The Warning Signs While Sleeping

The Hidden Dangers of Central Sleep Apnea: What You Need to Know

When we think of sleep apnea, most people picture loud snoring or obstructed breathing during sleep. But there's another, lesser-known form of the disorder—central sleep apnea (CSA) —and it carries its own set of serious risks.

What Is Central Sleep Apnea?

Central sleep apnea is a condition where your brain fails to send proper signals to the muscles that control breathing during sleep. Unlike obstructive sleep apnea, where breathing is blocked by a physical obstruction, CSA is a communication breakdown between the brain and the body. This makes it more complex and, in some cases, more dangerous.

The Quiet Threat: Why CSA Is Dangerous

Central sleep apnea is not just about poor sleep quality—it can have serious consequences for your overall health:

1. Interrupted Oxygen Supply

During an apnea episode, breathing stops for 10 seconds or more. This results in reduced oxygen levels in the blood (hypoxia), which can strain vital organs, especially the heart and brain.

2. Heart Complications

CSA is commonly associated with heart conditions, particularly congestive heart failure. In fact, the relationship is bidirectional—heart problems can cause CSA, and CSA can worsen heart problems. One type, called Cheyne-Stokes respiration, is often found in people with serious cardiac issues and is linked to a higher risk of death.

3. Cognitive Decline

Ongoing drops in oxygen and fragmented sleep can lead to memory loss, trouble concentrating, and mood disorders like depression and anxiety. Over time, this can affect job performance, relationships, and overall quality of life.

4. Increased Risk of Stroke

Studies have shown that people with CSA are at a higher risk of stroke. The irregular breathing patterns can lead to fluctuations in blood pressure and decreased brain perfusion, raising stroke risk significantly.

5. Daytime Fatigue and Accidents

CSA often leads to excessive daytime sleepiness, making activities like driving or operating machinery dangerous. People with untreated CSA are much more likely to be involved in accidents due to impaired alertness.

Who Is at Risk?

CSA is more common in:

- People over 60

- Those with heart conditions or atrial fibrillation

- Individuals using certain medications (especially opioids)

- People who have had a stroke

Diagnosis and Treatment

If you’re experiencing chronic fatigue, waking up gasping, or if your partner notices pauses in your breathing, it’s worth speaking to a doctor. A sleep study (polysomnography) is the gold standard for diagnosing CSA.

Treatment options may include:

- Adaptive servo-ventilation (ASV) devices

- BiPAP machines

- Treating the underlying heart or neurological condition

- Reducing opioid use (if applicable)

Central sleep apnea is a silent but serious condition. While it may not be as well known as obstructive sleep apnea, its effects can be equally or even more dangerous—especially if left untreated. Recognizing the symptoms and getting a proper diagnosis can protect not only your sleep but also your heart, brain, and overall health.

Don’t ignore the signs—sleep should heal, not harm.

Contact us to learn more.

Title: Understanding Sleep Apnea: A Silent Threat to Restful Nights

A good night's sleep is vital for our overall well-being, allowing our bodies and minds to recharge and rejuvenate. However, for millions of people worldwide, this restful experience is disrupted by a sleep disorder known as sleep apnea. Sleep apnea is a serious condition that affects breathing during sleep and can have far-reaching consequences if left untreated. In this blog post, we will explore what sleep apnea is, its causes, symptoms, and available treatment options.

What is Sleep Apnea?

Sleep apnea is a sleep disorder characterized by interrupted breathing during sleep. It occurs when the upper airway becomes partially or completely blocked, leading to brief pauses in breathing. These pauses, called apneas, can last from a few seconds to minutes and may occur multiple times throughout the night. The brain senses the drop in oxygen levels and triggers a brief awakening or arousal to restore normal breathing, often leaving the affected individual unaware of these disruptions.

Types of Sleep Apnea

There are three main types of sleep apnea:

1. Obstructive Sleep Apnea (OSA): This is the most common form of sleep apnea. It occurs when the muscles in the throat relax, causing a blockage in the airway. OSA is often associated with loud snoring, gasping, and choking during sleep.

2. Central Sleep Apnea (CSA): Unlike OSA, CSA is caused by a communication problem between the brain and the muscles responsible for breathing. The brain fails to send proper signals to initiate breathing, leading to pauses in respiration. CSA is less common than OSA and is often associated with underlying medical conditions such as heart failure or neurological disorders.

3. Complex Sleep Apnea Syndrome (CompSA): Also known as treatment-emergent central sleep apnea, CompSA is a combination of OSA and CSA. It typically occurs when OSA is treated with continuous positive airway pressure (CPAP) therapy, but the central apneas persist.

