Sleep Apnea Quiz – Find out if you’re at risk

Sleep apnea is a very common sleeping disorder that often goes un-diagnosed. The free 100% online quiz below is based on the most common sleep apnea symptoms that are used during sleep apnea tests and medical diagnosis. This quick questionnaire should not act as a replacement for visiting your physician or primary care provider, but it can offer a strong test indication of whether or not you are at risk.

The survey is 12 questions long and will display your results immediately. Each question of the quiz has a detailed explanation below (simply continue scrolling down the page). In fact, you can use the detailed answers as a “sleep apnea slef test.”

Understanding the Quiz

Question 1: Excessive daytime sleepiness, or hypersomnia, is a common symptom of sleep apnea. This can include feeling exhausted during the day even though you got plenty of sleep the night before. You should see your doctor to be tested for sleep apnea if your drowsiness causes you to fall asleep at inappropriate times, like when you’re working or driving.

Question 2: Snoring — especially if it’s loud enough to disturb others or cause you to wake yourself up — is a prominent symptom of obstructive sleep apnea, the most common type of apnea. It’s important to note that not everyone who snores has sleep apnea, and not everyone who has sleep apnea snores. But you should see your doctor if you snore loudly, especially if your snoring is interrupted by periods of silence.

Question 3: Alcohol — and other sedatives or tranquilizers — can relax the muscles in your throat to the point that it may obstruct your airway. Similarly, smoking increases your risk of developing sleep apnea because smoking may cause inflammation or fluid retention in your upper airway.

Question 4: If you’re carrying some extra pounds, it’s possible that some fat has deposited around your upper airway. That can obstruct your breathing, causing obstructive sleep apnea. It’s important to note, however, that people who are at a healthy weight develop this disorder, as well.

Question 5: Abrupt awakenings, especially when accompanied by shortness of breath, can be an indication of the central variety of sleep apnea. Waking with a dry mouth or sore throat can indicate you had been snoring during the night. Morning headaches are also a common symptom among sleep apnea sufferers.

Question 6: You’re more likely to develop the obstructive type of sleep apnea if you have a hard time breathing through your nose — regardless of if the nasal congestion is caused by an anatomical problem like deviated septum or allergies.

Question 7: You may be at an increased risk of developing the obstructive type of sleep apnea if the disorder runs in your family. If you have a family member who has been diagnosed and you are suffering from other symptoms of sleep apnea, you should make an appointment with your doctor.

Question 8: Having obstructive sleep apnea increases your risk of stroke, and if you have undetected heart disease, sleep apnea could cause a sudden heart attack. If you have central sleep apnea, it is likely a cause of your heart disease. Having high blood pressure also can be a complication of both types of sleep apnea.

Question 9: Adults older than 60 are significantly more likely to have obstructive sleep apnea than those who are younger, and people older than 65 are at higher risk for developing central sleep apnea, especially if they also have other risk factors.

Question 10: If you experience shortness of breath that awakens you from your sleep, or if your partner notices that you have pauses in your breathing in your sleep, you should see a doctor.

Question 11: Women are less likely than men to be diagnosed with obstructive sleep apnea according to a 2013 study led by UCLA. The study also found that the women who were diagnosed with OSA were also more likely to be severely impacted in terms of mood and judgement.


Did the results say you are at low risk, but you know you’re having abnormalities with your sleep? Click here to take a sleep test by the London Sleep Center that tests for a multitude of sleep disorders.

This survey is not designed to be a replacement for the advice and knowledge of a medical or healthcare professional. Consider sharing the information you discover here with your physician or healthcare provider in order to assist them in determining the optimal treatment options. We will never share the information you provide and we respect your privacy. Return home.

 

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Sleep Disorders and their Effect on Your Total Health

A report by the National Institute of Neurological Disorders and Strokes said at least 40 million Americans suffer from sleep disorders each year. These disorders are always present. They interfere with work, home life, driving and even social activities. They’re also the cause of an estimated $16 billion in annual medical costs.

