Have you been told by your medical practitioner that you should start singing? Although it seems like a fairly strange suggestion, it has now been shown that singing exercises can help alleviate the symptoms of obstructive sleep apnea.
A recent clinical study conducted by Exeter University and the Royal Devon and Exeter NHS Foundation Trust, concluded that exercising the muscles in the soft palate and upper throat – the muscles that are often in weak in patients with obstructive sleep apnea – can greatly reduce the severity and loudness of snoring and cases of apneas during sleep.
The study used patients who were considered to be chronic snorers as well as patients with mild to moderate sleep apnea. The best thing about the results? The singing exercises were easy and quick to do so that the majority of study participants were able to complete their exercises routinely without problems for 3 months. Basic exercises that help to strengthen the muscles in the throat are practised by professional singers and can be learned by anyone. And if you get good, you could even start your own local choir!
In recent news, a study conducted by the Taipei Medical University has definitively linked having sleep apnea with a high risk of developing blindness in the form of glaucoma (an eye disease which results in loss of vision or blindness). For the first time ever, researchers were able to link the two conditions in people aged 40 and over.
After studying more than 1000 patients, the nationwide study concluded that having obstructive sleep apnea (OSA) was a strong risk factor for developing “open-angle” glaucoma. This type of glaucoma is typically slower in developing, meaning it takes years before symptoms may appear. As a result, people who are at risk of potentially losing vision or going blind entirely may not realize until the later stages of the disease.
The study’s researchers are urging for all sleep apnea specialist and clinicians to talk to their patients about glaucoma and the risks associated with the disease. The American Academy of Ophthalmology also recommends that everyone over the age of 40 get an eye exam from an ophthalmologist to reduce the chances of developing glaucoma later in life.
A Press Release on the study from the American Academy of Ophthalmology can be found here.
The type of sleep apnea treatment that is recommended for you will depend upon your form of sleep apnea – whether it’s considered to be central or obstructive sleep apnea – as well as the severity of your case. Here we’re going to look at the most common forms of treatment for the most common form of sleep apnea (obstructive sleep apnea or OSA). As the treatment for children’s sleep apnea is slightly different (including surgery for tonsils and adenoids) we have not included it in this article, but you can find more information on the topic here.
CPAP stands for Continuous Positive Airway Pressure, and a CPAP machine is a medical unit that essentially pumps a continuous flow of air to you while you sleep through a hose and a mask. The reason a CPAP machine works so well with OSA is that the airflow forces open the airways that may otherwise be blocked by the muscle of your throat. Because of the way it works, using a correctly configured CPAP device can also reduce or eliminate any sounds of snoring.
If you are buying a CPAP machine or are recommended one by a sleep specialist, you will find that you need to try out a CPAP machine. There are three components for the machine – the unit itself, a mask that fits over either your nose or your mouth and nose, and a hose or tube that connects the mask to the unit. Many companies make CPAP machines, but probably the most well known are Resmed, Phillips and Fisher & Paykel. While each CPAP machine does basically the same thing – pump air into your mask, and keep track of how you are sleeping – they each come with different features such as heated hoses (to prevent condensation building up in the hose and mask) and different digital settings for airflow.
Because sleep apnea sufferers’ requirements are different, there are several different types of sleep apnea machines you can get. We’re not going into too much detail here, however here is a quick breakdown of the different types of machine you might encounter:
For the purposes of this article, we’ve called all of these machines “CPAP machines” because it’s the common term used for such devices.
If you are diagnosed with mild to severe sleep apnea, and you have obstructive sleep apnea, chances are your doctor will recommend you try a CPAP machine. It is currently considered to be the most effective treatment for sleep apnea on the market. Because it is so effective (and therefore lucrative) companies such as Resmed spend hundreds of thousands of dollars researching new equipment and technology. The range of CPAP machines, as well as the masks and accessories, has grown dramatically in the past few years so that now patients have a real choice in design, features and comfort. The good news is that as long as it is seen as a flourishing and growing market, we’ll see new and improved technology in the future.
The other benefit to using a CPAP machine is that it is relatively easy to use – you are, after all, mostly asleep when you are using it. It is true that it can take a while to get used to wearing something like a sleep mask to bed every night, and for some people, it’s just a matter of trying new masks and accessories such as sleep pillows to help them feel comfortable at night. Like with an exercise regime, using a CPAP machine takes persistence, patience and a little bit of faith.
Surgery for people with OSA is often suggested in very severe cases, or where a specialist believes significant improvement can be made through surgery to the patient’s airways. Any surgery for the condition will target widening or enlarging the airway passages, as well as strengthening the relevant muscles in the region.
Potential areas for surgery include the jaw, tonsils, soft palate nose and the throat wall, with the most common procedure being a uvulopalatopharyngoplasty (removal of the tissues of the throat). Surgery is often considered in cases where people find it difficult to adjust to a CPAP mask, and it is believed that repeat surgeries are more successful for reducing the symptoms of OSA than a one-off operation. For a more detailed examination of the types of surgery for OSA see this article.
Finally, we come to those lifestyle factors that may have caused your sleep apnea in the first place or may be making your symptoms more severe. These are all factors that your doctor should talk to you about when looking at your overall health and well being. These are things that you have control over – you may not be able to prevent your airways from collapsing as you breathe at night, but you may want to consider your choices in terms of your sleep apnea in the future.
There is no getting around the fact that being overweight is one of the prime risk factors for developing sleep apnea, although doctors do point out that not all obese people develop OSA, and not everyone who has OSA is obese. The key to whether you are at risk of developing the condition seems to be associated with neck circumference (17 inches or more for a man, 16 for a woman). If you fall into this group, a good sleep specialist or your doctor will recommend a weight loss regime that’s tailored to your needs (for example, swimming is often suggested for people who find it hard to put weight on their joints who are disabled). If you feel as though your dietary habits could be improved then you can always get advice from your doctor on good eating habits or visit a nutritionist.
