Sleep-related breathing disorders involve pauses in breathing or difficulties breathing during the night. If they are untreated, they can cause many serious problems, among which are heart attack, stroke, high blood pressure, and low blood oxygen.

Among the symptoms of sleep-related breathing disorders are weight gain, extreme daytime fatigue, tooth decay, and gum disease. People with these disorders often feel exhausted, and they are not aware of their problems with wheezing, snoring or breathing interruptions during the night. They usually find out about their problems when a partner tells them they snore or when they’re evaluated by a doctor or healthcare professional. They can occur at any age, in both men and women. Certain issues like sinus problems, wheezing, or obesity can increase the risk of having a sleep-related breathing disorder.

Sleep-related breathing disorders can be a subset of a broader group of disorders, including insomnia (difficulty sleeping), restless leg syndrome, parasomnias (including sleep terrors and sleepwalking), and hypersomnias such as narcolepsy (inappropriately falling asleep).

Types

As we mentioned, sleep-related breathing disorders are defined by difficulty breathing during sleep. They involve a range of breathing anomalies from chronic or habitual snoring to upper airway resistance syndrome (UARS), central sleep apnea, obstructive sleep apnea (OSA), and even obesity hypoventilation syndrome (OHS).

Snoring

Snoring happens during sleep when air flow from your breathing forces tissues in your throat to vibrate. About fifty percent of people will snore at some period of life. Even though snoring is more common in men, many women also have this problem. About forty percent of men and twenty percent of women have habitual snoring. Research suggests that it runs in family and becomes more frequent as you get older, but men have a lesser chance of snoring after the age of 70. Snoring can also happen because the throat muscles are relaxed due to the consumption of alcohol or other depressants, or from congestion that you get from cold or allergies.

Snoring can be a nuisance for your partner because it can create a loud or harsh sound during your sleep, and it can cause difficulties for you as well. Light snoring will not disrupt your sleep, but heavy snoring might. Heavy snoring can be linked to other sleep disorders like obstructive sleep apnea or increase your risk of having a stroke, heart disease, or diabetes due to sleep deprivation. It can also cause a sore or irritated throat or a dry mouth in the morning.

Sleep Apnea

Sleep apnea is a disorder that includes a temporary loss of breath during the night, and it happens when airway gets complete or partial obstructions. These obstructions can stop your breathing for short periods, and cause shallow breathing and temporary breath loss repeatedly during the night. When you have an episode of sleep apnea, your body increases the adrenaline levels to try and stop this issue, which causes constant interruption, minimizes the quality of sleep, and increases your blood pressure.

If you have sleep apnea, you can be chronically sleep-deprived, have an increased risk of severe health issues including liver problems, weight gain, diabetes, and heart disease, and show symptoms of slow reflexes, irritability, daytime sleepiness, poor concentration, depression, and moodiness. For developing sleep apnea, many factors depend on your anatomy, but some were caused by certain injuries to the nose and nasal passageways. You can feel fatigued during the day while having difficulties concentrating and falling asleep.

Obstructive Sleep Apnea

Obstructive sleep apnea is the most common type of sleep apnea. It occurs when your airway is blocked, causing you to stop breathing for a brief period, have loud snoring, or even wake you up from sleep. The airway is repeatedly blocked, which limits the amount of air that will reach your lungs.

Obstructive sleep apnea is a serious condition that occurs when a person stops breathing during sleep due to obstruction in the airway. It causes loud and frequent snoring, deprives our brain of oxygen, and wakes us up several times a night. Such condition causes daytime sleepiness or fatigue, followed by a number of other health problems, starting from insomnia, loss of concentration, morning headaches, memory losses and so on. Also, sleep apnea in children is different from obstructive sleep apnea in adults, and there are lots of variations of this disorder. Although slim people can suffer from sleep apnea as well, excess body weight is a major risk factor this condition (it increases with higher body mass index (BMI) of 25 or more).

Central Sleep Apnea

One of the variations as mentioned above is central sleep apnea, which is not caused by a blockage of the airway, but rather by some brain or heart problems. It means your body decreases or stops the effort of breathing during sleep in an off-and-on cycle because the heart and brain fail to interact in monitoring the air flow. This causes problems such as frequent waking up, difficulty falling asleep again, and as a consequence, daytime sleepiness. People become tired, they are not capable of restoring their concentration even after daytime naps, so the quality of life is significantly reduced.

Child Sleep Apnea

The percentage of children having obstructive sleep apnea which needs to be treated is about two, and it mostly occurs before they start school, because their tonsils are too large, due to which they may also have troubles with swallowing (dysphagia). It appears to occur at the same rate in young boys and girls, but it is more likely to occur in a child who has a family member with OSA. The cause for child sleep apnea may also be immature brainstem or some other medical condition.

When they fall asleep, the muscles relax and, the soft tissue blocks the airway, causing partial reductions in breathing, called hypopneas. But these can also induce complete breathing pauses, called apneas, usually occurring during the sleeping stage known as rapid eye movement (REM). Reduced levels of oxygen in the blood which result from apneas are called hypoxemia and are common in children because of their smaller lungs and lesser oxygen reserves.  Their shallow breaths cause an increased level of carbon dioxide in the blood, which is called hypercapnia.

While snoring, younger children can show unusual chest and abdomen movement, causing their rib cage to move inward as they inhale, which is not normal for healthy children. If untreated, it can lead to serious problems, such as funnel chest or depression in the chest wall. Children suffering from OSA also tend to sleep in the sitting position, they may sweat during sleep and have headaches in the morning, and experience bedwetting. During the day, they may breathe through the mouth, thus being more susceptible to respiratory infections. The problem with children is establishing the right diagnosis on time, because otherwise, they may have a slower growth rate and higher blood pressure.

Furthermore, problems in behavior may occur, such as aggressiveness, hyperactivity disorder, development delays and similar. But, even healthy children can have brief central apnea, due to some instability in breathing, and such pauses could be isolated events, occurring after sighs or moves. In such cases, they last less than 20 seconds. However, if they have prolonged breathing pauses lasting more than 20 seconds, they may need to be checked for OSA.

Infant sleep apnea

The apneas for infants can be central, obstructive or mixed. Central apneas happen when the body minimizes or stops its effort to breathe. Obstructive apneas happen when the soft tissue in the back of the throat collapses, causing it to block the airway during sleep. Mixed apneas are essentially a central apnea that is followed by an obstructive apnea.

Sleep-Related Groaning

Catathrenia or sleep-related groaning happens when you create a prolonged sound while sleeping. This sound is quite loud, and it resembles groaning, which is where the name came from. During this episode, the breathing becomes very slow with deep breaths that end in a loud exhale that can last up to 40 seconds. The groans can end with a loud grunt, and they often repeat in groups from a couple of minutes to an hour. The condition is very rare but more frequent in men. The cause is still not known because it is not related to any breathing problems, mental disorders, or abnormal brain activity.

Diagnosis

Most sleep-related breathing disorders can be diagnosed the same way as any sleep disorder – with polysomnography, which is an overnight sleep study in a sleep lab or at home. The sleep study will determine if you have any breathing changes during sleep.

Treatment

The usual treatment for sleep-related breathing disorders requires major lifestyle changes. The first is behavior modification aimed towards improving sleep hygiene. You also need to avoid supine positioning during sleep, sedative medications, and ethanol.

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