Who knows how much they cost in lost productivity each year?

Doctors have identified more than 70 sleeping disorders. While they can affect your total health, once doctors correctly diagnose them, the uplifting news is that they can be managed. The rest of this article will cover some of the most common diseases and disorders and their ultimate effect on overall health.

The four most common sleep disorders.

Sleep apnea

This results in interrupted breathing while sleeping. It’s typically associated with a buildup of fat or declining muscle tone due to aging — two factors that allow the windpipe to collapse while sleeping. The result is sleep apnea for 18 million Americans.

Another cause of the disorder is a malfunction of the neurons in charge of controlling breathing during sleep. Taking sedatives or sleeping pills is particularly dangerous because these drugs can keep sleep apnea sufferers from awakening enough to breathe. Click here to read more about sleep apnea diagnosis.

Insomnia

Just about everybody experiences it at some point. Its causes are too numerous to detail, though stress, jet lag, and diet are common. Insomnia nearly always has an effect on job performance and general physical condition the following day.

It affects around 40 percent of women and 30 percent of men. Sleeping pills can relieve the inability to sleep on a short-term basis. However, using them long term can actually make the problem worse. Did you know that there is a very interesting correlation between insomnia and apnea?

Restless legs syndrome (RLS)

This sleep disorder tends to run in families. It generates feelings of uncomfortable crawling, tingling or prickling in the legs. The estimated 12 million Americans who suffer from it feel the urge to move their legs to make these sensations go away. They experience constant leg movement throughout the day but insomnia at night.

The condition is most prevalent among the elderly and has been associated with illnesses such as anemia and diabetes. Some RLS patients also suffer from periodic limb movement disorder (PLMD). This causes arms and legs to jerk every 20 to 40 seconds, resulting in interrupted sleep. Doctors typically prescribe medications that control the neurotransmitter dopamine.

Narcolepsy

A quarter of a million people in the United States are afflicted with this disorder. Even though they manage to get a sufficient amount of sleep at night, they nod off frequently during the day. Each episode lasts from a few seconds to more than half an hour.

Occurrences of cataplexy — losing muscle control during highly emotional events – as well as hallucinations and temporary paralysis upon awakening affect some individuals with narcolepsy. Stimulants, antidepressants and other drugs help patients avoid the dangers of falling asleep at the wrong times.

Diseases and Disorders

According to the CDC, sleep disorders can play a prominent role in the development of chronic disease and significantly affect total health.

Cardiovascular disease.

Having sleep apnea creates an increased risk for hypertension, irregular heartbeats, coronary disease and stroke. There are also some shared physiological characteristics between those who suffer from sleep apnea and those experiencing a hardening of the arteries. Some physicians consider sleep apnea a predictor of cardiovascular problems.

Obesity.

Sleep that’s too short can cause metabolic changes potentially linked to obesity. Studies have noted an association between a short duration of sleep and excess body weight in subjects of all ages, but especially striking in children. Researchers believe that lack of sleep in children might negatively impact the hypothalamus, which regulates appetite and energy expenditure.

Depression.

For many years, clinicians have considered sleep disturbance a symptom of depression. However, recent studies suggest that once sleep apnea patients have been treated and start getting enough sleep, their symptoms of depression lessen.

Anyone suffering from sleep deprivation is also prone to irritability, headaches and an overall feeling of sluggishness. Innovative technology such as brain imaging can now help scientists understand how the regions of the brain operate during sleep. It could also lead to innovative therapies to treat sleep disorders and to overcome problems such as jet lag.

Sources:

ninds.nih.gov…understanding_sleep

cdc.gov/sleep…

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Cures for Sleep Apnea – Treatment WITHOUT a CPAP Machine

Realistically, CPAP devices are the best, most reliable treatment for obstructive sleep apnea. However, CPAP therapy is not the only treatment for sleep apnea. Furthermore, although your CPAP appliance will treat your sleep apnea, it will never cure it.

