Apnea

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Editor-In-Chief: Prab R Tumpati, MD
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Apnea
File:Snoring under severe sleep apnoea - 1741-7015-9-17.oga
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Breathing cessation, snoring, daytime sleepiness
Complications Cardiovascular disease, diabetes, fatigue
Onset Any age
Duration Variable
Types Obstructive sleep apnea, Central sleep apnea, Mixed sleep apnea
Causes Obesity, alcohol consumption, nasal congestion, neurological disorders
Risks Obesity, male gender, older age, family history
Diagnosis Polysomnography, home sleep apnea testing
Differential diagnosis Insomnia, narcolepsy, restless legs syndrome
Prevention Weight loss, avoiding alcohol, sleeping on side
Treatment Continuous positive airway pressure (CPAP), oral appliances, surgery
Medication Modafinil for daytime sleepiness
Prognosis N/A
Frequency Common
Deaths Can lead to premature death if untreated


Introduction

Apnea is a medical condition characterized by the temporary cessation of breathing, especially during sleep. The term is derived from the Greek word "apnoia," meaning "without breath." Apnea can occur in various forms, including obstructive sleep apnea, central sleep apnea, and complex sleep apnea syndrome.

Types of Apnea

Obstructive Sleep Apnea

File:Snoring under severe sleep apnoea - 1741-7015-9-17.oga Obstructive sleep apnea (OSA) is the most common form of apnea. It occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. This can lead to repeated episodes of partial or complete blockage of the airway during sleep, resulting in loud snoring, choking, or gasping sounds.

Central Sleep Apnea

Central sleep apnea (CSA) is less common and involves the central nervous system. In CSA, the brain fails to send appropriate signals to the muscles that control breathing. Unlike OSA, there is no physical blockage of the airway, but the breathing stops and starts repeatedly during sleep.

Complex Sleep Apnea Syndrome

Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, is a combination of obstructive and central sleep apnea. It occurs when someone with OSA develops CSA during treatment with continuous positive airway pressure (CPAP).

Causes

The causes of apnea vary depending on the type. Obstructive sleep apnea is often associated with excess weight, which can lead to fat deposits around the upper airway. Other factors include age, family history, and anatomical features such as a thick neck or narrow airway. Central sleep apnea can be caused by heart disorders, stroke, or other medical conditions affecting the brainstem.

Symptoms

Common symptoms of apnea include loud snoring, episodes of breathing cessation during sleep, abrupt awakenings accompanied by gasping or choking, morning headache, difficulty staying asleep (insomnia), excessive daytime sleepiness (hypersomnia), and attention problems.

Diagnosis

Diagnosis of apnea typically involves a sleep study, known as polysomnography, which records brain waves, blood oxygen levels, heart rate, and breathing during sleep. Home sleep apnea testing is also available for some patients.

Treatment

Treatment options for apnea depend on the type and severity. Lifestyle changes, such as weight loss, avoiding alcohol, and sleeping on one's side, can be effective for mild cases. Continuous positive airway pressure (CPAP) is the most common treatment for moderate to severe obstructive sleep apnea. Other treatments include oral appliances, surgery, and adaptive servo-ventilation for central sleep apnea.

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Contributors: Prab R. Tumpati, MD