It is not surprising that many patients with OSA complain that they lack the energy to embark on a vigorous exercise routine. Because they’re tired during the day they are less likely to want to participate in exercise (for example, taking the elevator instead of the stairs). Interestingly, doctors find that as soon as patients start to feel the benefits of using a CPAP machine – they have more energy and less tired all the time – they automatically start doing more exercise without even thinking about it. Many people find that their eating habits change naturally too, as they do not feel the urge to eat carbs as much or drink caffeinated drinks just to keep themselves awake during the day.
As if you needed another reason to quit smoking, the Mayo Clinic reports that people who smoke are up to three times more likely to develop sleep apnea than non-smokers. The reason is simple: smoking may cause the airways in the throat to become inflamed and cause fluid retention, leading to an obstruction when you’re sleeping.
Like smoking, drinking alcohol and taking sedatives before bedtime has a disastrous effect on your breathing at night – it is believed that the muscles in your throat become relaxed, leading to them “collapsing” occasionally when you take a breath. People who go to bed after having a few drinks tend to snore more, and that’s the reason why.
So you probably know about sleep apnea, but do you know what Obstructive Sleep Apnea (or “OSA”) is? Maybe you’ve just been diagnosed with OSA, and want more information. Maybe you’re curious to see if your daytime sleepiness is caused by OSA?
There are really two types of sleep apnea that doctors refer to: “central” sleep apnea and “obstructive” sleep apnea. The difference between the two comes down to the cause of the problem – so central sleep apnea is believed to be caused by the brain not regulating breathing properly while you sleep, and obstructive apnea is caused by an “obstruction” that occurs when the muscles at the back of your throat are “limp” and close off your airways. Obstructive sleep apnea is the commonest form of the condition, and when people refer to “sleep apnea” on the internet they are usually referring to OSA.
Depending on the severity of your OSA, the muscles creating a blockage in your throat can stop you breathing from 10 seconds and beyond while you’re sleeping. This is a scary idea, as anyone who’s shared a bed with someone who stops breathing like that regularly every night can attest to – the sounds the body makes trying to get air in after such an event are frightening. Some OSA events (where you’re not breathing) can last up to 2 minutes! To put this in perspective, try holding your breath at regular intervals during the day for 2 minutes. You quickly come to realise how destructive this could be to your body over time.
Interestingly, OSA can be found among a huge range of age groups (including very small children), although you are more likely to develop the symptoms between 35 to 65 and beyond. In fact, some studies have suggested that as many as 60 percent of people aged 65 and older have OSA.*
The causes of OSA differ, but for the most part, they in some way cause the airways to be blocked. Being overweight, or having a large neck – wide, not length – for example, means that the muscles around the throat can be “loose”, and in case you want to get out a measuring tape, the dimensions are usually given as anything over 17 inches for men, or 16 for women.
Particular ethnic groups are more at risk, so if you’re Hispanic, a Pacific Islander or African-American you have a better chance than most of having the condition. If you have what is considered to be a small jaw, an overbite, a recessed chin, a frequent smoking or alcohol-related habit you may also be more at risk for OSA. Sounds like a lot of us then! The most unfair thing about Obstructive Sleep Apnea seems to be that they’re looking into a possible genetic cause, which means if your parents or grandparents had OSA you have a good chance of also developing it in life.
including having a small upper airway (or large tongue, tonsils or uvula), being overweight, having a recessed chin, small jaw or a large overbite, a large neck size (17 inches or greater in a man, or 16 inches or greater in a woman), smoking and alcohol use, being age 40 or older, and ethnicity (African-Americans, Pacific-Islanders and Hispanics). Also, OSA seems to run in some families, suggesting a possible genetic basis.
The most common symptoms of Obstructive Sleep Apnea include:
Ok, so you snore, and you’re a little tired sometimes. So what? Well, it turns out that even if you’re considered to have mild obstructive sleep apnea, it’s still doing significant damage to your body.
Let’s look at what’s happening every time your body tries to catch its breath during sleep: even if your “events” only last for 10 seconds, your body is still being deprived of oxygen for those 10 seconds. As science is beginning to find out, having this happen on a regular basis for years on end can lead to concentration and memory issues down the track. Add to this the fact that you’re mostly being dragged out of a deep sleep each time your body has to “wake itself up”. Sleep specialists agree that adults need around 7 to 8 hours of “proper” sleep per night to function at an optimal rate. “Proper”, in this sense, means that you’re naturally falling into the deepest form of sleep (known as wave sleep) for at least 20 per cent of the time. People with sleep apnea often tend not to fall into this deepest sleep at all.
All this combines to put you at risk for some very nasty problems, including heart attack and cardiac death, high blood pressure, depression and even strokes.
The best thing about OSA is that it is easily and quickly treated.
Once you’ve been correctly diagnosed, the symptoms of OSA can often disappear overnight, especially if you’re starting on a CPAP machine. In fact, CPAP, or Continuous Positive Airway Pressure is usually one of the first treatments a sleep specialist will recommend if you’ve been diagnosed with OSA. If your OSA is caused by other factors, such as jaw alignment, then further dental treatment may be necessary as well.
Let’s not also forget that if you’re a little overweight, your doctor will suggest slimming down as one way to help the symptoms, and if you smoke or drink, you’ll probably be also asked to either quit or cut down considerably for your health.
*Source: NHS Choices website
Are you looking for a nice, neat summary of the risk factors and symptoms of sleep apnea?
Then check out our sleep apnea infographic which provides useful information on some of the most common risk factors for sleep apnea – including having a family history of the condition – plus the top 6 symptoms you should keep an eye out for.