Breathing, Interrupted

CHAPTER 2

  

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Breathing, Interrupted

PART 1

How Is Sleep Apnea Different from Snoring?

Snoring is very often associated with sleep apnea—but not everyone who has sleep apnea snores, and not everyone who snores has sleep apnea.

Obstructive sleep apnea (OSA), by far the most common kind, happens when a person’s pharynx, or upper airway, collapses while he or she sleeps. Air flow into the lungs is blocked for anywhere from 10 seconds to over a minute. (If air is blocked for less than 10 seconds, it’s not considered sleep apnea.) As the person struggles for breath, blood oxygen level falls, and the brain responds by waking the person up just enough to cause the upper airway muscles to constrict. This opens the airway, allowing for a breath. The person may snort or gasp and then fall back asleep. Snoring resumes (if the person snores). This cycle may be repeated literally hundreds of times a night. Sleep is fragmented and the amount of time spent in the deeper levels of sleep is decreased. READ MORE

Because people who have sleep apnea usually don’t fully regain consciousness when they wake after a sleep apnea episode, they often have no idea that they are waking up so many times a night. Until someone else notices their sleep patterns, they may have no idea why they wake up with a headache or feel so tired during the day. LESS
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PART 2

Is Sleep Apnea Dangerous?

Sleep apnea is much more than just annoying. People with sleep apnea have high rates of type 2 diabetes, cardiovascular disease, and stroke as well as an increased risk of death from any cause. As many as 50% of people with sleep apnea have high blood pressure. Having disrupted sleep can cause personality changes and make you feel sleepy and fatigued during the day, as well as irritable and depressed. READ MORE

Recent studies have found that sleep apnea can lead to a number of physiological changes in the cardiovascular system and brain. Falling, and then spiking, blood oxygen levels cause physical changes in the heart and blood vessels that can lead to cardiovascular problems and also damage the neurons of the brain. People with severe sleep apnea actually lose gray matter in their brains. Lack of restful sleep and physiological changes in the brain can lead to problems with concentration and memory. Sleep apnea also interferes with certain hormonal processes that take place only during sleep. In children, sleep apnea can interfere with proper growth and development.

Sleep apnea has societal consequences as well. People with sleep apnea are three to five times as likely to be in a serious car crash involving personal injury. Even people with fairly mild sleep apnea have an increased risk of serious crashes. Long-distance truckers with sleep apnea are especially at risk. A 2008 train crash near Boston, in which the driver was killed and numerous passengers were injured, was attributed to the sleepiness of the driver, who likely had undiagnosed sleep apnea. LESS
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PART 3

How Many People Have Sleep Apnea?

Sleep apnea can affect anyone, male or female, of any age—even children. It’s hard to say exactly how many people have sleep apnea because it’s so often missed: it’s estimated that over 85% of Americans with sleep apnea have never been diagnosed.

Studies vary widely, but a reasonable estimate is that in Western countries roughly 1 of every 5 adults has at least mild obstructive sleep apnea (OSA) and 1 of every 15 has at least moderate OSA. Up to 18 million Americans are thought to have sleep apnea. In general, men suffer from sleep apnea more often than women, and middle-aged people more frequently than other age groups. It’s thought that about 4% of middle-aged men and 2% of middle-aged women suffer from the disorder. READ MORE

There’s no doubt that rates of sleep apnea are on the rise because sleep apnea is linked with obesity, now an epidemic in the US and in other countries as well. It’s estimated that as many as 40% of obese people have sleep apnea, and about 70% of people with OSA are obese. Because obesity has become an epidemic among children and adolescents as well, they too are suffering from increased rates of sleep apnea. Unfortunately, there are very few studies on the prevalence of sleep apnea in childhood. A recent review conducted the Centers for Disease Control found that in 20 years, hospital discharges for children aged 6-17 for sleep apnea had increased 436%. About 1-3% of nonobese and otherwise healthy children aged 2-8 are thought to have sleep apnea. Obese children have four to five time the risk of sleep apnea as nonobese children. LESS
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