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Sleep Apnea: A silent killer
By Dr Zulfikar Bux,
Assistant Professor of Emergency Medicine
I have seen a few patients who wake up more tired than when they went into bed. Some develop unexplained medical conditions and struggle to find answers. Their problems occur in the silence of the night when they are asleep.
Dr Zulfikar Bux
A condition called sleep apnea is responsible for this and it is a potentially serious disorder in which breathing repeatedly stops and starts while sleeping. You may have sleep apnea if you snore loudly and you feel tired even after a full night’s sleep.
There are two main types of sleep apnea:
Obstructive sleep apnea, the more common form that occurs when throat muscles relax
Central sleep apnea, which occurs when your brain doesn’t send proper signals to the muscles that control breathing
SIGNS AND SYMPTOMS
The most common signs and symptoms of obstructive and central sleep apneas include:
· Excessive daytime sleepiness (hypersomnia)
· Loud snoring, which is usually more prominent in obstructive sleep apnea
· Episodes of breathing cessation during sleep witnessed by another person (they would say it sounds like you’re suffocating during your sleep)
· Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea
· Awakening with a dry mouth or sore throat
· Morning headache
· Difficulty staying asleep (insomnia)
· Attention problems
WHO’S AT RISK?
The following persons are more at risk of developing sleep apnea
· Excess weight. Fat deposits around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight.
· A narrowed airway. You may have inherited a naturally narrow throat. Or, your tonsils or adenoids may become enlarged, which can block your airway.
· 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 adults older than 60.
· 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.
· 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.
· Heart disorders. People with heart failure or irregularly beating heart are more at risk of central sleep apnea.
· Stroke or brain tumour. These conditions can impair the brain’s ability to regulate breathing.
COMPLICATIONS
· High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain your heart and blood vessels. The more severe your sleep apnea, the greater the risk of high blood pressure. However, obstructive sleep apnea increases the risk of stroke, regardless of whether or not you have high blood pressure
· Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible. People with sleep apnea often experience severe daytime drowsiness, fatigue and irritability. You may have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. You may also feel irritable, moody or depressed. Children and adolescents with sleep apnea may do poorly in school or have behaviour problems.
· Liver problems. People with sleep apnea are more likely to have abnormal results on liver function tests, and their livers are more likely to show signs of scarring.
· Sleep-deprived partners. Loud snoring can keep those around you from getting good rest and eventually disrupt your relationships. It’s not uncommon for a partner to go to another room, or even on another floor of the house, to be able to sleep.
· Seizures. Due to lack of oxygen some persons can end up seizing in their sleep and can even suffocate and die.
If you feel that you are at risk or are having symptoms of sleep apnea, do not hesitate to visit your doctor. Treatment options vary according to the cause. You should not have to suffer from the symptoms of sleep apnea. Visiting your doctor is the first step in ensuring this becomes a reality.
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