Sleep Apnea --- Causes and Cures

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July 14, 2012, last updated August 25, 2018
By Alison Turner,  Featured Columnist

[Health and fitness articles are reviewed by our team of Doctors,
Registered Nurses and other members of our Editorial Board.]

Does your partner or roommate keep you awake at night
with snoring or loud breathing sounds, that every now and
then sounds like choking?  If so, this could be more than
an inconvenience: he or she may be making all that noise at
night because of a condition called sleep apnea, a disorder
that Drs. Hiestand and Phillips with the University of
Kentucky College of Medicine find may be experienced by
as many a one in four American adults  (and their night-
time neighbors).  

Sleep apnea is a disorder characterized by one or more
pauses in breathing and/or shallow breaths during sleep,
which can last from a few seconds to a few minutes, and
which may occur between 5 and 30 times per hour.  

Snoring also occurs, though it may not happen every night
(NOTE: not everyone who snores has sleep apnea).  When
normal breathing starts again, it is sometimes accompanied
by a loud snort or choking sound.  

The nocturnal disturbances of sleep apnea can chronically
disrupt a person’s sleep, and is thus one of the leading
causes of daytime sleepiness.  

Other symptoms of sleep apnea may include morning
headaches. As many as 20% of those with obstructive
sleep apnea suffer from morning headaches, according to
a  2015 study from Dokkyo Medical University in Tochigi,
Japan. Other symptoms include inability to concentrate,
mood swings, and a dry throat when you wake up.  

Furthermore, if left untreated, sleep apnea can increase the
risk of
high blood pressure, obesity, diabetes, heart failure,
and atrial fibrillation (irregular heartbeats).  Indeed, a
2013 study by Dr. Sandeep Goyal of Vanderbilt University
Medical School found that obstructive sleep apnea is
responsible for a growing number of cases of atrial
fibrillation in the US. As many as 49% of all people with
osbtructive sleep apnea have irregular heart beats.

Taking an afternoon nap can lower your risk of
heart disease by 37%

How Do I Know if I Have Sleep Apnea?  

The catch to sleep apnea is that it happens at night.  This
means that doctors may not notice sleep apnea in a patient
(unless the doc stays the night…), because there are no
blood tests.  Sleep apnea is often noticed by other people
(those awakened by the patient) before the patient realizes
he or she has it.

What Causes Sleep Apnea, and How Can It Be Cured?  

The most common type of sleep apnea, eponymously
known as obstructive sleep apnea, occurs because the
airway has collapsed or is blocked during sleep. Air
squeezes past this blockage, resulting in loud snoring.  

Obstructive sleep apnea is frequently seen in people who
are overweight, though the two conditions are not
necessarily related.  For example, The National Heart, Lung,
and Blood Institute (NHLBI) explains that small children
may have sleep apnea not because they are overweight,
but because they have enlarged tonsils in their throats
which block the airway.  

Treatment for sleep apnea ranges from lifestyle changes, to
breathing devices such as the CPAP masks, to surgery.

Here is a list of ten recently-conducted studies that suggest
risk factors for sleep apnea and/or treatments for the
condition if you already have it.

Lose Weight to Tackle Sleep Apnea.  In almost every
teen comedy movie, the kid who is slightly overweight (or
sometimes not so slightly) snores in thunderous bursts
while all of the other kids laugh.  Research from 2009
suggests that obesity and snoring in youths may have more
serious consequences than childhood mockery: the child
may have sleep apnea.

In 2009, Drs. David Gozal and Leila Kheriandish-Gozal with
the Kosair Children’s Hospital Research Institute at the
University of Louisville in Kentucky , analyzed how obesity
in children affects their night-time noise-making.  

An overnight evaluation was conducted on 50 non-obese,
“habitually snoring” children between the ages of 6 and 9,
and 50 age, gender, and ethnicity-matched obese children.  
While the “mean obstructive apnea” values for each group
were “similar,” results showed that the obese children
showed greater “excessive daytime sleepiness” than the
non-obese children, no matter the “obstructive sleep apnea

That is, children with sleep apnea who are at a healthy
weight show a lesser risk of letting their sleep apnea
influence their daily energy levels, while obese children
with sleep apnea are more likely to feel sleepy throughout
the day.

Pre-teens and teenagers have enough to worry about
without being obese, or a snorer, not to mention dealing
with the more serious possibilities that accompany sleep
apnea (see introduction).  Working with your child to
prevent obesity may be a good way to help him or her
avoid some of these adolescent obstacles.

