Does breathing stop during sleep? Let's learn about this dangerous condition (Obstructive Sleep Apnea)!

Does your husband, wife, or someone in your home snore loudly at night? Sometimes, in the middle of that snoring, do you suddenly stop breathing, and after a few seconds, take a deep breath and start snoring again? Have you ever felt scared when you see this? This is really not something to take lightly. This could be a condition called Obstructive Sleep Apnea (OSA), which we are talking about today.

What is Obstructive Sleep Apnea (OSA)?

Simply put, this means that while we sleep, the muscles in our throat relax too much, narrowing or completely blocking the airway.

Think about it, when we sleep, almost every muscle in our body relaxes. That's normal. But in someone with OSA, the soft tissue at the back of the throat (tongue, palate) relaxes too much and blocks the airway. Then breathing stops for a few seconds, sometimes more than a minute.

What happens when this happens? The oxygen level in the blood gradually decreases. This sends a signal to our brain, saying, "There's a danger! We can't breathe!" Then the brain, to save our lives, barely wakes us up from sleep. To be precise, it brings us from deep sleep into light sleep. That's when the muscles in the throat tighten again and the way to breathe opens up. Then we suddenly take a deep breath.

This can happen hundreds of times a night. But the problem is that the person sleeping doesn't remember it. He doesn't know that he hasn't been breathing properly all night. But because he's constantly being interrupted in this way, he never gets a good, restful sleep.

What symptoms does someone with OSA show?

Some of these signs may not be noticeable to the person sleeping, but they are very noticeable to the person sleeping with them (their partner). Let's see what these signs are.

What does the snoring of someone with OSA sound like?

Imagine your partner is sleeping. He's been snoring loudly for a long time. Suddenly, the sound stops... complete silence. You're scared, thinking, "Why isn't there a sound? I don't know if he's breathing." After 10, 20 seconds, maybe even longer, he suddenly makes a 'hhhh' sound, takes a breath, and starts snoring again. That's one of the main symptoms of OSA. This can happen several times a night.

Why does OSA occur? What are the risk factors?

As we discussed earlier, the main cause is that the muscles in the throat relax too much during sleep, blocking the airway. But this doesn't happen to everyone. There are several specific risk factors that can affect this.

What are the dangerous complications that can occur if this is not treated?

If we ignore this as just a nuisance, it can lead to bigger problems. The lack of oxygen to the body throughout the night and the disruption of sleep both affect our entire body.

• Excessive daytime sleepiness: This is very dangerous. Falling asleep while driving or operating machinery can be life-threatening.
• Heart disease: Long-term lack of oxygen puts a lot of strain on the heart, which increases the risk of hypertension, heart attack, heart failure, and arrhythmias.
• Stroke: OSA significantly increases the risk of stroke.
• Type 2 Diabetes: OSA increases the body's resistance to insulin, increasing the risk of developing diabetes.
• Sudden death: Although very rare, untreated severe OSA can cause cardiac arrest during sleep and even death.

How do you know exactly if you have OSA?

If you or someone in your family has these symptoms, the first thing to do is see a doctor . The doctor will ask you about your symptoms and examine your throat, mouth, and neck.

Then, to confirm this condition, they will order a special test called a sleep study . These are done in two main ways.

1. Polysomnogram (PSG): This is the most accurate method. In this, you will have to stay overnight in a hospital or a specialized sleep center (sleep lab). There, while you sleep, your brain waves, heart rate, breathing pattern, blood oxygen level, and body movements are monitored throughout the night through sensors attached to machines.

2. Home Sleep Apnea Testing (HSAT): This is a simple test that can be done at home. You can wear a small device provided by the hospital while you sleep at home. It measures a few basic things, such as breathing and oxygen levels. Although it is not as detailed as a PSG, it is often enough to determine whether or not you have OSA.

What are the treatments for this?

Fortunately, OSA is a condition that can be managed well. There are several treatment options. The doctor will determine the best treatment based on the severity of the condition and the patient's condition.

• Lifestyle changes:
• Weight loss: Even losing 5-10% of your body weight can make a big difference in your OSA symptoms.
• Changing your sleeping position: When you sleep on your back, your tongue is more likely to fall back and block your airway. Therefore, it is best to sleep on your side .
• Avoid alcohol and sleeping pills: These should not be used at night as they relax the throat muscles further.

• CPAP machine (Continuous Positive Airway Pressure):

This is the most effective and widely used treatment for OSA. It is a machine with a small `mask` that is worn over the nose or over both the nose and mouth. It works by continuously delivering air at the pressure needed to keep the airway open while we sleep. This prevents us from stopping breathing. Although it can be a bit difficult to get used to at first, many people like it because of the restful sleep it provides and the feeling of freshness during the day.

• Oral Appliances:

This is a device that is custom-made for your mouth by a dentist. When worn while you sleep, it helps to keep your lower jaw slightly forward, keeping your airway open. It is usually suitable for people with mild to moderate OSA.

• Surgery:

If other treatments are unsuccessful or if there is a structural problem in the body, surgery may be recommended.

• Uvulopalatopharyngoplasty (UPPP): Removal of excess tissue at the back of the throat.
• Tonsillectomy/Adenoidectomy: Removal of the tonsils or adenoids if they are large.
• Nerve stimulation: A nerve stimulation device is implanted in the body to stimulate the muscles that keep the airway open during sleep.

When should I see a doctor?

If you or someone in your family has any of the symptoms mentioned in this article, see a doctor without delay . Especially,

• If your partner complains about your snoring and shortness of breath.
• If you feel excessively sleepy and tired during the day.
• If you wake up in the morning with a headache.

Emergency!

If you suddenly have difficulty breathing, or develop symptoms of a heart attack (chest pain, sweating) or symptoms of paralysis (loss of power on one side of the body, difficulty speaking), go to the nearest hospital's Emergency Department (ETU) immediately.

Snoring, Sleep Apnea, Obstructive Sleep Apnea, OSA, CPAP, Sleep Problems, Excessive Sleepiness