessation of breathing that lasts for at least 10 seconds during sleep, which is described by the relatives of the person and called "witnessed apnea".

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     How to diagnose sleep apnea?

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     The diagnosis of sleep apnea is made with a sleep test called "polysomnography". In the sleep test, the patient is hospitalized for one night in the sleep laboratory. By connecting various electrodes to the patient, brain activity, heart rhythm, respiratory arrest, snoring, lying position, blood oxygen level,abdominal, thoracic, chin and leg movements are videotaped. In the sleep test records evaluated by the physician, sleep apnea slowing is recorded as hypopnea. The polysomnography test determines whether there is cessation of breathing, decrease in oxygen and snoring during sleep. Sleep apnea is diagnosed when the number of stops or decreases in breathing is greater than 5 per hour.

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     What are the treatment methods for sleep apnea?

     Sleep apnea, a serious sleep disorder, is an important condition that needs to be treated. Treatment varies according to the type of apnea, the depth of the apnea and the characteristics of the person's respiratory tract. Obese patients should lose weight with the support of an endocrinologist and dietitian. In addition, the patient is asked not to smoke or use sleeping pills. At the same time, if there are other diseases, they should be treated. In some patients, the majority of apneas occur while lying on their back. In this situation, which is called positional apnea, a pocket can be sewn to the back of the pajamas to prevent the patient from lying on his back, and a tennis ball or a hard sponge can be placed inside. Intraoral device treatment by a dentist can be applied only in patients with mild to moderate sleep apnea who do not snore and do not have any other obvious complaints or discomfort. In addition, nose and throat surgeries can be performed by otolaryngologists for some patients who snore and have mild to moderate apnea syndrome. The “air machine” called Continuous Positive Airway Pressure is very effective in the treatment of sleep apnea. CPAP is the best known and definitive treatment for sleep apnea. The mask connected to this device is attached to the patient and the compressed air determined by the doctor is delivered to the patient. Continuous supply of positive pressure air prevents the closure of the upper respiratory tract during sleep. Thus, apnea and snoring are eliminated. The patient gets quality sleep throughout the night. The pressure required for each patient is different. For this reason, patients who will be given sleeping and breathing devices should be admitted to the sleep laboratory for the second time and their CPAP pressure should be determined. This is called CPAP titration.

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     What if sleep apnea untreated?

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     As a result of latening or pasuing sleep apnea treatment, Hypertension cardiac arrhythmias,left heart failure, coronary artery disease,Stroke, Obesity, Insulin Resistance , systemic and vascular diseases such as diabetes can develop. In addition, sleep apnea is one of the causes of sudden death during sleep.

The causes of sudden death in sleep apnea can be listed as follows:

• Heart rate changes

• Malignant arrhythmias

• Ischemic heart diseases

• Heart attack

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     What problems does sleep apnea cause in daily life?

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     Recurrent apneas throughout the night cause sleep disruption and decrease in the patient's sleep quality. The patient is usually unaware of waking up due to apneas. This situation is defined by the person as “waking up from sleep by suffocation”. Insufficient oxygen to the tissues due to apnea causes waking up tired, excessive insomnia during the day and the desire to sleep. Insomnia experienced during the day negatively affects the work and private life of the person.