Sleep Apnea Risk Factors, Symptoms, and Treatment

With more than 18 million American adults affected, it’s important allied health professionals know the sleep apnea risk factors, symptoms, and treatment.

Anyone can develop sleep apnea, but certain conditions put a patient at higher risk. The most common sleep apnea risk factors include:

Sleep Apnea Risk Factors

• Hypertension
• Coronary artery disease
• Heart failure
• Atrial arrhythmias
• Stroke
• Obesity
• Metabolic Syndrome
• Excessive alcohol use
• Sedative medication use

Sleep Apnea Signs and Symptoms

Sleep apnea (SA) has some significant symptoms like loud snoring, which are easily noticeable by a spouse or significant other. However, an individual is often unaware of the symptoms and so denies having any issues. He or she may also refuse to seek medical interventions. As a healthcare professional, it is important to know the major SA signs and symptoms, and to educate your patient on the need for proper treatment to avoid any of the sleep apnea risk factors noted above. The most common SA symptoms are:

• Loud snoring
• Suddenly waking up from a deep sleep
• Poor concentration during the daytime
• Daytime sleepiness - more common in men
• Fatigue - more common in women
• Depressed mood
• Irritability
• Learning and memory difficulties
• Falling asleep while at work, on a phone or driving
• Headaches
• Sedentary lifestyle
• Reduced social participation
• Poor quality of life
• Cardiovascular risk factors
• Sudden cardiovascular death

Cheyne-stokes respiration with sudden arousal from deep sleep is a classic sign for CSA (central sleep apnea) along with other serious complications including sudden cardiovascular event.

Sleep Apnea Treatment Interventions

Specific treatment interventions are tailored to the individual patient based on medical history, physical examination, and the results of polysomnography. Medications are usually not a treatment of choice for sleep apnea. The role of oxygen administration is controversial as not all patients with sleep apnea benefit from it. Also, oxygen therapy does not eliminate sleep apnea or prevent daytime sleepiness. Therefore, it is difficult to predict who will benefit from oxygen therapy. In addition, lifestyle changes have been proven to reduce apneic episodes and reduce symptoms. Reducing alcohol and tobacco consumption, weight reduction, and taking a hot shower before bedtime are examples of proven strategies that can help with sleep apnea. Eliminate or Stop Snoring: There are a variety of anti-snoring devices available on the market for mild cases of sleep apnea. These devices usually work in cases of obstructive sleep apnea (OSA) by correcting the anatomical positioning temporarily. Some of these devices include mouth guards, different anti-snoring strips or jaw belts, nose clips, or even anti-snoring supplements. The devices will keep the airway open during sleep and help reduce the apneic episodes. Although it takes some time to get used to sleeping with a device, patients notice a positive difference in sleep quality as well as a reduction in symptoms such as a headache.

Continuous Positive Airway Pressure (CPAP): CPAP is a non-invasive form of therapy used in the treatment of sleep apnea. The goal of the machine is to deliver pressurized air into the patient’s airway to keep it open throughout the night. The machine helps prevent collapse of the airway, allowing the patient to breathe comfortably. There are several different settings in CPAP that one can utilize based on breathing needs. A pulmonologist or ENT work very close with the patient to determine which settings will work best. BIPAP (BPAP) is another form of pressurized air therapy that can be used in the treatment of sleep apnea. It is a nice alternative for patients who failed CPAP trials as BPAP has added settings that provide more freedom compared to CPAP.

Surgery for Sleep Apnea: In severe cases of sleep apnea, surgery is considered. The majority of the procedures are concentrated on increasing the size of the airway, but they come with high risks of complications. Common surgeries for sleep apnea in children and younger populations are removal of adenoids, removal of tonsils, removal of nasal polyps, or removal of other tissues or growths in the airway. The surgical procedure can also correct structural deformities. Therefore, many times, more than one procedure may be necessary to achieve better outcomes. Other examples of surgical procedures are Uvulopalatopharyngoplasty (UPPP) and Laser-Assisted Uvulopalatoplasty (LAUP). Tracheostomy is another measure considered in the case of life-threatening sleep apnea. It is important to note that the older population often have fewer benefits from surgical procedures for sleep apnea. To learn more about sleep apnea risk factors, testing, and treatment, see the following:

• Sleep Apnea Types, Pathogenesis & Diagnostic Tests
• Altered Breathing Patterns and Disorders: Their Impact on Health, Posture, Pain, and Stress

References:

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