Apnea Essay, Research Paper

Apnea is involved with the respiratory and central nervous systems. The

respiratory system allows a person to breathe in oxygen and excrete carbon

dioxide (Deepak 116). After entering the mouth or the nose, oxygen travels into

the pharynx, the larynx, and then the trachea. The trachea splits into two

branches which then split into smaller tubes called bronchioles. Hair-like

projections called cilia cover the bronchioles and protect them from foreign

particles. From the bronchioles, air enters tiny air sacs called alveoli, each

of which is surrounded by capillaries containing the blood that gathers oxygen

to be transported throughout the body and releases carbon dioxide so that it can

be exhaled. Contractions of the diaphragm cause the lungs to be inflated and

deflated. According to Janet Fricker, sleep apnea is ?the periodic reduction

or cessation of breathing caused by temporary oropharyngeal collapse during

sleep?; in other words, it occurs when a person literally stops breathing

while asleep (Fricker 122). There are two main processes that produce sleep

apnea. The first, known as central sleep apnea, involves the level of brain

activity during sleep. The nighttime failure of the part of the brain that

controls breathing, located in the brain stem, results in unmonitored oxygen

Sumner 2 levels during sleep. When oxygen levels become too low and carbon

dioxide levels become too high, stimulation becomes strong enough to temporarily

awaken the brain to do its job. The brain triggers a snorting or sucking of air

in order to restore the balance of oxygen and carbon dioxide in the body. The

episodes recur as the brain returns to its sleep state (Coren 147-48). The

second form of sleep apnea, known as obstructive sleep apnea, is characterized

by a severe relaxation of the tongue, throat, and pharynx.(Deepak 116). The

severe relaxation of the tongue causes it to cover the opening to the trachea,

stopping the flow of oxygen into the lungs. After ten to ninety seconds of an

apnea respiratory centers alert the brain of its oxygen-deprived state, causing

the repeated sleep/wake cycle of the sufferer (Fricker 122). Sleep Apnea affects

about 4 percent of middle-aged men and 2 percent of middle-aged women (Walling

851). Symptoms of sleep apnea include loud snoring, gasping, and choking. It

causes breathing problems that cause a person to cough and gasp as many as

several hundred times a night (Pressman 65). Because a build up of fatty tissues

in the mouth tends to flow over the opening of the trachea, it is most common in

middle aged, overweight males (Coren 148). About sixty percent of sufferers are

overweight. However, it is not actual poundage but the thickness of the neck

that affects breathing. Men often develop thicker throat tissues and gather more

fat in their abdomen, neck, and shoulders than women. Men with a neck

circumference of seventeen inches or more and women with that of sixteen inches

or more are most likely to have sleep apnea, as well as Sumner 3 those with a

double chin or a lot of excess fat around the waist. Sleep apnea will worsen

with age as throat tissues become looser and people gain weight.(Barone 81).

Many side affects can occur due to sleep apnea. Sufferers can awaken to

headaches, irritability, difficulty in remembering, and problems with

concentration (Barone 81). More serious problems can occur, such as drowsiness

in the daytime, oxygen scarcity, and respiratory arrest while struggling to

breathe during sleep. Because there is less oxygen going to the heart, it has to

work harder; adrenaline is released and blood pressure rises rapidly. Repeated

bursts of nighttime blood pressure may cause hypertension during the day,

leading to increased risk of heart attack, stroke, and heart rhythm disturbances

(Barone 82). Diagnosing sleep apnea has become common only in recent years,

since the disorder was not officially defined until 1965. Snoring, daytime

fatigue, and a short attention span can be clues for diagnosis. If these

symptoms persist for a prolonged period of time it may become necessary to be

placed under the care of a pulmonary specialist, or an ear, nose, and throat

doctor. Diagnosis is made possible by examinations of the nose, throat, and jaw.