That is to say, unless you seek lifestyle changes, you can almost certainly count on using CPAP therapy (or a CPAP alternative) for the rest of your life. For many people, this does not pose a problem. Others cannot tolerate CPAP machines or are willing to do anything to escape their masks.

Obstructive sleep apnea is a chronic disease, caused when the throat and tongue relax enough to obstruct the airways.

Can sleep apnea be cured?

There are only two “cures” for Sleep Apnea, and neither are necessarily guarantees.

  1. Lose weight
  2. Surgically remove excess tissue from the palate or throat

Not everyone can “simply lose the weight.” And surgery can have side effects. These side effects warrant concern, and very few doctors will recommend it unless there are no other options left.

Treatment vs Cure

The term “cure” means that the patient’s condition will no longer exist after medical treatment or surgery. Some conditions and diseases can be cured. If you take diseases as examples, smallpox and whooping cough have cures.

Some conditions and diseases have no cure. Continuing the illustration, Parkinson’s disease and Progeria have no known cure. When there is no cure, the person will always have the condition. Nevertheless, many incurable illnesses have medical treatments that allow patients to manage their condition.

Most Popular Treatments

There are four primary treatments:

  • CPAP therapy (or other airway stimulation therapy machine) – ongoing treatment
  • Weight loss and diet – in some cases this treatment may lead to a cure
  • Oral/nasal appliances– ongoing treatment
  • Surgery – risk of side effects and a potential cure

CPAP alternatives?

If you hate the machine, your best bet is to start exercising to lose the weight. It may sound insignificant, but losing just 10% of your total weight can release a significant amount of pressure from your airways.

The clear majority of CPAP alternatives fall into the category of oral or nasal appliances. Others are machines that provide some type of airway therapy. Here are the most popular.

Oral Appliances

The goal is to prevent the tongue from collapsing into the throat. They are usually designed to push the jaw into a forward position. If you have severe OSA, this probably will not work.

Provent Sleep Apnea Therapy

Provent is a type of nasal device. Nasal devices are almost always less effective, or completely ineffective, for patents with moderate to severe OSA. Nevertheless, if you have been recently diagnosed or have mild to moderate OSA, this might be worth trying.

Winx Sleep Therapy System

This new system uses oral pressure therapy (OPT) instead of a mask.

Stop Sleeping on Your Back

There are a few devices, such as Night Shift, which are designed to stop patients from sleeping on their backs. This would fall into the category of “positional therapy.” Positional therapy is rarely recommended without accompanying treatment options like Provent or an oral device.

If you want to try this on your own, one solution is to clip a tennis ball to the back of your shirt. The irritation of laying on the ball may cause you to roll on your side.

Supplements

Supplements that help with weight loss could lead to improvements in OSA. However, there are additional supplements that just might positively affect your condition.

University Health News writes that antioxidant supplements, DHA, and Vitimin D may all be beneficial for OSA patients.

Conclusion

It is highly unlikely that there will be a new cure for sleep apnea in the future. Weight loss and breathing devices will likely continue to be the best options for treating obstructive sleep apnea.

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Worried You Have Insomnia? It Might Be Sleep Apnea

Lots of Americans complain about their sleep quality. And with good reason. More than 55 million Americans suffer from insomnia. 22 million Americans suffer from sleep apnea.

Does it feel like you’re awake throughout the entire night? Do you have trouble staying asleep? When you get up in the morning do you feel completely unrested? Are you drowsy throughout the day?

In the past 50 years, doctors have characterized a new clinical syndrome: sleep apnea associated with insomnia.

The quick run-down of sleep apnea: patients experience frequent episodes of “apnea” while sleeping, during which they are unable to breathe. Onset of respiration (i.e. a loud gasp/snort) causes them to partially or fully wake up.

The quick run-down of insomnia: habitual sleeplessness and/or an inability to sleep.

The takeaway from this new medical characterization is that some patients who complain of insomnia may likely suffer from sleep apnea.

How Could This Be?

“Wait, this makes no sense?” – If that is your kneejerk response, you aren’t alone, and you’re probably familiar with the usual sleep apnea symptoms. This correlation does seem paradoxical and even improbable.

