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Sleep Apnea

The most common type of sleep apnea, which is though to affect more than one in ten persons, is caused by a temporary blockage of the throat airway leading to the lungs. This type is known as obstructive sleep apnea or OSA. There is a fairly rare type of sleep apnea that happens when there is a disconnect between the brain and the nervous system that interferes with the body's natural subconscious breathing rhythm. This is called central sleep apnea.

There are a number of things that can cause or worsen the airway blockages associated with OSA. In some cases, the tongue may fall backwards to block the throat. In other cases, tissues within the back of the mouth such as the soft palate or the fleshy walls of the throat relax and collapse inward to partially or fully block the airway. If the airway is only partial blocked, it results in shallow breathing, which is known as hypopnea. A full blockage of the airway results in a stoppage of breath—an apnea—that triggers a series of events.

When the throat is blocked, air flow to and from the lungs halts. With no fresh air entering the lungs, the body's oxygen levels begin to drop, and carbon dioxide builds up within the lungs. As the stoppage continues, it triggers the body's subconscious survival reflexes, releasing stress hormones and causing the brain to send a signal to wake up. At this point, the sleeper is startled into wakefulness long enough to open the throat and resume breathing. The momentary interruption from sleep often comes in the form of a gasp for air, but this happens so quickly that the sleeper often does not come fully awake.

People suffering from OSA often do not remember the ongoing stops of breath and gasps for air that take place during the night, and might actually think they are sleeping soundly. But in reality, the apnea pauses are depriving the body of much of the the restorative benefit of sleep, releasing high levels of stress hormones, and creating a range of health problems.

At the very least, OSA can lead to daytime sleepiness, an inability to maintain focus, and a risk of falling asleep while driving. It may cause a person to gain weight, suffer from morning headaches or daily migraines, and lead to an increase in blood pressure. If left untreated, OSA can eventually cause or worsen a wider range of health problems that includes GERD (gastro-esophageal reflux disease), hypothyroidism, coronary artery disease, heart attacks, kidney failure, type two diabetes and an increased risk for cancer.

There are some factors that may predispose a person to having OSA. Carrying extra weight is one of the most common, but even thinner persons who have excessive soft throat tissue, large tongues or poor throat muscle tone can suffer from OSA. The condition has been found to be more common in men, and more likely to occur at older ages. But women are also at risk of developing OSA, and it also occurs in about two percent of all children.

Certain behaviors may also make a person more susceptible to OSA. Sleeping on the back may cause the tongue or the throat's soft tissues to collapse backward and block the airway. Nasal congestion or swollen glands can cause or worsen blockages. Studies have shown that smoking, drinking alcohol before bedtime or eating a large, high-fat meal soon before bedtime can all worsen OSA symptoms.

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Dr. Alexander Milman, DDS
282 Grand Street Jersey City, NJ 07302