Symptoms of Sleep Apnea

Sleep apnea can manifest itself through various signs and symptoms, including:

1. Loud snoring: Especially common in OSA, loud and chronic snoring is often a significant indicator of sleep apnea.

2. Pauses in breathing: Witnessed by a bed partner, breathing interruptions during sleep are a key symptom of sleep apnea.

3. Excessive daytime sleepiness: Due to disrupted sleep, individuals with sleep apnea often experience daytime sleepiness, fatigue, and lack of energy.

4. Morning headaches: Waking up with headaches is another common symptom, often caused by decreased oxygen levels during sleep.

5. Mood disturbances: Sleep apnea can contribute to irritability, mood swings, and difficulty concentrating.

6. Frequent urination at night: Nocturia, the need to urinate multiple times during the night, can be a symptom of sleep apnea.

Health Risks of Untreated Sleep Apnea

Sleep apnea is not merely a sleep disruption; it can have severe health consequences if left untreated. The repeated drop in oxygen levels and fragmented sleep patterns can contribute to various health problems, including:

1. High blood pressure: Sleep apnea is associated with hypertension, increasing the risk of heart disease and stroke.

2. Cardiovascular disorders: Sleep apnea can contribute to the development of irregular heart rhythms, heart failure, and other cardiovascular conditions.

3. Diabetes: Individuals with sleep apnea are at a higher risk of developing insulin resistance and type 2 diabetes.

4. Obesity: Obesity is both a risk factor and a potential consequence of sleep apnea, creating a vicious cycle that further exacerbates the condition.

Treatment Options

Thankfully, several treatment options are available to manage sleep apnea effectively. These include:

1. Continuous Positive Airway Pressure (CPAP): CPAP therapy involves wearing a mask over the nose or mouth during sleep, which delivers a continuous flow of air to keep the airway open.

2. Oral appliances: Custom-made oral devices, such as mandibular advancement devices, can help keep the airway open by repositioning the jaw and tongue.

3. Lifestyle modifications: Certain lifestyle changes, such as weight loss, regular exercise, and avoiding alcohol and sedatives, can help improve sleep apnea symptoms.

4. Surgery: In severe cases or when other treatment options have failed, surgical interventions may be considered to correct structural abnormalities that contribute to sleep apnea.

Sleep apnea is a common sleep disorder that affects millions of individuals worldwide. By understanding its causes, symptoms, and potential health risks, we can take the necessary steps to seek diagnosis and treatment. If you suspect that you or a loved one may be experiencing sleep apnea, consult a healthcare professional who can guide you towards appropriate management strategies. Remember, a good night's sleep is not a luxury; it's a vital component of our overall well-being.

Something to make you laugh.

Bursting the Myth Bubble on Sleep Apnea

Find out the facts about sleep apnea and let go of those old wives’ tales.

With the information highway available at our fingertips, it can often be difficult to decipher facts from fiction. Here we have gathered some of the common myths about sleep apnea and will provide you with the actual facts, based on research, science, and experience.

Myth: Sleep Apnea Is Just Snoring

Fact: While snoring can be a symptom associated with sleep apnea, there is a huge difference between being a snorer and having a sleep disorder. With sleep apnea, a person can stop breathing anywhere from 10 to 30 seconds at a time and this can happen numerous times throughout the night, possibly occurring in the hundreds.

These breaks in breathing are often followed by a rapid snort or sudden deep breath/gasp. This can cause a disruption in the natural sleep cycle and lead to excessive daytime fatigue.

Myth: Having Sleep Apnea Is No Biggie

Fact: A disruption in your breathing is a big deal.  Especially when it is happening repeatedly in the night. It can take a toll on your mind and body, wearing you down, increasing your daytime tiredness. This leads to loss of focus, affects appetite and weight management, coping mechanisms, increased stress levels and ultimately decreases your overall health.

Myth: Only Old People Have Sleep Apnea

Fact: Any person, regardless of age or gender, can have obstructive sleep apnea. This sleeping disorder does not discriminate. It is estimated that 18 million Americans have a form of sleep apnea. While it may show up more often in adults over age 40, anyone can have it, even children. In fact, 1 in 10 children suffers from some level of sleep apnea, from mild to severe, which may also affect their attention span and behavior (see the youtube video "Finding Connor Deegan").  Most children will outgrow it, but that does not mean it will not occur again later in life.

Myth: Sleep Aids Will Prevent Sleep Apnea And Help Me Sleep

Fact: Alcohol, sleeping pills, and natural remedies, such as Valerian Root or Melatonin, do not prevent sleep apnea in any way. In fact, alcohol and sleeping pills will cause your muscles to relax and thus create the perfect situation for obstruction of your airway and obstructive sleep apnea. Sleep apnea occurs your body subconsciously relaxes and your tongue, soft palate, or other tissues in the back of the throat block your airway. When you try to breathe in, the air can't get through. Therefore, sleep aids might possibly enhance the creation the perfect anatomical environment for your sleeping disorder.

