WHAT IS
SLEEP APNEA

By John G. Nozum



    Sleep apnea literally means absence of breathing during sleep. The reason why you don’t suffocate to death in your sleep is because your body wakes up at least partially in order to be able to breathe, although you probably most likely will not remember this. Because of this frequent partial or complete waking up, the quality of your sleep can suffer substantially. As a result, your daytime performance suffers. You are less energetic and much more apt to fall asleep in inappropriate settings, such as at work, while driving, taking classes, sitting in meetings, and more. In fact, sleep apnea can even wreck your career and possibly your life! In rare cases, it can even cause death.

    There are three basic types of sleep apnea. The most common type is obstructive sleep apnea. Here the airway gets obstructed in one or more locations due to fatty tissues, swelling, and/or physical abnormalities. MOST people that have obstructive sleep apnea are obese. The second type is central sleep apnea. Here the respiratory system makes little or no attempt to breathe during sleep. This defect can either be in the brain, spinal cord, and/or in breathing mechanisms (not reacting to breathing commands from the brain). The last type is mixed sleep apnea. This is simply a combination of obstructive and central sleep apnea put together.

    While there are three basic types of sleep apnea, most of their symptoms are the same. Below are the symptoms of obstructive and central sleep apnea.

OBSTRUCTIVE SLEEP APNEA:  
CENTRAL SLEEP APNEA:
* - This symptom is almost always present.
** - This symptom is required for a diagnosis of this disorder.
    To accurately diagnose sleep apnea, a person must spend at least one night in a sleep lab. Here, various monitors are placed on the patient, such as EEG, EKG, EMG, pulse oximeter, thermocoupler(s), and respiratory effort straps. All these tests are non-invasive and painless (except during the scrubbing/prepping process). A few sleep labs may even insert a special balloon into the throat. However, this is rarely used due to its significant discomfort. In addition, a video camera will be focused on the patient to check for strange behaviors while asleep. During the night, the patient is observed and monitored from a nearby room. Everything is recorded for later review by a doctor. Sometimes, sleep apnea can be intermittent, and this can require more than one night in a sleep lab.

    In addition to one or more overnight sleep studies, a person may also undergo a multiple sleep latency test (MSLT). Here, a patient is wired up the same way as for an overnight sleep study, but connected to one or more cables that can be easily connected and disconnected. The person is free to do whatever he or she wants between scheduled nap periods. At regular intervals (usually 2 hours), the person will be connected to the monitoring equipment and be given an opportunity to take a short snooze. If the patient does not fall asleep within an allotted time (usually between 20-35 minutes), he or she is said to be doing satisfactory at that point in the test. The test usually covers the course of a standard workday.

If You Are About to Have a Sleep Study

    Many people just simply can’t relax well in a sleep lab, knowing that they are being monitored and have a video camera snooping on them. Here are some tips to help you sleep a significant portion of the night in the lab.

If you are found to have obstructive sleep apnea, you may be asked to spend another night in the sleep lab. The procedure will be the same except that you will be introduced to a CPAP machine (stands for Continuous Positive Air Pressure). Rest assured that they will NOT make you go cold turkey. They will introduce you to it and explain it before you even lie down to sleep. After going sleep, the technician will gradually increase the pressure until the obstruction(s) are counteracted (if possible). However, this will be so gradual that you probably won’t even realize that it is happening. You do NOT have to worry about suffocating in one of these masks even if the power goes out. The full-face masks have a special valve that opens if the power is interrupted. The nasal masks do not cover your mouth, so your mouth is free for breathing if the power goes out.


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