Sleep Apnea Can Cause:
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According to the National Sleep Foundation, over 47 million people in the U.S. suffer from sleep disorders. It is believed that as the U.S. population continues to age, sleep disorders will increase in numbers. By 2050, it is estimated that over 100 million people will suffer from some form of sleep disorder. Insomnia is the leading sleep disorder, but sleep apnea is closing fast, as America gets older and less healthy.
“Sleep disordered breathing in its various manifestations is arguably the number one health problem in the U.S., and probably throughout the world” says the “Father of Sleep”, William C. Dement. Dr. Dement has been working in the field of sleep for more than a half century, and he is more worried now than ever before. Why? Because America is sick. Breathlessly sick.
According to an annual poll conducted by the National Sleep Foundation, 75 percent of Americans experienced sleeping problems ranging from minor to severe and from transient to chronic. That is a 21% increase since 1999, when the NSF first conducted its poll. Largely due to an increase in advertising, the number of Americans turning to prescription sleep aids for help has increased even more dramatically: nearly 60% during that same time frame.
American pharmacists filled about 42 million sleeping pill prescriptions in 2005. In that same year, drug companies spent more than $300 million on ads for prescription sleep aids, which is more than four times as much as they spent in 2004. The result? Americans spent more than $2.5 billion on sleep aids in 2006.
Sedatives used as sleeping aids decrease muscle tone in the back of the throat, much like alcohol and opiates, can cause a colapse of the airway, and can exacerbate obstructive sleep apnea.
Even with $2.5 billion worth of drugs ingested, America remains sleep-deprived. Before Thomas Edison invented the light bulb, we were getting an average of 10 hours of sleep each night. Now, we are lucky to get 7. In 2002, we averaged 6.9 hours on weeknights when we need it the most and in the most recent poll by the National Sleep Foundation in 2005 , that dropped to 6.8. In the last 40 years, Americans have cut their average sleep time by almost 2 hours.
The Annals of Internal Medicine in 2004 reported a link between sleep deprivation and hormone changes, specifically the hormones that govern appetite. Researchers found that after limited sleep, the hormones were out of balance, which brought an increase in hunger, especially for foods with high carbohydrate content. Less sleep = more weight.
Researchers at Columbia University in New York City found that people who slept six hours a night were 23 percent more likely to be obese than people who slept between seven and nine hours. Those who slept five hours were 50 percent more likely and those who slept four hours or less were 73 percent more likely to be obese. Weight gain is the leading indicator for developing an obstructed airway. As America sleeps less in the 21st century, our nightly breathing is headed the wrong way. Sleep Disorders are the most common medical malady today.
As Americans gain weight, the presence of sleep disordered breathing becomes more prevalent. The following graphical representation relates this disturbing correlation of obesity with a rise in sleep disordered breathing problems.
Although some states in 2005 had more than 30% of their citizens listed as obese, this is not as much of a concern as is the dramatic trend we are witnessing. Just ten short years prior, not one state had even 20% of their population marked as obese.
Why does weight contribute to snoring and sleep apnea? When weight is gained, fat is deposited in the tissues surrounding the airway making them more prone to collapse when relaxed while we sleep. The excessive pull of gravity, especially while in the supine position, creates added pressure on the pharynx, leading to compression and a decrease in air flow. This can further close the airway and increase the progression to sleep apnea.
Snoring is a loud sound generated by some people as they breathe during sleep. According to recent sleep studies, approximately 45% of the general population, 30% of men and women over age 30, 40% of the middle-aged population, and 6% of children snore on a regular basis. It has also been estimated that 60% of all males and 40% of all females over the age of 60 snore. The sound of snoring in some people has been measured at 90 decibels - a loudness that would require ear plugs in the industrial workplace. It comes from the uvula, the piece of soft tissue that hangs down in the back of the throat, fluttering in response to a more rapid air flow caused by narrowing of the airway. Virtually all people who have apnea snore to some extent, but not all snorers have apnea.
