Is Sleep-Disordered Breathing The Same As Sleep Apnea?
Sleep-related breathing disorders are a common group of conditions that affect many individuals worldwide. Among them, sleep disordered breathing (SDB) and sleep apnea are two terms that are often used interchangeably, but they have distinct differences. As a speech language pathologist, I’ve found that many of my patients also struggle with some sort of sleep-disordered breathing. So in this blog post, we will explore the different types of sleep disordered breathing to help shed some light on these all-to-common conditions.
What Is Sleep-Disordered Breathing?
Sleep disordered breathing (SDB) is a general term that encompasses a wide range of breathing abnormalities during sleep. It can refer to any disruption in the normal breathing pattern during sleep, including partial or complete blockage of the airway, irregular breathing, or abnormal breathing effort. Here are some of the common types of sleep-disordered breathing:
Obstructive Sleep Apnea (OSA): This is the most common type of sleep-disordered breathing. OSA occurs when there is a partial or complete blockage of the upper airway during sleep, resulting in pauses in breathing, often accompanied by loud snoring, gasping, or choking. These pauses in breathing can lead to reduced oxygen levels in the blood and disrupt the normal sleep pattern, leading to daytime sleepiness, fatigue, and other health issues.
Central Sleep Apnea (CSA): Unlike OSA, CSA is not related to an obstruction in the airway. Instead, it occurs when the brain fails to send proper signals to the muscles that control breathing during sleep. This results in pauses in breathing without any effort to breathe, and it is less common than OSA. CSA is often associated with certain medical conditions, such as heart failure, brainstem lesions, or central nervous system disorders.
Complex Sleep Apnea Syndrome (CSAS): Also known as treatment-emergent central sleep apnea, CSAS is a combination of OSA and CSA. It initially presents as OSA but may transition to CSA after continuous positive airway pressure (CPAP) therapy is initiated. The underlying cause of this transition is not fully understood and may require further evaluation and treatment adjustments.
Upper Airway Resistance Syndrome (UARS): UARS is characterized by partial blockage of the upper airway during sleep, leading to increased effort to breathe and disrupted sleep. It may not meet the criteria for a diagnosis of sleep apnea, but it can still cause symptoms such as snoring, fragmented sleep, and daytime sleepiness.
Snoring: Although snoring is not always considered a sleep-disordered breathing condition, it can sometimes be a sign of an underlying issue. Snoring occurs when there is partial blockage of the airway during sleep, leading to vibrations of the throat tissues that produce the sound of snoring. In some cases, snoring can progress to more severe forms of SDB, such as OSA.
Signs and symptoms of SDB may include snoring, gasping or choking during sleep, restless tossing and turning, frequent awakenings during the night, daytime sleepiness, morning headaches, and irritability. However, it's important to note that SDB can sometimes be asymptomatic or have mild symptoms, making it challenging to detect without proper evaluation and diagnosis.
What is Sleep Apnea
Sleep apnea is a specific type of sleep disordered breathing that is characterized by repetitive episodes of partial or complete blockage of the airway during sleep, leading to interrupted breathing (apneas) and disrupted sleep. Sleep apnea is often associated with loud snoring, abrupt awakenings accompanied by choking or gasping, restless sleep, excessive daytime sleepiness, morning headaches, difficulty concentrating, and irritability. In stark contrast to normal snoring patterns, loud gasps for air or pauses in breathing at night may be present. These episodes can sometimes last as long as 10 seconds or more and occur several times throughout the night. It is a serious condition that can have significant health consequences if left untreated, including increased risk of cardiovascular disease, diabetes, mood disorders, and impaired cognitive function.
Causes Of Sleep Disordered Breathing
Causes of sleep-disordered breathing can vary and be multifactorial. Common causes include:
Obesity: Excess body weight, particularly in the neck and upper airway, can increase the risk of sleep-disordered breathing, including obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) (Young et al., 2002).
Anatomical abnormalities: Structural abnormalities in the upper airway, such as enlarged tonsils, adenoids, deviated septum, or narrow airway, can contribute to sleep-disordered breathing by causing partial or complete blockage of the airway during sleep (Jordan et al., 2005).
Age and gender: Sleep-disordered breathing tends to be more prevalent in older adults and males, although it can occur in individuals of any age and gender (Redline et al., 1997; Peppard et al., 2000).
