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Complications Related to Obstructive Sleep Apnea Obstructive sleep apnea is a common and serious disorder in which breathing repeatedly stops for 10 seconds or more during sleep. The disorder results in decreased oxygen in the blood and can briefly awaken sleepers throughout the night. Sleep apnea has many different possible causes.
In adults, the most common cause of obstructive sleep apnea is excess weight and obesitywhich is associated with soft tissue of the mouth and throat. During sleepwhen throat and tongue muscles are more relaxed, this soft tissue can cause the airway to become blocked.
But many other factors also are associated with the condition in adults. In children, causes of obstructive sleep apnea often include enlarged tonsils or adenoids and dental conditions such as a large overbite.
Less common causes include a tumor or growth in the airway, and birth defects such as Down syndrome and Pierre- Robin syndrome. Down Syndrome causes enlargement of the tongue, adenoids and tonsils and there is decreased muscle tone in the upper airway.
Pierre-Robin syndrome actually has a small lower jaw and the tongue tends to ball up and fall to the back of the throat. Regardless of age, untreated obstructive sleep apnea can lead to serious complications, including cardiovascular diseaseaccidents, and premature death.
Other Risk Factors for Obstructive Sleep Apnea In addition to obesity, other anatomical features associated with obstructive sleep apnea -- many of them hereditary -- include a narrow throat, thick neck, and round head.
Contributing factors may include hypothyroidismexcessive and abnormal growth due to excessive production of growth hormone acromegalyand allergies and other medical conditions such as a deviated septum that cause congestion in the upper airways.
Continued Obstructive Sleep Apnea and Overweight More than half of people with obstructive sleep apnea are either overweight or obese, which is defined as a body mass index BMI of In adults, excess weight is the strongest risk factor associated with obstructive sleep apnea.
Compared to normal-weight adults, those who are obese have a sevenfold increased risk of developing obstructive sleep apnea. But the impact of BMI on obstructive sleep apnea becomes less significant after age Men with a neck circumference above 17 inches 43 centimeters and women with a neck circumference above 15 inches 38 centimeters also have a significantly increased risk of developing obstructive sleep apnea.
In addition, extreme obesity defined as a BMI above 40 is associated with obesity-hypoventilation syndrome Pickwickian syndromewhich can occur alone or in combination with obstructive sleep apnea.
Although modest weight loss improves obstructive sleep apnea, it can be difficult for fatigued and sleepy patients to lose weight. Obstructive sleep apnea is up to four times as common in men as in women, but women are more likely to develop sleep apnea during pregnancy and after menopause.
In older adults, the gender gap narrows after women reach menopause. But hormone replacement therapy is not considered to be an appropriate therapy for the condition, because it can affect health in other ways.
Other factors associated with obstructive sleep apnea include: Sleep apnea also is more common in African-Americans, Hispanics, and Pacific Islanders than in whites.
Complications Related to Obstructive Sleep Apnea Increasing evidence suggests that obstructive sleep apnea is strongly associated with conditions such as high blood pressure hypertensionstrokeheart attackdiabetesgastroesophageal reflux disease, nocturnal anginaheart failurehypothyroidismand an abnormal heart rhythm.
About half of sleep-apnea patients have hypertensionand untreated obstructive sleep apnea increases the risk of heart -related illness and death. In addition, obstructive sleep apnea is associated with excessive daytime sleepiness, which increases the risk for motor vehicle accidents and depression.
Some complications may be related to the release of stress hormones, which may be triggered by frequent decreases in blood oxygen levels and reduced sleep quality.
Stress hormones can increase heart rate and also can lead to the development or worsening of heart failure. Medical treatment -- which includes control of risk factors, use of continuous positive airway pressure CPAP or oral appliances, and surgery -- may improve signs and symptoms of obstructive sleep apnea and its complications.
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