Dying for sleep? Understanding sleep apnea

If you have sleep apnea, your brain cells could be dying for sleep; quite literally. At least 25 percent of the population has been diagnosed with some form of sleep apnea—a condition in which breathing stops or is obstructed while asleep. Even more alarming, 75 percent of people who suffer from this condition don’t even know it.

Sleep apnea is a potentially serious sleeping disorder where breathing repeatedly stops and starts during sleep. “Apnea literally means ‘without breath,’” said Steven Bender, DDS, director of the Center for Facial Pain and Sleep Medicine and clinical assistant professor at the Texas A&M University College of Dentistry. “Sleep apnea refers to periods of time during sleep when you stop breathing for at least 10 seconds,” he continued. “There are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea.”

According to Bender, the sleeper who struggles with obstructive sleep apnea is unable to breathe effectively because tissues are obstructing their airway—or because their airway has collapsed. A sleeper with central sleep apnea, on the other hand, periodically doesn’t breathe at all, or breathes so slowly that oxygen intake is ineffectual, because the brain is telling the body not to breathe during sleep.

“The severity of sleep apnea is based on how many times you stop breathing (for at least 10 seconds) during a full night’s sleep period, or, if you have a drop in oxygen concentration in the bloodstream for extended periods of time,” Bender said. “The time when you stop breathing is called an ‘event’ and health care providers will measure how many of these ‘events’ occur during sleep.”

For example: Less than five events per hour during a sleep period is considered normal. Five to 15 events per hour is considered mild sleep apnea, while 16 to 30 events per hour are moderate. Experiencing more than 30 events per hour would result in a diagnosis of severe sleep apnea.

Bender said common symptoms of sleep apnea include headaches upon waking, daytime sleepiness and low energy throughout the day. “Snoring is often the biggest indicator of sleep apnea. It should never be considered normal,” he said. “At least 30 to 50 percent of people who snore habitually usually have some form of sleep apnea.”

Snoring may occur nightly or intermittently and is characterized as a vibrating or rattling sound while breathing during sleep. During sleep, the muscles of your throat relax, and it becomes narrow. The throat then begins to vibrate as you breathe, and these vibrations lead to the sound of snoring.

“This constant vibration of the tissues in the back of your throat does increase your risk for certain health conditions,” Bender said. “These vibrations cause the nerves in your throat to become less functional, which then makes it harder to keep the airway open. When this occurs, the patient is more prone to develop sleep apnea.”

A diagnosis of sleep apnea could also mean more serious health concerns are looming on the horizon. “Sleep apnea is a stand-alone problem, but it does occur with other conditions like hypertension, diabetes and cardiac issues,” Bender said. “We also see obesity and sleep apnea together quite often. This is because obese patients will have physical suppression of their airways.”

Genetic pre-disposition to sleep apnea is possible, but surprisingly, it comes in the form of how the face is structured. Bender said there is a strong correlation between narrow noses and jaws and sleep apnea.

“Think of your airway as a box. The smaller the box the air is pushed through, the more turbulent it will be,” Bender said. “If we have a small or narrow nose, airway or mouth, the air will be inhaled faster, causing more suction. The airway becomes more unstable as more suction occurs, which induces airway collapse.”

The good news is sleep apnea is easily treatable, as long as you’re willing to take the steps to remedy the problem. The best treatment for facial predisposition is usually surgery on the jaw or surgery to increase the volume of the nose. But, since surgery is very invasive, many people opt for positive airway pressure to bring the jaw forward.

Continuous positive airway pressure, also known as the (CPAP) device, is the leading therapy for sleep apnea. While they’re asleep, patients wear a mask, which is connected to a pump that provides positive flow of air into the nasal passages to ensure the airway stays open.

Bender said it’s important to always check in with your physician if you experience signs of sleep apnea and have a discussion about different treatment options. “The CPAP is the gold standard in treatment,” he said. “However, we don’t really know how well people utilize this method. The largest problem with the device is that people won’t wear it. If you don’t use it, it can’t effectively treat you.”