Sleep Disordered Breathing

Overview

Obstructive Sleep Apnea (OSA) is a treatable disorder in which a person stops breathing many times during the night due to upper airway collapse. The inability to breathe properly can disrupt sleep and is associated with serious health problems and a diminished quality of life. Snoring is a strong indication that OSA may be present.

Sleep and Breathing

breating_image1During normal breathing, air passes through the nose and the flexible structures in the back of the throat, such as the soft palate, uvula and tongue. While you are awake, the muscles in these structures hold the airway open. Normally, when you fall asleep, these muscles relax but still hold the airway open and healthy sleep can occur without disruption.

Sleep-Disordered Breathing is a term which indicates that breathing is affected due to the sleeping process itself where the throat muscles collapse excessively and prevent adequate breathing. This in turn disrupts sleep creating a condition where both sleep and breathing are dangerously affected. Snoring and Obstructive Sleep Apnea are both considered Sleep-Disordered Breathing Events.

The Problem

Prevalence of Obstructive Sleep Apnea

Everyone knows someone with Diabetes or Asthma, but did you know that Obstructive Sleep Apnea (OSA) is as prevalent as these common problems?

  • Nearly 1 out of 5 adults has at least mild OSA
  • 85% of people with sleep apnea remain undiagnosed and untreated
  • Almost as many traffic accidents are caused by sleep apnea as DUI
  • The risk is 1 to 2 times greater in men than women
  • The risk to women greatly increases after menopause
  • Pregnancy may be a time of particular risk for women
  • OSA is the most common chronic disease in industrialized societies
  • 27% of all children are affected by habitual snoring
  • 2 to 3% of all children have OSA
  • The problem is getting worse due to the trend toward obesity

Quality-Of-Life

Night after night of improper sleep and breathing takes its toll on our quality-of-life and may include the following:

  • Always feeling tired, no energy
  • Feelings of depression
  • Easily irritated
  • Falling asleep at inappropriate times
  • Difficulty concentrating
  • Forgetfulness
  • Waking up with a headache
  • Decreased sex drive
  • Frustration of bed partner
  • Embarrassment

OSA and Your Health

The three most important fundamentals of life are eating, breathing and sleeping. Those who suffer from sleep-disordered breathing (snoring and obstructive sleep apnea) are missing out on 2 of the 3!!

When breathing and sleeping are disrupted night after night, adverse health consequences are more frequently seen such as high blood pressure, heart attack and stroke.  In addition, diabetes and depression become more prevalent and are harder to treat when obstructive sleep apnea is present.

Vehicular and Workplace Accidents

People with Obstructive Sleep Apnea have higher motor vehicle crash rates based on crash records, as well as poor performance on driving simulators (similar to driving while intoxicated). Because traffic safety is under governmental regulation, there are legal implications for both private and commercial drivers/pilots if OSA is a significant cause of impaired driving. In addition, recent research shows that accidents and injuries in the workplace are increased when workers suffer from fatigue and sleepiness from obstructive sleep apnea.

Sleep Apnea in Children

Witnessed apneas occur in approximately 5% of children. Although obesity is an important risk factor in children as it is in adults, symptoms of sleep-disordered breathing will often occur in non-obese children. Studies suggest that a minimum prevalence of obstructive sleep apnea of 2 to 3% is likely, with prevalence as high as 10 to 20% in children who snore habitually. Daytime sleepiness is reported in 25 to 30% of children.

According to the American Sleep Apnea Association, children may present with hyperactivity, inattentiveness, aggressive behavior, irritability and mood swings when they are sleep-deprived. OSA in children is a serious disorder that may result in health problems as well as behavioral and academic problems.

Tonsils and Adenoids

Large tonsils and adenoids are often responsible for snoring and sleep apnea in children. When large tonsils and adenoids are removed, the snoring and apnea resolves in many of the cases.

Orthodontic Treatment

In many instances, snoring and sleep apnea in children can be caused by dental/facial abnormalities. Often, the upper airway can be widened through orthodontic expansion of the dental arches (a routine procedure done in most orthodontic offices).

Down Syndrome

It has been reported that the incidence of upper airway obstruction may be as high as 31% in children with Down Syndrome.

ADHD

A 2002 study found that children who frequently snore or have sleep disorders are almost twice as likely to suffer from ADHD-like symptoms as those who sleep well.

Sleep Apnea in Pregnancy

According to some researchers, the upper airway of pregnant women narrows in the last trimester of pregnancy. It has been found that if a woman has severe snoring or sleep apnea, the health of both the mother and the fetus can suffer. In pregnant women, blood pressure rises as the upper airway becomes narrower. Data indicate that pregnant snorers have an increased risk for preeclampsia.

Prevention

The shape of the face and dental arches in children is critical to ensuring the development of a properly functioning upper airway throughout life. Situations that tend to cause narrow dental arches or long faces can result in a compromised upper airway in the young child. Often, mouth breathing due to allergies or large tonsils and adenoids can create these harmful anatomical features and lead to snoring and sleep apnea. Sometimes, thumb-sucking or commercial pacifiers may result in narrow dental arches with compromised breathing and sleeping. Some researchers feel that breast-feeding serves to shape the dental arches in infants in a manner which increases the likelihood that the upper airway becomes adequately formed for proper breathing and sleeping.

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