How is my sleep-related breathing problem affecting my health?
What is my upper airway doing while I’m sleeping? Your brain breathes in 3 basic gears: awake, asleep, and dream sleep (REM sleep). As we drop down from awake to sleep, our body gets more relaxed; the most relaxed state is in dream sleep. This is especially important when we dream, so we do not act out our dreams. However, if your body has a “floppy” upper airway, being very relaxed can cause that airway to either close partially, causing snoring, or actually collapse shut, causing obstructive sleep apnea.
What does it mean to/why do I have a “floppy” airway? Sleep apnea can be caused by one of, or a combination of, three things. First, how we are built – big tonsils and big uvula (the punching bag), among others, create a very narrow throat opening. Second, how much we weigh – extra weight pushes down on the collapsible part of your airway. Third, how we are wired – how does your brain tell you to breathe? Usually, it is a combination of these three things that determine how severe your sleep apnea is.
Why is it so bad if sometimes my airway closes? When your airway collapses shut when you are sleeping, a number of bad things happen quickly. First, your brain thinks that it is being strangled, and will hit a “panic” button to make you jerk awake briefly and open that airway. This “panic” button is the “fight or flight response” all people have to danger, and your body responds by releasing stress hormones and adrenaline into your system. These hormones increase your blood pressure, make your heart beat faster, raise your blood sugar, and jerk you out of restoring sleep. Over time, those problems can become permanent – for example, high blood pressure, diabetes, and memory problems. You also become 3-4 times more likely to have a stroke or heart attack. Secondly, with a closed airway, your oxygen level drops. All of your body’s panic responses are now taking place with low amounts of oxygen, making a bad situation worse. Organs like the heart, brain, and kidneys begin to shut down and “misfire” when they do not get enough oxygen.
How do I treat this? We will discuss with you the options available based on your level of sleep apnea. The “gold standard” is Continuous Positive Airway Pressure (CPAP); a machine about the size of a shoebox. CPAP blows a small amount of air into your nose or mouth through a mask, thereby “splinting” open that collapsible airway. The pressure is adjusted to perfectly fit your airway; if this fit is correct, you should not even feel any extra air. Other options to treat sleep apnea include a mandibular advancement device (a dental device), which is like a mouth guard that gently pushes your lower jaw forward, creating an underbite. This helps pull your airway apart while you sleep by pulling your tongue forward slightly and off the back of your throat. Surgery is also an option, depending on how “crowded” your airway is. However, surgery is often a temporary fix and is very painful. Weight loss is also recommended, regardless of the severity of your apnea. The Corvallis Clinic offers a weight-loss program – ask us for details and a referral.
How do I get help & support? There is a support and information group for patients with sleep apnea, their family and friends, and people wanting to learn more about sleep-related breathing disorders, called A.W.A.K.E. (Alert, Well, and Keeping Energetic). This group is sponsored by Good Samaritan Regional Medical Center and the American Sleep Apnea Association. For more information, call (541) 768-5260.