It is also helpful for a sufferer?s mate to answer questions about snoring and

sleep habits. The best way to make an accurate diagnosis and determine the

severity of the disorder is a polysomnography exam, usually involving an

overnight stay in a sleep clinic. There specialists are able to monitor blood

oxygen levels, heart rate, body temperature, brain waves, and the number of

times breathing stops. The sleep apnea rate, or the number of apneatic episodes

per hour of sleep, determines the severity of the disorder. Rates of fifteen or

fewer indicate only mild sleep apnea, Sumner 4 may not even be considered

clinically significant. Rates of fifteen to thirty indicates moderate sleep

apnea, and rates of thirty or more disturbances per hour indicate severe sleep

apnea (Pressman 204). While effective for determining treatment, polysomnography

can cost approximately two thousand dollars, but is usually covered by

insurance. A second option is a home monitoring device, costing about half as

much as lab observations but not usually covered by insurance (Barone 84).

Continuous positive airways pressure (CPAP) is the most commonly recommended

treatment for sleep apnea. It was first described in 1981 by University of

Sydney, Australia researcher Colin Sullivan (Fricker 122). CPAP stops snoring

and allows the sufferer to breathe without colapsation of the throat (Stradling

201). It consists of an airflow generator, tubing, and a mask that goes over the

nose. Air is supplied at slightly above atmospheric pressure, holding the

airways open (Fricker 122). Many patients find CPAP masks to be uncomfortable,

but without them would relapse into their pretreatment state within only

twenty-four hours (Stradling 201). Studies indicate reductions in daytime

drowsiness and general health improvements as a result of CPAP, but have not

shown improvements in morbidity, mortality, or quality of life (Walling 851).

Along with CPAP treatment, personal health measures can be taken in order to

help reduce the symptoms and risk of sleep apnea. Dr. Richard Millman of the

Sleep Disorders Center at Rhode Island Hospital suggests avoiding alcohol and

sleeping pills near bedtime because they slow breathing , laying on one side

while sleeping, and using Sumner 5 nasal strips while suffering from congestion

(Barone 84). Smoking is also a major contributor to sleep apnea because it can

swell the throat tissues and worsen the already low oxygen levels that accompany

it. Since being overweight is a leading cause of sleep apnea as well as many

other health problems, it is a good idea to be as physically fit as possible.

Even a ten percent weight loss can affect the number of apneatic episodes that

occur each night (Barone 84). Though CPAP is the most commonly recommended and

utilized treatment of sleep apnea, there are other options. Oral devices similar

to a retainer can be used to reposition the tongue and jaw. These are effective

because moving the jaw forward also pulls the tongue forward, reducing

obstruction of the trachea. However, these devices can be expensive and may not

be covered by insurance. Surgery is a last resort option.

Uvulopalatopharyngoplasty, or UPPP (UP3 ) widens the airway by reducing the size

of the uvula, the soft palate, or both. UP3 has only a fifty percent success

rate, is very expensive, and involves a painful recovery. Laser-assisted

uvulopalatoplasty, or LAUP, utilizes lasers to remove excess throat tissue. It

is less expensive and painful than UP3, but it may require several treatments (Barone

84). Sleep apnea does not have to control a sufferer?s life. It is important

to realize that the affects of sleep apnea on a person?s respiratory system

can be devastating. Being able to identify the causes, health effects, and

treatment of sleep apnea can help to prevent problems before they arise. The

constant drowsiness, headaches, and incessantly loud snoring affect work habits,

overall health, and even cause problems between married Sumner 6 couples who

cannot sleep in the same bed together due to snoring. Because some people may

not even realize that they are suffering from obstructive sleep apnea, it is

important to be aware of the symptoms and steps necessary to confront the

problem. Avoiding smoking, alcohol, and excessive weight gain are valuable

factors for prevention, as well as basic principles of good health.

Psychologists study sleep disorders such as sleep apnea in order to understand

their effect on sleep as a state of consciousness. Consciousness is defined as a

state of awareness. Going to sleep does not mean that a awareness ceases;

instead, sleep changes the type of consciousness that is experienced. Sleep is

also necessary to maintain a balance of the body?s functions and to allow the

body to rest and restore itself. Prolonged periods of sleep deprivation for any

reason result in fatigue, irritability, and inefficiency throughout the day.

Being able to identify and treat sleep apnea and other sleep disorders provides

more restful and fulfilling sleep, allowing for a productive and satisfying

lifestyle.