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What are sleep related breathing disorders?
Sleep related breathing disorders are a group of disorders that affect our breathing while we are asleep, and are characterized by disruptions of normal breathing patterns that only occur during sleep. Therefore, the person with the disorder may be the last to know he or she has a problem. Sleep related breathing disorders constitute a subset of the broad group of sleep disorders that include many other disorders such as insomnia (difficulty sleeping), hypersomnias (inappropriately falling asleep, for example, narcolepsy), parasomnias (activities during sleep, for example, sleepwalking and sleep terrors), and sleep related movement disorders (for example, restless leg syndrome). The most common sleep related breathing disorders are snoring and sleep apnea.
Why do we sleep?
This is a complex topic that we only partially understand. Mammals, reptiles, birds, and even fruit flies have been observed sleeping. A manatee can sleep with one side of its brain while the other side is awake and alert. Sleeping in this way avoids a long period of unconsciousness, during which it would be very vulnerable. Humans typically need 7-8 hours of sleep every night, but individuals vary in their need for sleep. Sleep should be restorative and is necessary to maintain health. During sleep, we rest and repair our muscles and organize our thoughts and memories. Therefore, if we become sleep deprived, we feel both physically fatigued and mentally exhausted. Many studies show that sleep deprivation causes a decrease in problem solving ability, attention, and manual reflex times.
What are the stages of sleep?
Sleep stages can be measured by monitoring the electrical impulses within the brain, often termed brain waves. These electrical impulses, or brain waves can be monitored with an electroencephalogram (EEG). Sleep can be broken up into three stages and REM (rapid eye movement) sleep. Stage 1 sleep is the most superficial and stage 4 is the deepest. Stage 1 and 2 sleep are both considered to be light sleep, while stage 3 sleep is deeper, more restorative sleep. This stage is important for the body to feel well. REM sleep is the sleep stage in which we typically dream. During REM, the brain sends signals to the muscles to relax, so we do not "act out" our dreams. The relaxation of muscles in REM sleep can sometimes worsen sleep related breathing disorders like snoring and sleep apnea. We typically spend about 50% of our sleep in stages 1 and 2, 25% in stages 3, and 25% in REM sleep.
For additional information please visit the Sleep Center.
Medically reviewed by Peter O’Connor, MD; American Board of Otolaryngology with subspecialty in Sleep Medicine
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Adenoids and Tonsils
Tonsillitis is a contagious infection with symptoms such as:
- Bad breath
- Coughing up blood
Tonsillitis can be caused acute infection of the tonsils, and several types of bacteria or viruses (for example, strep throat or mononucleosis), chronic tonsillitis, and peritonsillar abscess. Treatment of tonsillitis and adenoids include antibiotics and other medications depending on the cause, symptom relief, and in some cases, surgery (tonsillectomy or adenoidectomy ).
Airway PictureThe path air follows to get into and out of the lungs. See a picture of Airway and learn more about the health topic.
Deviated SeptumA deviate septum is a condition that may require surgery. With a deviated septum, the bone and cartilage that divide the nasal cavity of the nose in half (nasal septum) is significantly off-center or crooked. The causes of a deviated septum can be congenital, or develop after a trauma or injury to the nose. Symptoms of a deviated septum include:
- nasal congestion,
- recurrent sinus infections,
- facial pain,
- postnasal drip,
- and loud breathing.
HypersomniaHypersomnia is a condition where a person has excessive daytime sleepiness and trouble staying awake during the day. Treatment for hypersomnia includes medication, CPAP machines, and lifestyle changes.
Hypoxia and HypoxemiaHypoxia is a condition in which the normal concentration of oxygen in the blood is not enough for normal life functions. Hypoxemia is a condition in which there is a lower than normal amount of oxygen in arterial blood. Anoxia is a condition in which there is an absence or near absence of oxygen. There are a variety of causes of hypoxia and hypoxemia such as chemical or gas poisonings; lung conditions such as COPD, emphysema, lung cancer, and sleep apnea; medications; heart problems; anemia; and low oxygen concentration due to the lack of concentrated oxygen for example, mountain climbing, aviation, drowning, and fires. Symptoms of hypoxia and/or hypoxemia may be acute such as fast heart rate, rapid breathing, and shortness of breath; or severe symptoms include confusion, the inability to communicate, coma, and sometimes death. Symptoms in children include irritableness, anxiousness, and inattentiveness. Treatment of hypoxia and/or hypoxemia is to provide supplemental oxygen to the body as soon as possible.
Marfan syndrome is hereditary (genetic) condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics:
- Dislocation of one or both lenses of the eye
- A protruding or indented breastbone
- Flat feet
- Aortic dilatation
- Dural ectasia (a problem with the sac surrounding the spinal cord)
- Stretch marks
- Collapsed lung
Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Pulmonary hypertension is an increase pressure in the pulmonary arteries that carry blood from the lungs to the heart. The most common symptoms are fatigue and difficulty breathing. If the condition goes undiagnosed, more severe symptoms may occur, for example:
- Ankle swelling (edema)
- Heart palpitations
- Chest pain
- Decreased appetite
- Pain in the upper right side of the belly (abdomen)
- Fainting (syncope)
- Lightheadedness, particularly during physical activity
- Swelling in the legs and ankles
- A bluish color to the lips and skin
People at risk of developing pulmonary hypertension are those who:
- Live at high altitudes
- Have a family history of the condition.
- Have diseases and conditions that may put them at risk of developing pulmonary hypertension
- Use illegal drugs like cocaine, and certain diet drugs.
NIH. National Heart, Lung, and Blood Institute. "What is Pulmonary Hypertension?" Updated: Aug 2011
NIH. PubMed Health. "Pulmonary Hypertension (PH)."
CDC. Division for Heart Disease and Stroke Prevention. "Pulmonary Hypertension Fact Sheet." Updated: Jul 22, 2014.
Sleep ApneaSleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Sleep DisordersLearn about the different types of sleep disorders such as insomnia and sleep apnea. Explore the symptoms, causes, tests and treatments of sleep disorders.
SleepwalkingSleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.
SnoringSnoring, like all other sounds, is caused by vibrations that cause particles in the air to form sound waves. While we are asleep, turbulent air flow can cause the tissues of the nose and throat to vibrate and give rise to snoring. Any person can snore. Snoring is believed to occur in anywhere from 30% of women to over 45% of men. People who snore can have any body type. In general, as people get older and as they gain weight, snoring will worsen. Snoring can be caused by a number of things, including the sleep position, alcohol, medication, anatomical structure of the mouth and throat, stage of sleep, and mouth breathing.
SomnoplastySomnoplasty is a procedure that reduces snoring by removing tissues of the uvula and soft palate. Complications include:
- prolonged pain,
- impaired hearing,
- nasal regurgitation,
- failure to cure sleep apnea, and
- failure to eliminate snoring.