How could it be that insomnia is present in patients that commonly suffer from the symptom of excessive sleepiness (i.e. sleep apnea patients)? To put it more colloquially, how could it be that the same patient who is at risk of dozing off while operating heavy machinery could have insomnia?

The Research

Recent research shows that about half of patients with a breathing related sleep disorder also experience insomnia.

This is a relatively new field of research, but there are several available studies.

Chronic Insomnia

Most of us experience the occasional transient insomnia. Others experience chronic insomnia, severe enough to negatively influence our jobs, academics, and lifestyles.

When a patient experiences insomnia for several months, they are often treated with a sleep medication. Unfortunately, patents often complain these medicines do little good. Research from the Rowe Neurology Institute discovered that many patients who complain of insomnia are experiencing obstructive sleep apnea. At this point, it comes as no surprise that the drugs did not help, because sleep apnea is the root cause for these patients.

Diagnosing Sleep Apnea and Insomnia

If you’re worried that you have Sleep Apnea paired with Insomnia, your best bet is to take a polysomnography or PSG. These are commonly known as “sleep studies.” These tests monitor your sleep overnight and provide a detailed report that helps a physician correctly diagnose your sleeping problems.

If you have severe obstructive sleep apnea, a dentist may have identified your condition. There are many dental specialists that are qualified to make this diagnosis. However, without a sleep study it would be more difficult to identify insomnia.

Sources:

Johns, Murray W. “A new method for measuring daytime sleepiness: the Epworth sleepiness scale.” sleep 14.6 (1991): 540-545.

https://doi.org/10.1126/science.181.4102.856

Murray W. Johns; A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale, Sleep, Volume 14, Issue 6, 1 November 1991, Pages 540–545

https://doi.org/10.1093/sleep/14.6.540

Nasr-Wyler, A., et al. “Syndrome d’apnées du sommeil et accident vasculaire cérébral dans une population âgée.” Revue neurologique 155.12 (1999): 1057-1062.


Photo Credit: Imgur.com

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How to Recognize Sleep Apnea in Children

The affliction of sleep apnea is not exclusively an adulthood disorder, as many would believe. It is estimated that between 1 to 4 percent of children between the ages of 2 and 8 suffer from obstructive sleep apnea. What is more staggering is the effects that sleep apnea can have on a developing child. Recognition of the signs and symptoms of OSA in children is vital in deterring long term physical and behavioral damage.

Signs and Symptoms of Pediatric Sleep Apnea

As with all sleep disorders, the most common sign of possible sleep apnea in children is loud, persistent snoring. On average, 10% of children who snore are diagnosed with sleep apnea. This will also be followed by gasping, snorting, and awakenings as the airway is partially or fully blocked during sleep. You may also notice that your child tosses and turns throughout the night, consistently mouth breathes, and sweats during the night (caused by the struggle to breathe).

Other symptoms related to the lack of a full nights rest because of obstructive sleep apnea are drowsiness during the day, moodiness, and the inability to focus on academic studies. A child’s sleep is crucial to their development and frequent disruptions during the night can initiate poor behavior and limit physical abilities.

Children, who are overtired due to the lack of sleep, also display abnormal behavior such as hyperactivity and busy behavior as well. This behavior should be noted but does not clearly define that the child is suffering from obstructive sleep apnea.

Bed-wetting is yet another physical symptom of pediatric sleep apnea; however, this will also not be a defining absolute that the child has obstructive sleep apnea. Children that do suffer from the condition frequently wet the bed due to enuresis, where an increase of urine is produced in the nighttime.

All factors should be assessed and observed to fully diagnose obstructive sleep apnea in children.

Causes

Children can suffer from sleep apnea for varying reasons. These can include obesity, where fat deposits that reside in the throat cause the airway to narrow, enlarged tonsils and adenoids, which is most common in children, family history, medical conditions such as cerebral palsy and Down syndrome, as well as malformations of the mouth or jaw that may limit airflow.

