Sleep Apnea

Sepi Latifi
Sep 4, 2018 · 5 min read

Written by Professor Adrian Williams; Edited by Sepi Latifi

Laugh and the world laughs with you, weep and you weep alone.

[Solitude, in Poems of Passion]

Snore and you snore alone [anonymous wit], a problem recognised by most of us.

But is this a modern disease?

Apparently not with a quote by A Roger Ekirch in his At Day’s Close:

“in 1737 a snoring husband received a shovel of hot embers in his gaping mouth”!

Snoring is common.

One half of middle-aged men and 25% of middle aged women snore intrusively.

Picture from standard.co.uk

Why does this happen?

It relates to the anatomy of the breathing passage in the throat.

  • When we are awake, the muscles in our throat are sufficiently active to keep the breathing passage open so that we don’t snore.

Given this, one can imagine that the breathing passage might narrow to the point of closing off, or almost closing off, the condition called obstructive sleep apnea.

Picture from newsnetwork.mayoclinic.org

This is also very common with a half of snorers having some interrupted breathing during the night. This occurs first in the state of dreaming sleep [REM or Rapid Eye Movement sleep] in which the body is literally paralysed to prevent us acting out our dreams.

This happens every 90 minutes during the night with extended periods later in the night, times during which that interrupted breathing might first be seen by bedpartners. It might then extend to other times of the night. This is dependent in small part upon aging but in greater part upon weight gain.

The problem is therefore a “continuum” in which individuals may just snore without interruptions of sleep, or may snore to the point of waking [called snore-arousals] or may progress to interruptions of breathing, obstructive sleep apnea.

This condition may go unrecognized for many years but over time there are consequences which become apparent. These are grouped as neurocognitive, cardiovascular, and metabolic and when these changes occur the condition is then called the obstructive sleep apnea syndrome.

Consequences:

  • disrupted sleep (interpreted as insomnia)

With all this concern about snoring and sleep apnoea…

What can the medical community do?

  • The answer is of course to diagnose or recognize the condition as early as possible. This is not difficult, perhaps because snoring is a marker for the condition with witnessed interruptions to breathing. The observance of this marker would support the notion that sleep apnea exists within the individual, especially in patients with high blood pressure and those that are overweight.
Home Sleep Apnea Test. Picture from cpap.1800cpap.com.

Assuming that a sufficient degree of sleep apnea is identified…

What treatments are available?

  • There are no medications to activate the muscles in the throat and surgeries are hardly ever contemplated these days.
  1. Dental devices [so-called mandibular advancement splints], usually being suggested for those with a milder form of the condition.
CPAP. Picture from edition.cnn.com.

What can individuals do themselves to minimise these problems?

  • Severe nasal congestion will make them worse and should be addressed, and of course any weight gain is detrimental.
Picture from victorstock.com

What does the future hold in the area?

  • There may be medications that increase the activity of the airway muscles and these are being searched for but have you not yet been identified.
Video from youtube.com
  • Electrical treatment of the muscles is also being in investigated and maybe a future alternative.

A final insightful thought however, posed 7 years before sleep apnea had been recognised:

“The sleeping patient is still a patient. His disease not only goes on while he sleeps, but may progress in an entirely different fashion from its progression in the waking state, or indeed may originate in sleep.The interrelations between sleep and the pathologic physiology of disease constitute a fruitful field for a more complete understanding of many diseases.”

► Eugene Robin MD. Archives of Internal Medicine. 1958

Circadia Sleep

Welcome to your journey to better sleep. Change your sleep, change your life.

Sepi Latifi

Written by

Circadia Sleep

Welcome to your journey to better sleep. Change your sleep, change your life.

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