Hypoxia In Obstructive Sleep Apnea
Sleep disorders affect more than 50 million adults in the United States alone, and a further 20 – 30 million experience sleep disruptions on an intermittent basis.
The expression “sleep disorder” is an umbrella term used to refer to dozens of conditions. Approximately 80 different sleep disorders have been identified, some of which pose a higher risk of health complications than others.
In this article, we look in detail at obstructive sleep apnea, a common disorder with potentially serious health implications.
In the second half of the article, we’ll look at how oxygen therapy can help alleviate the symptoms of this sleep disorder and improve overall quality of life.
Key facts about obstructive sleep apnea
Obstructive sleep apnea (often shortened to OSA) is a sleep disorder that interferes with normal breathing patterns. Disordered breathing is the main symptom, as OSA patients experience multiple breathing interruptions throughout the night – sometimes 100 or more in one night.
These interruptions happen when the upper airways relax excessively and collapse during sleep, causing blockages to the normal flow of air. In turn, abnormal breathing patterns cause a drop in oxygen levels, to which the body responds with snoring, choking, or snorting, accompanied by sudden awakenings.
In addition to loud snoring and disordered breathing, other common OSA symptoms include unexplained daytime fatigue, changes to mood and concentration, morning headaches, waking up with a sore throat or a dry mouth, and restless sleep.
Other facts you need to know about OSA include:
- This sleep disorder is more common in men than in women.
- Irrespective of gender, obesity is one of the main risk factors for OSA.
- Age is another risk factor, as researchers have found OSA is 2 to 3 times more common in people aged 65 than in the 30 to 64 year old group.
- Approximately 90% of OSA cases go undiagnosed, as people are unaware of the nightly breathing interruptions and attribute other symptoms to unrelated causes.
Hypoxia and obstructive sleep apnea
Abnormal oxygen levels are one of the trademark signs of OSA, although this doesn’t happen in all cases. For instance, some people are diagnosed with UARS or Upper Airway Resistance Syndrome, which is a less severe form of OSA that does not have a major impact on the body’s oxygen levels.
In most cases though, untreated OSA leads to low oxygen levels, also known as hypoxia. This is one of the possible complications linked to this sleep disorder, and the risks increase the longer this condition is left untreated.
Studies have shown that intermittent but recurrent hypoxia causes increased oxidative stress in the body, which in turn is connected to other negative health outcomes, from a higher risk of developing neurological conditions to cardiovascular disease, high blood pressure, and diabetes.
Researchers have pointed out that even as little as 2 to 4 weeks of intermittent hypoxia are enough to disrupt blood pressure levels.
Another study found that in severe cases, hypoxia can increase the risk of stroketo stroke and brain damage in OSA patients, which confirms the potentially life threatening nature of this condition. This study evaluated the risks in two groups of OSA patients: those who followed treatment and those who did not, and found that treatment withdrawal consistently led to higher risks.
This brings us onto the next section, where we look at the different treatments that can help with this sleep disorder and with its common side effects, such as low oxygen levels.
How is obstructive sleep apnea treated?
Once an OSA diagnosis is confirmed, patients are advised to make certain lifestyle recommendations that can improve their symptoms. In mild cases, OSA symptoms may resolve after losing weight, quitting smoking, reducing alcohol intake, and having a more active lifestyle.
However, most people diagnosed with OSA need to follow some form of treatment. CPAP or Continuous Positive Air Pressure is considered the first line of treatment in moderate and severe OSA cases.
CPAP addresses OSA symptoms and keeps the airways from collapsing by releasing a constant stream of pressurized air into the respiratory system. Oxygenated air is delivered by a special machine and reaches the airways via a tube that is connected to a face mask.
Oxygen therapy: an alternative treatment for obstructive sleep apnea
CPAP therapy often results in fewer breathing interruptions, and can therefore help restore oxygen levels to a normal and safe range.
However, not all people diagnosed with OSA respond to CPAP. Some studies suggest that up to 30% of OSA patients never make it past the initial CPAP trial, whereas others state that compliance ranges between 30% to 60%.
Oxygen therapy has emerged as an alternative treatment in cases where CPAP is not an option, and its effects have been studied for approximately 30 years.
A review of several studies explored the efficiency of this treatment in restoring oxygen levels in patients with OSA. Researchers concluded that oxygen administration helped prevent the negative effects of hypoxia, and that oxygen therapy improved saturation levels at least at the same level as CPAP.
On the other hand, oxygen therapy does not always help with other OSA symptoms, like high blood pressure, fragmented sleep, or daytime fatigue.
In addition, while this therapy can be beneficial to patients who don’t respond to CPAP and to those with minimal symptoms, it can’t be recommended across the board.
Patients with OSA and other comorbidities may see their symptoms worsen after starting oxygen therapy, as is the case of those with COPD or an impaired lung function.
Final thoughts
In summary, oxygen therapy can help reduce the risks associated with hypoxia in some OSA patients. However, it doesn’t replace CPAP therapy, which remains the gold standard in obstructive sleep apnea treatment. Your sleep specialist can make personalized recommendations about the best treatment options for your situation.
Sources:
https://www.sleepfoundation.org/sleep-related-breathing-disorders
https://www.verywellhealth.com/oxygen-therapy-in-sleep-apnea-3015220
https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
