The problem of sleep apnea

by S. C.

The complex interplay between the central and the peripheral nervous system, the upper airway, and the neurotransmitters all play a role in the resultant partial or complete obstruction or collapse of the upper airway. Factors including airway anatomy, nasal congestion, and nasal obstruction, body fat and muscular tone all play a part. Recent evidence has shown that people with sleep - disordered breathing, have a primary defect in the airway anatomy, coupled with a sleep caused reduction in the airway muscle tone. Certain conditions such as chest wall deformity, neuromuscular diseases, central nervous system disorders and other respiratory diseases can also cause snoring.
The triad of obesity, advanced age and snoring often cause of the progression of sleep disordered breathing.
Morbidity of this condition falls into 2 categories:
- Neuropsychosocial
This causes excessive daytime sleepiness, intense morning headaches, highly irritable, impaired concentration, poor memory, depression and problems with social interactions. There are also reports of increased fatigability in person with sleep apnea, while feeling deprived of sleep especially in the morning. In recent studies, they even link obstructive apnea syndrome to lowered IQ scores in children. Individuals with neuropsychosocial causes are also more vulnerable to motor vehicular accidents.
- Systemic
The effects of hypoxia and hypercarbia (or increased carbon dioxide level in the blood) during sleep produce derangements in the cardiovascular and respiratory systems, causing hypertension and pulmonary hypertension. This pulmonary hypertension further results to cor pulmonale or right-sided
congestive heart failure, an extremely serious form of heart failure.
It has been reported that African Americans exceed the Caucasians with regard to the number of casesì of sleep-disordered breathing. The male sex seems to be one of the risk factors of snoring, as well as sleep related disordered breathing due to the hormone testosterone. In certain studies, lowered blood levels of testosterone, especially during andropause (male version of menopause) may play a part in sleep apnea in men.