Understanding Sleep Apnea
Sleep-disordered breathing (SDB) encompasses a range of sleep abnormalities, including Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and snoring. OSA involves repeated instances of complete (apneas) or partial (hypopneas) airway obstruction during sleep, each lasting at least 10 seconds. These interruptions frequently cause sleep fragmentation, trigger the body’s stress response, and may lead to a significant reduction in blood oxygen levels. The threshold for clinical concern often starts at 5-15 such events per hour, but severe cases can exhibit 100 or more disruptions hourly.
OSA, the predominant form of SDB, arises when the airway is mechanically blocked due to a relaxation of the muscles that usually keep it open. Risk factors include obesity, a pronounced overbite, or excess tissue at the back of the throat. In some cases, OSA can also stem from irregular breathing patterns controlled by the brain. On the other hand, CSA, which is less common, originates from these very irregularities in respiratory control, leading to insufficient breathing and sleep disturbances. CSA is typically found in those with heart or brain circulation disorders or in opioid users. While OSA and CSA have distinct causes, they can coexist.
The Risks Associated with Sleep Apnea
Numerous studies have highlighted the severe short-term and long-term consequences of SDB. Affected individuals may struggle with daytime drowsiness, doubling their risk of car accidents, increasing their likelihood of workplace incidents by 25%, and reducing their overall work productivity. More serious health complications linked to SDB include heightened risks of stroke, heart rhythm problems, chronic high blood pressure, heart failure, and dementia. The National Commission on Sleep Disorders Research attributes approximately 38,000 cardiovascular deaths in the U.S. each year to SDB. Additionally, the sleep partners of those with SDB can experience their own health issues due to disruptive snoring.
Prevalence and Economic Impact of Sleep Apnea
It is believed that a staggering 80-90% of SDB cases in the U.S. go undiagnosed, often not recognized until after a severe or fatal event occurs. Studies suggest that over 20% of U.S. adults suffer from OSA, with a global estimate of one billion affected individuals. Men are more commonly affected than women. The financial burden of untreated OSA is significant, with the annual economic impact in the U.S. alone estimated to reach up to $150 billion.
Addressing Suspected Sleep Apnea
If one suspects they have SDB, it is critical to undergo testing to confirm the condition and gauge its severity. Home testing equipment, which is widely available, accurate, and cost-effective, is commonly used for diagnosis. However, in certain situations, in-lab sleep studies may be more appropriate. If diagnosed with SDB, it is vital for the individual to take steps to manage their symptoms. Treatment options are further discussed in another blog on this website. Breath training, possibly starting with the breathesimple app, can be a beneficial initial step in improving breathing patterns.
For further information, the following references provide additional insights:
– Mulgrew A T, Nasvadi G, Butt A, et al. Risk and severity of motor vehicle crashes in patients with obstructive sleep apnea/hypopnea. Thorax. 2008; 63:536-541.
– Accattoli M P, Muzi G, dell’Omo M, et al. Occupational accidents, work performance and obstructive sleep apnea syndrome. G Ital Med Lav Ergon. 2008; Jul-Sep;30(3):297-303.
– Nena E, Steiropoulos P, Constantinidis T C, et al. Work productivity in obstructive sleep apnea patients. J Occup Environ Med. 2010; Jun;52(6): 622-625.
– Yaffe K, Laffan A M, Harrison S L, et al. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA. 2011; 306(6):613-619.
– Beninati W, Harris C D, Herold D L, et al. The effect of snoring and obstructive sleep apnea on the sleep quality of bed partners. Mayo Clin Proc. 1999; Oct;74(10):955-958.
– Boccabella A, Malouf J. How do sleep-related health problems affect functional status according to sex? J. Clin Sleep Med. 2017;13(5):685–692.
– “Hidden Health Crisis Costing America Billions”. Frost & Sullivan Report, 2016, A summary of published statistics and references to government sources on sleep apnea.
