Watching a baby, or a loved one, sleeping peacefully at night, breathing peacefully, has inspired music, art, poetry. It’s all about that miracle of life that starts with breathing.
But how about your nights and peaceful sleeping and breathing, and/or the nights of your partner? Because it’s so natural, we don’t often think about whether or not we are breathing. But there has been more than one person who claimed, “my ex had one very annoying habit—breathing!” Well, that could be just one of those sarcastic comebacks of today, because what could be annoying or maddening, or even terrifying about someone’s breathing? A lot.
Air goes in, air comes out –all natural without planning, of course. Breathing involves a lot of your body in fact; it’s not just about the nose and the air around you. It involves muscles of the head, neck, thorax and abdomen. All of these muscles are important because research has shown that certain degrees of tension in any of the body’s muscles can interfere with your ability to breathe normally.
At rest, you breathe 16-17 respirations a minute. If you are anxious, it gets shallow. Your breath deepens with relaxation and sleep.
Breathing is described as a pleasure movement. It is rhythmic and experienced as a feeling of floating, softness, lightness and excitement. It begins in the deep abdomen, the belly expands outward, then moves up and the body expands. The head moves to suck in air, and the nostrils dilate and or the mouth opens. Then the expiration wave begins and moves downward as the head drops back, chest and abdomen collapse and pelvis rocks forward. Sounds like dancing!
Your breathing supports the fires of your life giving you the oxygen for all your metabolic processes.
Whew! So how can it be possible that you or your partner may stop breathing during the night? And if that should happen, are you or your partner having a momentary lapse of life? Or, what to do?
Normal breathing does need to continue at all times. In healthy people when sleeping, most muscle and brain activities will slow down and shut down, but breathing goes on –it’s on auto pilot. But when something goes wrong with your auto pilot, your breathing can become crazed and not helpful to your body’s needs. Your body’s energy levels will not be restored as they should be because of fragmented sleep and abnormal oxygen and carbon dioxide levels in your blood. This can result in daytime sleepiness, exhaustion, and various other disorders and problem situations.
All this has been researched and documented recently as scientists in all —disciplines, from neurobiology to pulmonary medicine– have studied details of sleep and sleep disorders. They have termed sleep apnea, as a one of the major respiratory disorders of sleep, along with narcolepsy and clinical insomnia.
Apnea is a Greek word meaning “want of breath.” It was first described in 1965 as a clinical sleep apnea. The term Pickwickian has also been used to describe people with sleep apnea even during the day. It comes from the overweight red-faced boy who snores and breathes heavily in Charles Dickens’ first acclaimed novel, the Pickwick Papers.
In 1988, concerned by the loss of productivity associated with disturbed sleep, Congress created the National Sleep Commission on Sleep Disorders. Thanks to the research by this Commission we now know so much more about sleep disorders and how to treat them.
One of the discoveries of the Commission is that it is “normal” to occasionally stop breathing at night. People with so called normal breathing during the night can have an average of 7 breathing pauses of up to 10 seconds in one night–and this will not signify problems or symptoms. But, if breathing irregularities are greater than this with reduced oxygen and repeated loss of sleep, then people are at risk of more serious problems.
It is estimated that 20 million Americans have sleep apnea. The length of a breathing pause can last for 10 seconds to 60 seconds. If you have less than 30 breathing pauses during a 7-hour sleep, or shorter breathing pauses, you probably don’t have sleep apnea.
Most people with confirmed sleep apnea have 20-30 breathing interruptions in an hour and sometimes 200 in a night. They may be in clusters. Often there is also choking, snoring, early morning headaches, and excessive daytime sleepiness. Sometimes a person may turn blue.
Snoring is documented as a sign of potential sleep apnea. More often than not, extended pauses in breathing are accompanied by snoring. If you don’t notice your partner stop breathing, most likely you notice the snoring! The thing, is snorers rarely wake themselves, so their bed partners do play a critical role in seeing that they are helped. Consequently, it may not be a great idea to kick your partner out of bed because of snoring and not be able to monitor the nature of the snore.
The situation is really widespread. Nancy Rothstein had a personal struggle with a snoring husband and was inspired to write a popular children’s book about it, My Daddy Snores. And in her household, no one got any sleep because his snore boomed, rumbled, like dinosaurs and earthquakes, and got worse every day!
But, snoring is not child’s play, and can be indicative a serious problem, and should not be ignored, for both the health of the snorer, and peace in the household!
The reduced amount of oxygen going in and the increase in carbon dioxide causes an arousal from deep sleep and a signal is sent to those upper air way passages to open up the airway. So, then breathing can continue again, and that is why you hear a loud snort or, gasp. Those arousals are like a rescue service. This is what happens in obstructive apnea.
Now in central apnea the brain does not send a signal to the breathing apparatus for the breathing. In central apnea the airways remain open, but air still is not passing because the muscles of the chest and diaphragm are stopped. In central apnea people may not snore, and are often more aware of frequent awakenings, than people with obstructive apnea.