A closer look at the relationship between obesity and obstructive sleep apnea, research conducted within the last few years found that nearly 50% of children referred to the University of Louisville Sleep Center were obese. Whereas this number was significantly lower two decades ago at around 15%. These statistics suggest that children who are overweight can have a significantly increased risk of developing OSA. As in adulthood, weight loss can have a profound effect on reducing symptoms of sleep apnea.

Effects of Pediatric Sleep Apnea

There are many detrimental and potential long term effects on a child suffering from obstructive sleep apnea. Namely pediatric sleep apnea can delay growth in children as well as present cardiovascular problems with age. Children require much more sleep than adults and therefore devote most of their sleep to REM cycles. It is within the REM cycle that the body experiences more restorative periods of sleep. The fragmented sleep caused by OSA reduces these periods, therefore presenting these physical conditions.

From a behavioral standpoint, it is estimated that 25% of children diagnosed with attention deficit disorder have symptoms of obstructive sleep apnea. Habitual broken sleep patterns caused by OSA correlate to the behavior and learning challenges that face these children. OSA may even be the undiagnosed condition a child is suffering from but has been masked by a diagnosis of ADHD.

Overview

Pediatric sleep apnea can be a frightening condition for any parent. The typical stereotype for sleep apnea of a middle-aged overweight male all too often leads to misdiagnoses in children who do suffer from sleep apnea. If you suspect that your child may have the symptoms related to OSA it is imperative to seek medical advice to prevent the toll that can be taken on a young child’s development, learning, and social abilities.

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Complications of Sleep Apnea

Sleep apnea refers to intermittent, cyclical cessations or reductions of airflow, with or without obstruction of the upper airway. This is manifested to the patient and the observers as snoring. On a long-term basis, Obstructive sleep apnea (extreme snoring) can cause several major and minor complications to an individual’s health and well-being, which will be the primary focus of this article.

Why complications?

Major complications that occur in a patient with apnea are due to the compromised airway and reduced or inefficient oxygenation of blood. This leads to significant arterial hypoxemia and hypercapnia which in the long run can give rise to severe medical conditions.

What are the main complications & how they occur?

Endothelial (Cells lining blood vessel lumen) dysfunction & Atherosclerosis (Fat plaques in vessel walls), Hypertension, Coronary artery disease, Stroke, Congestive heart failure, Cardiac arrhythmias, metabolic conditions and Cognitive impairment are the most detrimental and dreaded long term effects of sleep apnea.

Repetitive episodes of oxygen desaturation and reoxygenation, which is a hallmark feature of OSA (Obstructive Sleep Apnea), imparts a risk for increased oxidative stress which increases free radical production.1 Increase in oxygen free radical production results in lipid peroxidation, protein oxidation, DNA damage, and alteration in cellular homeostasis, leading to up regulation of certain proinflammatory genes. This proinflammatory state coupled with elevated sympathetic nerve activation leads to endothelial dysfunction. Endothelial dysfunction is a major accelerating factor for Atherosclerosis which makes the individual vulnerable for other illnesses.

Sympathetic over activity caused by OSA is considered as the cause for Hypertension. Intermittent hypoxia and negative intra-thoracic pressure leads to chemoreceptor activation and increased sympathetic outflow, and subsequently endothelial dysfunction that predisposes to increased arterial stiffness which leads to development of hypertension.2

It has also been shown that OSA is associated with activation of thrombotic pathways and leads to cardiovascular diseases, especially coronary artery disease. Furthermore, repetitive episodes of hypoxia, intra thoracic pressure swings, and increased afterload create a state of demand-supply mismatch causing cardiac ischemia as demonstrated electrocardiographically by ST depression, accompanying episodes of hypoxia and apnea.3

OSA is another known factor for strokes. As described above, OSA causes hypertension, atherosclerosis, and thrombosis which are major causes for the development of strokes. Several case–control studies have demonstrated an increased prevalence of OSA in individuals with cerebrovascular disease.4

OSA and cardiac failure has a bidirectional relationship. OSA affects cardiac function through adverse effects of hypertension, atherosclerosis and ischemic injury. Conversely, heart failure may contribute to the development of OSA by accumulation of fluid (pulmonary edema) of the upper airway.

