Sleep Apnea

Sleep apnea is a sleep disorder that is characterized by repetitive episodes of upper airway obstruction. While it can lead to daytime drowsiness and lethargy, it can be potentially life threatening if left untreated. Sleep apnea is a condition where the blockage of the airway prevents air from getting into the lungs. This leads to snoring at regular pace and short periods of time where the breathing ceases. Apnea is the lack of spontaneous breathing. The patient may become limp and lifeless, have a seizure or turn bluish.

This is followed by sudden attempts to breathe with a loud gasp and snort. Consequently this condition affects the sleep and the person is not well rested. Besides the oxygen levels remain low leading to drowsiness and tiredness. Severe sleep apnea is likely to cause pulmonary hypertension. A large neck or collar size can be one of the causes of obstructive sleep apnea. Sleep apnea can be potentially life threatening since it can cause heart attacks or strokes.

Prolonged apnea is called as respiratory arrest. In children, this can quickly lead to cardiac arrest in which the heart stops beating whereas in adults, cardiac arrest usually is the first to happen followed by respiratory arrest. In adults, common causes of apnea and respiratory arrest include choking, drug overdose, near-drowning, head injury and cardiac arrest. In children, the causes may be different - prematurity, swelling of the airways, choking on a foreign object, seizures, regurgitating food or near-drowning.

Obstructive sleep apnea: This is a condition where tissues of the body obstruct the airways during sleep. Obstructive Sleep apnea is common in obese men who sleep on their backs. Other factors include Smoking, heavy alcohol consumption, emphysema, and an inherited tendency toward a narrowed airway.

Diagnosis of sleep apnea

• ECG to show arrhythmia during sleep
  
  
• Echocardiogram to study the heart functioning
  
  
• Thyroid function tests
  
  
• Sleep studies
  
  

Sleep apnea treatment

Treatment for sleep apnea can range from lifestyle modification, medication to even surgery in some cases. Weight loss and avoiding smoking are some of the changes that may need to be introduced into the lifestyle to prevent episodes of sleep apnea.

The risk of obstructive sleep apnea choking can be reduced by avoiding alcohol, tobacco smoking, tranquilizers and sedatives before bed. There is a surgical procedure called as LAUP (Laser Assisted Uvula Palatoplasty) where removal of the offending tissue is done to allow for unobstructed airflow.

Sleep apnea is often treated with surgery that removes the cause of obstruction. Enlarged tonsils or adenoids are removed to cure sleep apnea. Another sleep apnea surgery is UPPP - Uvulopalatopharyngoplasty, which involves removal of excess tissue from the back of the throat. This is done to increase the size of the upper airway. Usually it involves removal of the soft palate that hangs down the back of the throat. Such sleep apnea surgery is performed under general anesthesia. These days it is done under local anesthesia with laser assistance. Nasal reconstruction surgery straightens the nasal septum and shrinks the nasal tissue, thereby improving nasal airway. Changing the bony structure in the upper airway allows air to move more freely, especially during sleep.

The CPAP (Continuous Positive Airway Pressure) mask uses air pressure to push the tongue forward. This opens the throat to air and reduces snoring and apnea. It does not cure sleep apnea but relieves the patient by preventing recurrent episodes. Personalized sleep apnea masks are created to fit exactly on your face, nose, cheeks, lips and forehead. The sleep apnea mask is secured well so that there are no leaks.

Hyperkalemia

Hyperkalemia is higher than normal levels of potassium in the blood stream. This may be due to an increase in total body potassium. Although Hyperkalemia occurs without any symptoms, rarely one can detect signs of irregular heartbeat, nausea, slow, weak or absent pulse, cardiac arrest. Emergency treatment becomes imperative if potassium is high or if symptoms are present, including changes in the ECG. Hospitalization and close monitoring are required.

Cardiopulmonary resuscitation

Cardiopulmonary resuscitation or CPR is an emergency measure administered to a person whose heart has stopped beating. A person who has turned unconcious or is not breathing normally can be given cardiopulmonary resuscitation. This involves chest compressions and mouth-to-mouth resuscitation. CPR allows oxygen and blood circulation to a person's heart when it has suffered a cardiac arrest. It allows the brain and other organs to remain alive till the person is taken to a hospital. This delays tissue death and permanent brain damage. CPR can be performed on adults, children and infants.