Sleep-Related Breathing Disorders

Sleep-related breathing disorders, such as sleep apnea or chronic snoring, lead to abnormal or difficult breathing. While some sleep-related breathing disorders don’t harm your health, a few of them do. Breathing-related sleep disorders can also adversely affect your sleep and oxygen and carbon dioxide balance in your blood. There are several types of breathing-related sleep disorders that vary in symptoms and severity. Let’s understand more about them.

Obstructive Sleep Apnea

Obstructive sleep apnea is a sleep-related breathing disorder where your breathing starts and stops while you are asleep. There are different types of sleep apnea, but obstructive sleep apnea is the most common. It occurs when the throat muscles tend to relax, blocking your airway as you sleep. Snoring is one of the noticeable symptoms of obstructive sleep apnea or OSA. 

In Adults

The air cannot flow normally through the lungs for someone suffering from obstructive sleep apnea. And obstruction may occur due to the collapse of soft tissues in the upper airway and tongue. OSA is more common in men and could be hazardous to health if not treated in time. 

In Children

Pediatric obstructive sleep apnea is a sleep-related breathing disorder in children. It is when a child’s breathing becomes partially or completely obstructed when they are asleep. It occurs due to the narrowing or blockage in the upper airway. Unlike adults, children don’t experience daytime sleepiness but have behavioural issues. Usually, enlarged tonsils and adenoids are the cause of pediatric obstructive sleep apnea.

Symptoms of Obstructive sleep apnea

Some of the most common symptoms of obstructive sleep apnea are; 

• Snoring too loudly 
• Your partner may notice episodes where you stop and start breathing when asleep
• Feeling irritable 
• You wake up gasping for breath 
• You wake up with a dry mouth 
• Morning headaches 
• Insomnia 
• Hypersomnia

Immediate consequences of OSA on pulmonary haemodynamics

The main pulmonary artery pressure tends to increase during an OSA episode. Here, OSA leads to a complete blockage of the upper airways and can last anywhere from 10 seconds to 2 minutes. It can lead to hypoxemia, hypercapnia, changes in intrathoracic pressure, and post-apnoeic with sympathetic elevation. These conditions can cause the pulmonary artery pressure to modify and tweak the vascular tone.

Central Sleep Apnea

Central sleep apnea is also a condition where your breathing repeatedly starts and stops during sleep. It occurs because the brain is unable to send the right signals to the muscles controlling breathing. Unlike obstructive sleep apnea, your breathing isn’t restricted due to the blockage of the upper airway. CSA is not as common as obstructive sleep apnea and can result from stroke or heart failure. 

Immediate consequences of CSA on pulmonary haemodynamics

Based on studies, CSA has a severe effect on pulmonary artery pressure compared to OSA and can lead to an increase in pulmonary artery pressure. However, unlike OSA, the event doesn’t occur due to oxygen desaturation. Instead, oxygen saturation in apnea goes back to normal. So here, there is no deeper oxyhaemoglobin desaturation.

Sleep-Related Hypoventilation Disorders

Sleep-related hypoventilation is when your breathing is too slow or shallow. It can lead to reduced sleep quality and even cause sleep deprivation. The reasons why sleep-related hypoventilation disorder occurs;

• When the diaphragm gets affected 
• Prominent narrowed airways
• Damaged lung
• If the lung is unable to move due to chest wall deformities 
• The brain’s control of breathing is damaged

Types of sleep-related hypoventilation disorders

Obesity Hypoventilation Syndrome (OHS) – OHS is a sleep-related breathing disorder that occurs in obese individuals. While the specific reason why the condition occurs is still unknown, experts believe it is due to the issue in the brain and its ability to control breathing. Also, the extra weight puts pressure on the chest, which prevents the muscles from breathing properly. 

Due to medication or substance: A few medicines, drugs, or alcohol can cause sleep-related hypoventilation. 

Medical disorders: Some medical conditions, such as lung tissue disease, can lead to sleep-related hypoventilation disorder. 

Congenital Central Alveolar Hypoventilation Syndrome: Also known as Ondine’s curse, it is caused by gene mutation and starts in childhood. 

Late-Onset Central Hypoventilation with Hypothalamic Dysfunction: This disorder occurs in the central nervous system and is associated with the central control of breathing. People suffering from this disorder also have any two of the following.

• Hormone abnormalities 
• Obesity
• Tumour 
• Behavioural problems or severe emotional problems 

Idiopathic Central Alveolar Hypoventilation: A condition is diagnosed as idiopathic central alveolar hypoventilation when other diseases and sleep-related disorders are ruled out.

Immediate consequences of sleep-related hypoventilation

As per clinical studies, the effects of sleep-related hypoventilation on pulmonary haemodynamics are minimal. And since these studies are conducted on patients suffering from chronic obstructive pulmonary disease, we don’t know if mild sleep-related hypoventilation on pulmonary haemodynamics leads to pulmonary artery pressure.

When to See A Doctor?

You must consult a doctor if you or your partner notice the following symptoms;

• You snore too loudly
• Your breathing starts and stops when you are asleep 
• You wake up gasping or choking 
• There is a pause in your breathing
• You experience excessive daytime drowsiness

Conclusion

Sleep is crucial for everyone as it helps you heal and affects your ability to function well. If you notice any disturbances in sleep, it is essential to get in touch with your doctor to rectify the condition.

FAQs