Genetic factors: There is evidence to suggest that certain genetic factors may predispose individuals to sleep-disordered breathing. Family history of sleep apnea and genetic variants related to upper airway anatomy and respiratory control have been identified as potential risk factors (Patel et al., 2018).
Alcohol and sedatives: Consuming alcohol or sedatives before bedtime can relax the muscles in the upper airway, leading to increased collapsibility of the airway and increased risk of sleep-disordered breathing (Bhattacharyya et al., 2014).
Medical conditions: Certain medical conditions, such as obesity hypoventilation syndrome, congestive heart failure, hypothyroidism, acromegaly, and neuromuscular disorders, can contribute to sleep-disordered breathing (Mokhlesi et al., 2017).
Lifestyle factors: Poor sleep hygiene, irregular sleep patterns, and sleep deprivation can also disrupt the normal breathing pattern during sleep and contribute to sleep-disordered breathing (Young et al., 2003).
Diagnosis of Sleep Disordered Breathing
Sleep disordered breathing, if left untreated, can have serious health consequences. The repeated interruptions in breathing during sleep can lead to decreased oxygen levels in the blood, which can strain the heart and other organs. Over time, this can increase the risk of developing high blood pressure, cardiovascular disease, stroke, and type 2 diabetes. SDB has also been linked to mood disorders such as depression and anxiety, cognitive impairments, decreased quality of life, and an increased risk of accidents due to daytime sleepiness.
If you suspect you may have sleep disordered breathing, it's important to seek a proper diagnosis from a healthcare professional. Diagnosis typically involves a sleep study, which can be done at a sleep center or in some cases, at home using a portable monitoring device. The sleep study monitors various parameters during sleep, such as brain activity, eye movement, heart rate, oxygen levels, and airflow, to determine the presence and severity of SDB.
Treatments For Sleep Disordered Breathing
Treatment options for sleep disordered breathing depend on the severity of the condition and may include lifestyle changes, positional therapy, oral appliances, continuous positive airway pressure (CPAP) therapy, and in some cases, surgery. Lifestyle changes may include losing weight, avoiding alcohol and sedatives before bedtime, sleeping in a different position, and practicing good sleep hygiene.
As I said earlier, I encounter many patients in my practice that are also suffering from SDB; likely because most of my patients are coming to me for some sort of underlying neurological condition or orophayrngeal dysfunction. In conjunction with the above listed treatments, breathing retraining therapy can also be a powerful tool for controlling SDB.
Breathing Retraining Therapy
Specialty trained speech language pathologists, such as Eloquium Speech Therapy, may provide breathing retraining exercises to individuals with SDB. This may involve teaching proper breathing techniques, such as diaphragmatic breathing, nasal breathing, and slow, controlled breathing, to help individuals establish healthy breathing patterns during both wakefulness and sleep. Breathing retraining can help improve the coordination and efficiency of respiratory muscles, reduce respiratory effort, and enhance overall lung function, which can have a positive impact on sleep quality. (Guillen et al., 2015; Camacho et al., 2021).
If you suspect you may have sleep disordered breathing, consulting with a qualified speech therapist as part of a comprehensive treatment team can be beneficial in addressing the overall symptoms of the condition.
Prevention is Better
While sleep disordered breathing is a common condition, there are steps you can take to reduce your risk of developing it. Maintaining a healthy lifestyle, including regular exercise, maintaining a healthy weight, avoiding smoking and excessive alcohol consumption, and practicing good sleep hygiene, such as establishing a consistent sleep schedule and creating a conducive sleep environment, can all help promote healthy sleep patterns and reduce the risk of sleep disordered breathing.
Conclusion
So to wrap up, sleep disordered breathing is a common condition that affects many people, yet often goes unnoticed or untreated. It can have serious health consequences if left untreated, including cardiovascular disease, mood disorders, and cognitive impairments. If you suspect you may have sleep disordered breathing, it's important to seek a proper diagnosis from a healthcare professional and discuss appropriate treatment options. Remember, prioritizing good sleep hygiene and adopting a healthy lifestyle can go a long way in preventing sleep disordered breathing and promoting overall health and well-being. So, take a step towards breathing easy and getting a restful night's sleep!
