Types of Sleep Disordered Breathing

Maintaining an open airway for effortless breathing is a critical factor in achieving a restful sleep. The muscles of the nose, mouth and neck allow proper breathing during our waking hours by maintaining an open airway, but while a person is unconscious there is a decrease in muscle tone. In addition, constriction of the bones and soft tissues inside the nose can restrict proper airflow. If these relaxed muscles and other tissues reduce the amount of air passing through the airway, the result may be snoring or sleep apnea.

Snoring 

Snoring occurs when the airway structures vibrate as air passes through the restricted passage (especially the soft palate and uvula at the back of the mouth and the tongue). The resulting sounds may be loud or irritating. The snorer usually doesn’t notice the sounds but they may greatly disrupt the sleep of a bed partner.

Upper Airway Resistance Syndrome

UARS is a condition where there is a decreased amount of airflow to the lungs often related to a restricted airway. This may be due to abnormal muscle or bony anatomy of the airway and may include snoring. The result is a reduced amount of oxygen to the brain and body which may lead to psychological difficulties, fatigue, chronic insomnia and frequent headaches. In some cases, UARS is a progressive condition leading to obstructive sleep apnea.

Sleep Apnea

Obstructive sleep apnea occurs when the airway becomes blocked by the tongue and soft palate/uvula at the back of the mouth. The result is a complete lack of airflow to the lungs. When the brain detects the elevated level of carbon dioxide in the blood, it stimulates an arousal of the person that permits them to choke or gasp for a breath of air then fall back to sleep again. The person may move violently while attempting to breathe or may be clenching or grinding heavily which can cause excessive wear of the teeth. This cycle may occur a few times or several hundred times in a night without a person being aware. A bed partner may be the first person to notice the potentially life threatening disorder.

In adults, obstructive sleep apnea may also be caused by enlarged tonsils/adenoids, abnormal airway anatomy, being overweight/obese, smoking, alcohol use, sedative medication use and temporary nasal congestion due to illness.

Central sleep apnea is a condition characterized by a lack of airflow when the chest muscles and diaphragm fail to create normal breathing movements. This usually has a neurological cause.

Mixed apnea occurs when a person’s failure to breathe is caused by both obstructive and central sleep apnea.

This repetitive cycle of suffocating and gasping for air disrupts normal sleep patterns resulting in daytime fatigue and sleepiness. The lack of oxygen also leads to elevated blood pressure, a greater chance of stroke or heart attack, sexual dysfunction, poor memory function and learning difficulties. Snoring and sleep disruptions can also affect a bed partner's sleep patterns, causing fatigue and affect their mental health as well. This, in turn, can result in relationship problems and even divorce.

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