There is also Mixed Apnea where a time of central apnea is followed by a time of obstructive apnea before regular breathing starts up again. There is usually snoring with mixed apnea.
According to the National Library of Medicine, severe sleep apnea is known as “Obstructive sleep apnea hypopnea syndrome (OSAHS). OSAHS is a serious medical condition which is on the increase in the past 50 years. It causes significant morbidity and mortality in both developed and developing nations of the world. Early recognition and prompt appropriate intervention measures will reduce the mortality and improve the quality of life in patients with such conditions.
For sleep, disordered breathing to be diagnosed as OSAHS, the person must have at least 5 obstructed breathing events per hour or 30 events per 6 hours of sleep. This can be a combination of obstructive apnea and hypopnea which makes for an apnea-hypopnea index or AHI. The AHI is the number of apneas plus hypopneas per hour of sleep. The standard to define and qualify the severity of OSAHS is an AHI of more than 5 events per hour, with the severity of apnea increasing with the AHI increases. The AHI is the number of airway obstructions, or partial obstructions, that result in a reduce airflow. A partial obstruction is called a hypopnea, if there is a complete stop of airflow that is called an apnea. Hypopnea is defined as a 110-second event during which there is continued breathing but where ventilation during sleep is reduced by at least 50%. Apnea is total stop of airflow for at least 10 seconds.
Apnea is a medical term that describes slowed or stopped breathing. Because it usually happens during sleep it is usually called sleep apnea. There are levels and types of apnea, but take heart because they are usually treated and there are various ways of treating it depending on your level and lifestyle.
When your airway becomes blocked, or when the brain does not send a signal to breathe, apnea occurs. Typical causes of sleep apnea happen from overly relaxed throat muscles enlarged tongue, enlarged tonsils, being overweight, irregular brain signals, the shape of your neck.
What happens is the passage way to breathe–your airway, becomes blocked or narrowed which usually causes loud snoring, long breaks in between breaths, and even stops in breathing and gasping for air during sleep. Usually people do begin breathing again on their own. Extended time without breathing should be cause for alarm. If breathing stops but the heart is still active this is respiratory arrest and is a life-threatening event that needs immediate medical attention. In any case, this is a situation that needs to be addressed.
A doctor would ask questions about sleep patterns, medications taken, and often sleep testing. There are tests that measure brain waves, breathing rate, blood pressure, blood oxygen levels during sleep.
But even before this extensive type of testing, there are several things you can consider first:
Weight loss if you are overweight.
Wearing a breathing mask while you sleep a continuous positive airway pressure method or CPSP. This mask gives you continuous air while you sleep.
Using a mouthpiece to keep airways open.
But do stay tuned for more detailed information about help for sleep apnea in upcoming chapters.
Sleep apnea can cause cardio vascular problems. It can lead to a slowing of the heart beat, or irregular heartbeat, or high blood pressure,
Of course, it through off your sleep patterns. There are abrupt changes in sleep from deep sleep to light sleep and this absence of restful sleep often causes depression irritability, defects in attention and concentration and performance, and even sexual problems. Yes, indeed. A recent study published by the National Heart, Lung and Blood Institute found that men who had poor sleep for as little as one week, showed a real drop in their testosterone–you know, the hormone that men need for male functioning, vigor and well-being, so the published study reported. The leading doctor of the study reported that in restful sleep Human Growth Hormone is replaced as well.
A man named Tom–which could be any name, as thousands of others could also report this same story–was deciding whether snoring and stopped breathing was a big deal or not.
He describes knowing about his sleep apnea because his wife told him that he stopped breathing during the night and that she would lie awake and counted off seconds until he would breathe again. But Tom did not feel it necessary to bother much about this since he believed he was getting enough sleep, even though he was tired during the day, and was known to nap in the car after going out to lunch with co-workers –snoring the whole way back! It annoyed coworkers, but still Tom thought no big deal. Even worse, he knew he often took a quick nap at traffic lights on the way home from work.
Luckily for Tom, during a routine physical he did manage to cough up the truths to the doctor who immediately prescribed a sleep clinic for evaluation.
He describes in detail his tests with electrodes to monitor with a video camera. The report confirmed sleep apnea and he was then monitored for a night with an apparatus called a CPAP a continuous positive airway pressure machine, that kept him breathing and would record how much pressure he needed to control his apnea. Right away, that next morning, he realized what a difference a night makes! He reported feeling like a gung-ho kid again, refreshed and invigorated, and well rested! His report showed he stopped breathing almost 600 times or about 45 seconds of sleep at a time…horribly interrupted sleep. No wonder he never was able to dream. His blood oxygen level had dropped to 50 percent while normal level is at least 95 percent.
So, the moral of this story, is don’t just get used to terrible situations about your sleep, because it is possible to have a whole new outlook on life, and for your family and others around you too.