Several mechanisms have been investigated linking OSA and insulin resistance/ diabetes mellitus. Intermittent hypoxia associated with increased sympathetic activity directly can alter glucose metabolism or indirectly increase other counter-regulatory hormones like cortisol and, possibly, growth hormone that increases insulin resistance.5

OSA related hypoxia, fluctuating intra thoracic pressure and imbalanced autonomic nervous function predisposes the patient to cardiac arrhythmias (irregular heart rhythm). Untreated sleep apnea has been identified as a risk factor for recurrent atrial fibrillation after treatment by cardioversion. Furthermore, the future development of atrial fibrillation in individuals with sleep apnea was retrospectively investigated; nocturnal hypoxia was identified as a future predictor of arrhythmia development.6

Since it impairs the oxygenation of blood, OSA is known to cause cognitive impairment on a long term basis. Patients with sleep apnea are mostly unaware of their nocturnal symptoms. Patients with OSA commonly experience difficulties in working, memory problems, and concentration, and these symptoms have been best correlated with a degree of hypoxia at night.7

Treatment of OSA has shown to significantly improve the symptoms and quality of life of many patients.

OSA and day to day life

OSA patients are often subject to excessive daytime sleepiness, insomnia, social/sexual dysfunction, impaired work performance and higher prevalence of psychological problems such as depression. As a result, usually these individuals have poor quality of life and poor general health.

Preventing Complications

So, it is of utmost importance to identify sleep apnea early and direct these individuals to get the correct treatment in order to prevent complications. Getting yourself educated about complications of sleep apnea, things you can do at home (proper sleeping position) and when and where to get proper treatment are some important measures. Significant reduction in morbidity and mortality can be achieved by early intervention.

References

  1. Christou K, Markoulis N, Moulas AN, Pastaka C, Gourgoulianis KI. Reactive oxygen metabolites (ROMs) as an index of oxidative stress in obstructive sleep apnea patients. Sleep Breath. 2003 Sep; 7(3):105-10.
  2. Brooks D, Horner RL, Kozar LF, Render-Teixeira CL, Phillipson EA. Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J Clin Invest. 1997 Jan 1; 99(1):106-9.
  3. Hanly P, Sasson Z, Zuberi N, Lunn K. ST-segment depression during sleep in obstructive sleep apnea. Am J Cardiol. 1993 Jun 1; 71(15):1341-5.
  4. Bassetti C, Aldrich MS. Sleep apnea in acute cerebrovascular diseases: final report on 128 patients. Sleep. 1999 Mar 15; 22(2):217-23.
  5. Bratel T, Wennlund A, Carlström K. Pituitary reactivity, androgens and catecholamines in obstructive sleep apnoea. Effects of continuous positive airway pressure treatment (CPAP). Respir Med. 1999 Jan; 93(1):1-7.
  6. Gami AS, Hodge DO, Herges RM, Olson EJ, Nykodym J, Kara T, Somers VK. Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. J Am Coll Cardiol. 2007 Feb 6; 49(5):565-71.
  7. Quan SF, Wright R, Baldwin CM, Kaemingk KL, Goodwin JL, Kuo TF, Kaszniak A, Boland LL, Caccappolo E, Bootzin RR. Obstructive sleep apnea-hypopnea and neurocognitive functioning in the Sleep Heart Health Study. Sleep Med. 2006 Sep; 7(6):498-507.

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Risk Factors for Sleep Apnea

Sleep apnea is a common disorder that is characterized by a marked reduction or even absence of airflow at the mouth or nose during sleep due to increased collapsibility of the airway. Apnea occurs in episodes that result in a reduction of oxygen reaching the brain, and they are typically terminated by minor arousals. Patients with apnea usually present with snoring and/or excessive daytime sleepiness typically while watching TV, talking or – in advanced cases- driving. Bed partners often witness the patient’s apnea and report it.

