Complex modern lifestyles have disturbed the biological rhythms of the body, giving rise to a lot of diseases and forcing researchers to delve into the enigma called sleep
FROM darkness we come and into darkness we go, but in between this a mysterious darkness ebbs in and out of our
lives every 24 hours, rejuvenating us for
the struggles of the day. But for some 20
million Americans suffering from
obstructive sleep apnea, this biological
necessity called sleep is a nightly struggle
to breathe.
Apnea is the condition in which a
person's ability to inhale while asleep
becomes blocked for a brief period
extending from 20 seconds to a minute
or more, until they become partially
awake to gulp in air with a snore. Then
they immediately fall back into a sound
sleep repeating the cycle.
'The condition renders people deficient in vitality, good humour, concentration, memory and the ability to stay
awake and alert during the day, especially during sedentary activities like reading and driving. Yet, an estimated 80 per
cent of those affected by sleep apnea do
not know it. Only a few people are aware
of the fact that these sleep -shattering
snores are symptoms of a serious and
potentially fatal disorder that can and
should be treated. Even among those
who now know that they have sleep
apnea, many waited a decade or more to
find out why they repeatedly fell asleep
at the wheel and always felt tired.
Obstructive sleep apnea results from a
sleep induced relaxation of the muscles
in the back of the mouth and throat that
causes the main airway to collapse,
totally blocking the ability to inhale. As
blood levels of carbon dioxide rise and
oxygen levels fall, the hapless sleeper
struggles to take a breath. Finally, the
person comes out of deep sleep to
restore adequate muscle tone to open
the airway briefly and allow a breath.
After sleep resumes, breathing stops
again and again, the sleeper being usually unaware of these awakenings.
Apnea becomes more common with
age, although children are sometimes
affelicted. The condition seems to be
hereditary, according to a study by
Susan Redline, a pulmonary specialist at
Case Western Reserve University in
Cleveland, us. A tendency towards sleep
could be due to an underlying genetic
susceptibility or could result from a
farnihal weight problem. Excessive fatty
tissue in the neck region in obese people
is believed to cause airway blockage. In
these people, loss of significant amount
of weight often overcomes sleep apnea.
Various abnormalities in the mouth and throat can also cause a total
obstruction 'and sleep apnea. Unlike the
ordinary snoring that accompanies
rhythmic breathing, sleep apnea, with
its breathing disruptions, is a dangerous
condition that can cause hypertension,
abnormal heart rhythms, heart attacks,
strokes and sudden death.
To detect the presence of the disorder, various screening devices like snore
meters can be worn at home overnight,
but an accurate diagnosis of sleep apnea
usually requires spending a night in a
sleep laboratory for complete monitoring of limb movements, sleep stages,
breathing patterns, heart function, partial pressures of carbon dioxide and
oxygen in blood.
With the changing lifestyles of
people, sleep-related diseases are
becoming more and more common.
Many of these disorders can be treated
by a shift in routine and by following a
rigorous discipline, like going to bed
and getting up at the same time almost
everyday, exercising regurly, losing
weight and abstaining from cigarettes
and alcohol just before going to sleep.
For the more serious cases, a mask connected to a blower that forces air
through the nasal passages may be worn
over the nose and mouth during
sleep. This therapy which keeps the
airway open is called the continuous
positive airway pressure (CPAP). This
has been shown to eliminate day time
grogginess and cardiopulmonary problems and produce rhythmic breathing.
But CPAP also has its side effects like
nasal stuffiness, a running nose and
facial discomfort, resulting from pressure. However, this therapy represents a
better option than the original cure
for sleep apnea: tracheostomy, the
surgical creation of a breathing hole in
the throat to bypass the sleep-related
obstruction.
Those who cannot Use CPAP may
benefit from the use of an individually
molded oral appliance, that repositions
mouth structures during sleep.
Whatever may be the solution, it is
most important to repeat the original
sleep study to determine the effectiveness of the remedy not just in reducing
snoring but in restoring normal breathing patterns, heart function and levels of
blood gases. Periodic assessments are
also required as patients commonly
relapse into old habits or stop using the
breathing device.
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