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Written by Pharmacist,  Andy Tan Wee Loon & Liaw Sea Yean.

What is Sleep Apnea?

Obstructive sleep apnea​​(OSA) ​is a potentially serious sleep-related ​breathing disorder​ in which ​breathing is briefly and repeatedly interrupted ​during sleep. The “apnea” in sleep apnea refers to a breathing pause that lasts ​at least ten seconds​. ​Obstructive ​​sleep apnea occurs when the​​ muscles ​in the back of the ​throat fail to keep the airway open​, despite efforts to breathe. Another form of sleep apnea is ​Central​ sleep apnea, in which the ​brain fails to properly control breathing​ during sleep. ​

 

 

Risk groups

  • People who are ​overweight (Body Mass Index of 25 to 29.9) and obese (Body Mass Index of 30 and above)
  • Men and women with ​large neck sizes​: 17 inches or more for men, 16 inches or more for women
  • Middle-aged and ​older men​, and ​post-menopausal women
  • Children with ​large tonsils ​and adenoids
  • Anyone who has a family member with OSA
  • People with ​endocrine disorders​such as Acromegaly and Hypothyroidism
  • Smokers
  • Those suffering from nocturnal nasal congestion due to abnormal morphology​, rhinitis or both.

Effects of Sleep Apnea

  • ​Fluctuating oxygen levels
  • Increased heart rate
  • Chronic ​elevation ​in daytime ​blood pressure
  • Increased risk of stroke
  • Higher rate of death due to ​heart disease
  • Impaired ​glucose tolerance​and ​insulin resistance
  • ​Impaired concentration, memory loss

Treatments

Sleep apnea must first be ​diagnosed at a sleep center​ or lab during ​an overnight sleep study​, or “polysomnogram.”

The sleep study charts vital signs such as​​ brain waves, heart beat and breathing.

  • Continuous positive airway pressure (CPAP)​: Standard treatment option for moderate to severe cases ​of OSA and a good option for mild sleep apnea.

It provides a ​steady stream of pressurized air ​to patients through a mask that they wear during sleep​. This airflow​ keeps the airway open​, preventing pauses in breathing and restoring normal oxygen levels.

  • Oral appliances​: Mild to moderate​ OSA patients who either prefer it to CPAP or are ​unable to comply with CPAP therapy. 
  • Surgery​: An effective option when ​non invasive treatments ​such as CPAP or oral appliances have been ​unsuccessful​. 
  • Behavioral changes​: ​Weight loss and changing from back sleeping to ​side-sleeping​ may help those with mild cases of OSA.
  • Over-the-counter remedies: Although some​​ external nasal dilator strips​, ​internal nasal dilators​, and l​ubricant sprays may ​reduce snoring​, there is ​no evidence ​that they help treat OSA.
  • Position Therapy: A treatment used for patients suffering from mild OSA. Patients are advised to stay off of the back while sleeping and ​raise the head of the bedto reduce symptoms.

 

References

  1. org. 2020. [online] Available at: <https://aasm.org/resources/factsheets/sleepapnea.pdf> [Accessed 9 April 2020].
  2. org. 2020. ​Sleep Apnea | National Sleep Foundation. [online] Available at: <https://www.sleepfoundation.org/sleep-apnea> [Accessed 9 April 2020].
  3. org. 2020. ​Sleep Apnea. [online] Available at: <https://www.helpguide.org/articles/sleep/sleep-apnea.htm> [Accessed 9 April 2020].
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