A number of factors are known to increase the risk for sleep apnea. They include:

1. Age:

Sleep apnea is more common in the elderly. The prevalence of apnea in the elder people (more than 65 years) is two-fold greater than the young. This is explained by many factors, the most important of which are the age-related decrease in the size and shape of the upper airway lumen and the increase in pharyngeal resistance.

2. Male sex:

Males are more liable to develop sleep apnea than females. In general population, the male to female ratio of sleep apnea is two to one. This gender difference is attributed to multiple factors including hormonal changes, differences in pharyngeal collapsibility and central respiratory drive. However, females are liable to develop sleep apnea during pregnancy due to obstruction of the upper airway.

3. Obesity:

Obesity is considered a major risk factor for sleep apnea. It is estimated that about 70% of sleep apnea patients are obese. Fat deposition in the neck and the resulting increased neck circumference cause obstruction of the upper airway and apnea. Typical sleep apnea patients are obese with short thick neck. Some studies indicate that the neck circumference is more predictive of sleep apnea than the body mass index.

4. Family history:

Different studies showed that the first-degree relatives of patients with sleep apnea are more vulnerable to develop the disorder than those with no family history. It was also found that the number of affected relatives is directly correlated with the susceptibility of an individual to develop the disorder.

5. Craniofacial abnormalities:

Over the last the decades, abnormalities in the skull and face were stablished to have an important role is the development of sleep apnea. The most abnormalities identified were smaller mandibles, a narrowed posterior buccal air space, a greater flexion of the skull base and an elongated soft palate. Those abnormalities when present – especially if associated with obesity – cause narrowing of the upper air way and cessation of breathing during sleep.

6. Smoking:

Smoking irritates the airway resulting in edema and narrowing, thereby predisposing to sleep apnea. Studies showed that smokers are 2.5 times more liable to develop sleep apnea than non-smokers.

7. Alcohol consumption:

When taken close to bed time, alcohol relaxes the upper airway muscles increasing its collapsibility and resulting in apnea. Moreover, alcohol can prolong the duration of sleep apnea resulting in more compromise to the oxygen flow to the brain, thereby worsening the complications of apnea.

8. Medical conditions:

Certain medical conditions are associated with sleep apnea. For instance:

  1. Cerebrovascular stroke: sleep apnea is prevalent in ischemic stroke patients. In some studies, more than 70% of ischemic stroke patients have sleep apnea. Sleep apnea is an independent risk factor for ischemic stroke and it has a negative impact on the prognosis and long-term outcome of stroke.
  2. Congestive heart failure: sleep apnea is prevalent in patients with heart failure. Several studies showed that more than 50% of patients with heart failure suffer from sleep apnea.
  3. Ischemic heart disease: Significant sleep apnea was found in about 30-50% of patients with ischemic heart disease. Patients in acute exacerbations of their cardiac condition were found to have more severe forms of apnea.
  4. Acromegaly: About 70% of patients with acromegaly suffer sleep apnea. The enlarged tongue and pharyngeal soft tissue are responsible for obstruction of the airway during sleep.
  5. Diabetes Mellitus: Sleep apnea is highly prevalent in diabetic patients. It is estimated that about 50-80% of diabetic patients suffer from sleep apnea. Sleep apnea is thought to be a consequence of the altered respiratory function caused by diabetic neuropathy, and the disrupted sleep architecture caused by apnea can cause alteration of blood glucose level and consequently diabetes Mellitus.
  6. Hypothyroidism: About 25-30% of patients with hypothyroidism have sleep apnea, and this number is increased to up to 90% in patients with myxedema. The enlarged thyroid gland along with the hypothyroidism weakened muscles are thought to be the responsible mechanisms for sleep apnea.
  7. Cushing syndrome: Weight gain in Cushing patients, fat deposition around the neck, face, trunk and the weak respiratory muscles are responsible for the high prevalence (around 25%) of sleep apnea among those patients.

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