Obstructive Sleep Apnea results from a partial airway closure and/or a narrow airway. The more obstructions, the more turbulence and greater suction on the walls that close the airway. Tonsils, adenoids, fat tissue in the throat, swollen nasal membranes, long palate, deviated septum, and a large tongue narrow the airway and increase the speed and turbulence when air is taken in. However, the most common cause of obstructive sleep apnea is the relaxation of the throat tissue when one lies down to sleep. The degree to which this relaxed skin and muscle clog the airway determines the degree of snoring and apnea, which results in the greatest danger of all – the reduced oxygen absorption and consequent reduction of oxygen to the brain. It is this event that leads to the potential problems of heart attacks, stroke, and other dangers.
Hypopnea is a partial airway obstruction, but not a full closure (apneic event), during sleep, in which there is breathing effort but reduced airflow. Hypopneas also result in arousals and symptoms similar to obstructive sleep apnea.
Upper Airway Resistance Syndrome (UARS) is defined as a decrease in inspiratory effort caused by a lack of muscular activity and reduction in airway size resulting in arousals from sleep without episodes of apnea or hypopnea, and usually characterized by snoring. One of the most common of these is grinding or clenching of the teeth. The literature is consistent that upper airway resistance syndrome to obstructive sleep apnea represents a continuum from least severe problem to most, but that all are serious in terms of having morbid consequences.
Central apnea results when the brain fails to signal the chest muscles to breathe. A defect in the metabolic control center does not respond properly to carbon dioxide in the blood and shuts down the breathing effort. A 10 second or greater episode of no breathing effort and no consequent air flow defines central apnea. Central apneas cause arousals from sleep and the resultant decrease of oxygen to the brain.
America is not getting younger. 
In 1870, the first census of people in the United States who were 65 years of age or older showed that about 1.2 million people, or 3% of the total population, were over 65. The decades since that first census have seen a remarkable transformation—the graying of America.
In 1999 it was estimated that there were nearly 34 million “gray” Americans, or about 12% of the total population, and that by the year 2030 that number may reach 20% of the total population.
As people get older and their tissues become looser, we see an increase in pharyngeal airway collapsibility during sleep , which leads to a restricted airway and concomitant obstructive sleep apnea. The prevalence of snoring and obstructive sleep apnea increase with advancing age, with a prevalence of 70% of senior males and 56% of senior females.
Another anatomical observation during maturation is the length and thickness of the soft palate. It has been shown that the soft palate both lengthens and thickens as one ages , which would lead to an increased prevalence of obstructive sleep apnea in the elderly.
By all accounts, allergic rhinitis (allergies) is affecting the western world at a record pace each year. The largest study from Britain showed a threefold increase in men and a fourfold increase among women over a 20-year span at the end of the last century. A study from Sweden showed a twofold increase over a 12-year span from 1979 to 1991. Germany showed a homogenous increase across the spectrum during a 5-year study period. Denmark showed the same over 8 years.
All dimensions of sleep are impaired by allergic rhinitis, and breathing is impacted specifically with an increase in snoring and obstructive sleep apnea. Mouth-breathing secondary to relative or complex obstruction of nose or upper airway in children leads to abnormal bone growth and underdevelopment of craniofacial structures, and therefore, can adversely affect dental occlusion and natural interaction of upper and lower jaws.
Even if children do not develop a breathing disorder from their allergies early in life, continued nasal obstruction may produce habitual mouth breathing leading to a high or vaulted palate, which effectively closes down the needed nasal airway in adulthood.
Allergic disorders may affect more than 1.4 billion people worldwide, and one study showed that 42% of children had physician-diagnosed allergic rhinitis by 6 years of age. When you consider that these numbers are rising at a significant rate, it’s easy to see that sleep breathing disorders will continue to be a significant health concern among every age group.
For many people the presence of sleep disordered breathing creates subtle changes – inattentiveness, yawning, nodding off during meetings or in front of the television, lessened sex drive, and a host of other seemingly benign inconveniences.
But, if you or a loved one exhibits any of the following symptoms such as excessive daytime sleepiness, morning headaches/migraines, short term memory problems, weight gain, dry mouth, inability to lose weight, high blood pressure, memory and concentration difficulties and other symptoms, investigate whether snoring or sleep apnea is present with a qualified professional.
The greatest danger to your health would be the elimination of snoring symptoms while sleep apnea is present. Only a qualified professional can determine if you have sleep apnea.
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