Myth: Only People Who Are Obese Have It

Fact: Obstructive Sleep apnea occurs commonly in people who have excess weight due to excess tissue on the neck pushing down on the airway when they are in a supine position. This does not mean just extra fat, but extra muscles mass as well. It can show up in people that are physically fit and have large, heavy muscles or large necks in addition to those that have excess fat.

Losing excess weight can help reduce your chance of experiencing sleep apnea symptoms.  Talk to your doctor about your goals and see if a weight loss program is right for you.

Myth: Surgery Is My Only Treatment Option

Fact: There are many solutions that may be able to help someone with a sleeping disorder. For a small population, having surgery will help their sleep apnea, for instance a child having oversized tonsils removed.  Additionally having surgery to improve nasal breathing may be of benefit.  Non-surgical treatments, especially in adolescents, such as such as creating more space in the mouth through orthodontic intervention (preferably without removing teeth and often times by expanding the palatal vault) will allow for more space for your tongue and other soft tissues that could potentially obstruct the airway during sleep.

• You can always try sleeping on your side. This is a difficult fix to maintain since most of us shift positions quite often in the night.
• You can try using pillows to prop your body up at an angle. Again, this may only be a short-term solution.
• A better option for continuous and effective treatment is using a CPAP machine. CPAP stands for continuous positive airway pressure. A CPAP machine blows a steady stream of air into your airway, preventing you from having any disruptions in your breathing. You can adjust the flow under a physicians' guidance until it is strong enough to keep your airway open while you sleep. This is the most common treatment for adults with moderate to severe Obstructive Sleep Apnea.
• For those that are unable to not use a CPAP machine, you may be able to use an oral appliance designed by a qualified dentist. This device is custom tailored to your mouth, is small and compact enough to fit in a purse or backpack, and does not require an outlet for power. An oral appliance will adjust the position of your lower jaw allowing preventing your airway from being blocked. You can learn more about oral appliances by contacting our practice.

If you have any questions about sleep apnea, feel free to contact us at any time.

Connecting the Dots

What is the connection between weight and sleep apnea?

According to WebMD, excessive body weight and obesity, defined as a body mass index of 25.0 - 30.0 or above, are the most common reason and “strongest risk factor” for experiencing obstructive sleep apnea. [1]  Although, not just weight matters, but also directly correlates to neck circumference in both men and women. This excess body weight can add pressure onto the neck and chest while a person sleeps on their back. This will make it difficult for the airway path to remain open and for the lungs to fully expand, thus, compressing the lungs and creating shallow, insufficient breaths.

It may seem the obvious solution to this would be to lose weight. However, this can be very difficult for someone whom, night after night, is not getting adequate sleep. Additionally, exercising during the day while exhausted can be dangerous.

When we do not get enough sleep at night, we over compensate throughout the day to combat excessive tiredness. In the morning, too tired to wake up when the alarm goes off, you hit the snooze button, possibly more than once and now you are rushing to get out the door. You down a cup of coffee, perhaps even two or three. You add sugar and cream for that extra boost. With the lack of time, making a healthy breakfast is out; you grab something quick on the go or grab a donut or bagel from the office break room. Then after a long day at the office, or with the kids, or whatever your day can bring, come dinner time the mind and body is too tired to make a large healthy dinner and clean up the mess after, so you order take out. By then, it’s possible that you are so hungry that you over-eat. Does this sound familiar? I know that many of us can relate to this scenario. When it happens again and again, the body’s chemistry and hormones are adjusting to compensate for the erratic diet and slowly the weight begins to grow. Coupled with a poor diet and being too tired to exercise, over time, the body may become obese keeping the poor sleep and eating cycle feeding on itself.

It may seem obvious what the solution here is ... get more sleep! But it is not always that simple. There can be many contributing factors to weight gain, not just lack of sleep. Doing our best to keep off the excessive weight will directly decrease your chances of developing obstructive sleep apnea.  But if the vicious battle with fatigue continues it is best to consult with a physician, a sleep specialist, to determine your symptoms and seek treatment. After testing and diagnosis, the trained specialists can help you determine what areas of your lifestyle may be contributing to sleep apnea, whether it be excessive body weight or another issue. Speak to your specialist about developing a personalized treatment plan to help you get more sleep and maybe even lose some weight.  Then you can wake up refreshed and bounce out of bed before your alarm goes off!