Swollen Legs and Sleep Apnea --Surprising Link  

Have you recently noticed swelling in your legs or ankles?  
Do you feel tired throughout the day and have trouble
sleeping?  If you answered a fatigued and weary "yes" to
both of these questions, it may be because the two
conditions are related.

Nephrotic syndrome is a group of symptoms such as
protein in the urine, high cholesterol, and swelling, that is
caused by disorders that damage the kidneys.

“Nephritic lower limb edema” is swelling in the legs that is
attributed to nephritic syndrome,  and which may,
according to experts in Hong Kong, be associated with
sleep apnea.  (Read more about
natural remedies for leg

In 2010, Kar Neng Lai with the Division of Nephrology at
The University of Hong Kong and Queen Mary Hospital and
colleagues from various institutions in Hong Kong,  
recruited 23 patients with nephrotic lower limb edema,
48% of whom showed evidence of sleep apnea at the
beginning of the study.  

After steroid-based treatment for nephritic syndrome, there
was a “complete disappearance of lower limb edema,” a
decrease in “respiratory disturbance”, and, in patients with
sleep apnea, a decrease in sleep apnea symptoms along
with “improvement in sleep efficiency.”  The report
concludes that “nephritic lower limb edema is associated
with disturbed respiratory breathing and increased
propensity to [obstructive sleep apnea].”  

There are other ways to treat symptoms of nephritic
syndrome, besides the steroids that were used by the
researchers in Hong Kong.  You can make lifestyle choices
such as keeping your blood pressure low to delay kidney
damage, treating high cholesterol, following a low-salt
and/or low-protein diet to help prevent swelling, and
taking vitamin D supplements.  

Ecstasy or A Good Night's Rest: You Have to Choose.

Methylenedioxymethamphetamine, or, with its less
intimidating and more optimistic street name, MDMA or
“ecstasy,” is an increasingly popular drug that influences
the user's serotonin levels.  

In addition to the risks involved with any sort of
recreational drug, researchers have recently discovered
that the consequences of MDMA may not be so ecstatic:
users of ecstasy may be at a higher risk for sleep apnea.

In 2009, experts at The Johns Hopkins School of Medicine,
led by Dr. Una McCann with the Department of Psychiatry,  
recruited 71 “medically healthy” recreational users of
ecstasy, and 62 control subjects.  All participants
underwent all-night sleep “polysomnography” that
recorded rates of apneas.  

Results showed that MDMA users had “significantly
increased rates” of obstructive sleep apnea when
compared to non-MDMA users, and that “severity of
[obstructive sleep apnea] was significantly related to
lifetime MDMA exposure.”  

What this means to science, the team concludes, is that
“brain serotonin neuronal dysfunction plays a role in the
pathophysiology of sleep apnea”; what it means to laymen
and their children, is that the use of ecstasy increases the
risk for obstructive sleep apnea.

Is one night of ecstasy worth a lifetime of troubled nights?
It looks like we all have yet another long term versus short
time choice to make.

If You Have Sleep Apnea, Stop Smoking!  

Smokers know that NO SMOKING signs follow them
everywhere they go: now, for the sake of a good night's
rest, those signs may also appear in dreams.  

In 2006, Lena and Peretz Lavie with the Lloyd Rigler Sleep
Apnea Research Laboratory at the Technion-Israel Institute
of Technology in Haifa, Israel , investigated how cigarette
smoking influenced patients with sleep apnea.  

Thirty-five sleep apnea patients between the ages of 20
and 60 who smoked 20 or more cigarettes a day for at
least five years, were “matched” with other sleep apnea
patients who have never smoked.  The researchers
examined blood samples of all the patients.  The samples
revealed that not only was there a “significant interaction
effect between smoking and apnea severity,” but that
smokers with sleep apnea had lower levels of HDL
cholesterol (the good kind).  

The report concludes that “patients with severe sleep
apnea who smoke are at a greater cardiovascular risk than
smokers with mild-moderate sleep apnea and patients who
do not smoke.”

If you have sleep apnea and smoke, then you probably
already suffer from the symptoms of each condition: for
the sake of your cardiovascular system, work at finally
kicking that smoking habit in tandem with seeking a
professional about treating sleep apnea.

Exercise in the Day for Better Sleep at Night.  

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