Written by: Doctor Easy
2021-03-16 11:15
Last updated: 2021-03-16 20:26
Have you ever been woken up by your own snoring, or experienced sudden breathing difficulties while sleeping? These might seem like minor issues, but they could be signs of sleep apnea! In Hong Kong, over 100,000 people suffer from sleep apnea, but not everyone has a deep understanding of this condition, leading to delayed diagnosis and worsening of the illness.
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What is sleep apnea?
Sleep apnea is a sleep disorder where a person's breathing significantly reduces or even temporarily stops during sleep, leading to oxygen deprivation. This usually occurs during light sleep and dreaming, causing the patient to struggle awake after an apnea episode and resume normal breathing before falling back asleep, severely affecting sleep quality.
During sleep, a patient's breathing may temporarily stop or decrease by 25%, causing blood oxygen levels to drop by more than 4%. This can happen tens or even hundreds of times each night, lasting from a few seconds to over a minute each time, leading to persistent fatigue even after waking up.
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Why does suffocation occur during sleep? Can it even be fatal?
When the muscles of the upper airway relax and lose tension during deep sleep, the airway narrows, causing snoring. When the airway narrows to the point of complete obstruction, sleep apnea can occur.
Although sleep apnea is temporary and not directly fatal, it can trigger other problems. For instance, reduced sleep quality due to sleep apnea can lead to insufficient rest, affecting daytime alertness and work performance, and increasing the risk of traffic accidents. Moreover, if left untreated for a prolonged period, frequent oxygen deprivation during sleep can lead to high blood pressure, arrhythmia, heart disease, stroke, impaired lung function, polycythemia, and type 2 diabetes; in severe cases, it can even cause sudden death.
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Sleep apnea is mainly divided into three types:
1. Obstructive Sleep Apnea
This is the most common type of apnea, accounting for about 90% of cases. It occurs when the upper airway is too narrow, preventing air from passing through smoothly and leading to suffocation. The airway can become too narrow due to relaxed throat tissues, a tongue positioned further back, enlarged turbinates, nasal congestion, obesity, enlarged tonsils, or severe allergic rhinitis.
2. Central Sleep Apnea
This type is caused by brain injury, a history of stroke, or slowed brain activity affecting the brain's "respiratory center." As a result, the central nervous system fails to send breathing signals to the relevant organs, disrupting breathing patterns and leading to apnea. This condition can also be induced by medications or high altitudes.
3. Mixed Sleep Apnea
This occurs when both of the above types of sleep apnea happen simultaneously.
Sleep apnea affects nighttime breathing, lack of rest can lead to irritability and slow reactions
If you experience the following symptoms, it could be a warning sign of sleep apnea, so pay close attention. These include severe, unusually loud snoring after falling asleep, and frequent episodes of suffocation, meaning breathing completely stops for ten seconds or more. Because there isn't enough oxygen supplied to the body, patients will wake up suddenly, experiencing a racing heart and difficulty breathing.
Insufficient sleep at night leads to a lack of energy, affecting normal daily life and work efficiency. If you frequently experience headaches, drowsiness, and fatigue during the day, and notice slower reactions, difficulty concentrating, and memory decline, seek medical attention immediately. If sleep apnea remains unaddressed for a long time, it can lead to anxiety, irritability, low mood, and even sexual dysfunction.
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Six types of individuals to be cautious about, increased risk of sleep apnea
Individuals with the following characteristics have a higher risk of developing sleep apnea. Please pay close attention.
Poor lifestyle habits, such as smoking, heavy drinking
Overweight, obese individuals
Congenital problems, such as: short neck, small mouth, deep and narrow palate, receding jaw, large neck circumference or tonsils
Individuals with deviated nasal septum, displaced nasal bones, nasal polyps
Suffering from endocrine diseases, such as hypothyroidism
Taking sedatives, sleeping pills
Two simple tests to diagnose sleep apnea
Epworth Sleepiness Scale: This scale assesses the likelihood of falling asleep in specific situations to initially estimate the degree of sleepiness. 0-7 points: normal sleepiness; 8-11 points: slightly more sleepiness; 12-15 points: significant sleepiness; 16-24 points: severe sleepiness. People with sleep apnea typically score above 16 points. This test needs to be supplemented with other examinations for a more detailed diagnosis.
Polysomnography: This test uses equipment to record and analyze a patient's sleep, including brain waves, eye movements, muscle activity, blood oxygen levels, oral and nasal airflow, chest and abdominal movements, and snoring sounds. It also records the patient's overall sleep activity for diagnosis.
Diagnosis with 5 apnea events per hour, treatment based on type of sleep apnea
Based on the results of the sleep test, doctors will diagnose whether the patient has sleep apnea and which type, and recommend appropriate treatment based on the severity. If there are 5 apnea events per hour, it is considered a diagnosis. 5 to 15 events is mild, 15 to 30 is moderate, and more than 30 is severe.
To improve mild sleep apnea (5 to 15 apnea events per hour), one should first adopt healthy eating and exercise habits to control weight and reduce fat accumulation around the trachea that obstructs the airway; minimize alcohol consumption and avoid taking sedatives before bed; and consider sleeping on one's side or wearing a mouthguard or dental splint to reduce the chance of the tongue falling back and obstructing the airway.
For patients with moderate to severe sleep apnea, long-term use of a continuous positive airway pressure (CPAP) machine may be required, or surgery may be performed to address the problem, as advised by a doctor.
The above content and treatments are for reference only and vary from person to person. They should not be taken as any form of medical advice or diagnosis. If necessary, please seek medical attention early and consult relevant specialists.