Obstructive sleep apnea syndrome is one of the most common sleep disorders. Sleep apnea affects approximately 25% of men and 9% of women. This equates to millions of Americans. Researchers are finding people with sleep apnea have reason to be concerned because sleep apnea is associated with brain damage.
What is Obstructive Sleep Apnea
Obstructive sleep apnea is the reversible intermittent closure or partial closure of the upper airway.
What are the Symptoms of Sleep Apnea?
Sleep Apnea symptoms are described as daytime symptoms or nighttime symptoms.
Daytime symptoms include waking up with a headache, irritable behavior, low energy, excessive daytime sleepiness.
Night symptoms include difficulty falling or staying asleep, snoring, restless sleep, waking up more than once to urination and leg jerks.
How is Sleep Apnea Treated?
The most common treatment for sleep apnea is positive airway pressure therapy (PAP therapy).
There are three types of PAP therapy:
1. A continue single amount of pressure (CPAP)
2. Two different pressures: A higher pressure delivered with inhalation and a lower pressure during exhalation (BiPAP)
3. Auto-titration. The machine senses closure of the airway and delivers the appropriate amount of pressure to open the airway. (APAP)
What is the Goal of PAP Therapy?
The purpose of PAP therapy is to help the patient return to a normal sleep pattern by keeping the airway open during sleep and reversing the symptoms of sleep apnea.
How Successful is PAP therapy?
Nearly 90% of people with sleep apnea benefit from using PAP therapy. However, some people, even with adequate treatment, continue to have problems with excessive daytime sleepiness. New research suggests four possible reasons for sleepiness persists.
Four Reasons Why Sleepiness Persist Even With Adequate PAP therapy
1. Oxidative Injury
The chronic intermittent drops in the blood oxygen level, which occurs with severe obstructive sleep apnea, injures wake-promoting dopaminergic and noradrenergic neurons. Dopaminergic and noradrenergic neurons help keep us awake.
2. Degeneration of wake-promoting neurons
Sleep apnea causes fragmentation of sleep. Chronically fragmented sleep damages not only noradrenergic neurons but orexigenic neurons. Orexigenic neurons are important to keeping you awake.
3. Reduced gray matter
When the imaging studies of the brains of healthy people were compared to the imaging studies of people with untreated OSA, researchers noted people with sleep apnea had a reduction in gray matter volume in brain regions associated with wakefulness and neurocognitive performance.
4. Structural changes to white matter
Even patients who use CPAP for at least 6 hours or more each night continued to have sleepiness. The sleepiness is thought to be associated with structural changes to white matter, potentially indicating compromised neuroconnectivity
Does Obstructive Sleep Apnea Cause Permanent Brain Damage?
With adequate use of PAP therapy, researchers have documented reversal of some of the brain damage caused by sleep apnea.
How Can You Improve Your Ability to use CPAP?
You’ll find lots of tips for increasing your ability to use your CPAP machine is my book, “How to love your CPAP machine.” Available at bit.ly/lovecpap
Reference: 1. https://www.esandosa.com/