Apnea - diagnostic, causes and Treatment
Apnea is the temporary and involuntary cessation of BREATHING. Apnea may result from neurologic causes (central apnea), mechanical causes (obstructive apnea), or a combination of both. Central apnea is more common in premature infants, whose nervous systems are not fully developed, and the very elderly, whose nervous systems may be failing. Central apnea is also more common in people who have underlying neurologic disorders or who have heart failure. Obstructive apnea may occur in children who have greatly enlarged tonsils or adenoids and in individuals who have OBESITY. Some people have irregular breathing patterns that are, for them, normal. A doctor should evaluate irregularities in breathing to determine whether the circumstances merit medical intervention.
Most people who have apnea are unaware of apneic episodes, though others who observe them may become alarmed (especially parents or caregivers who notice apnea in young children). Recurrent apnea that occurs during sleep, called OBSTRUCTIVE SLEEP APNEA, is a serious health condition that disrupts the sleeping patterns and results in sleep deprivation though most people are not aware of this because they do not have conscious recollection of the apneic episodes. Researchers believe that severe and persistent obstructive sleep apnea contributes to cardiovascular conditions such as HEART FAILURE.
The Diagnostic Path and Causes Central Apneas
The diagnostic path includes careful analysis of apnea patterns, taking into consideration the person’s age, the onset of the apnea, and adverse effects that may result (including effects resulting from sleep deprivation). The pulmonologist may conduct pulmonary function tests, BLOOD tests to measure levels of erythrocytes (red blood cells) and HEMOGLOBIN in the blood, and X-rays or other diagnostic imaging procedures to look for obstructive causes. A comprehensive NEUROLOGIC EXAMINATION, including ELECTROENCEPHALOGRAM (EEG), may reveal the cause of central apnea.
Treatment targets the underlying cause of the apnea. For some people, surgery to remedy the cause of an obstruction may provide long-term relief (such as TONSILLECTOMY and ADENOIDECTOMY in children who have enlarged tonsils and adenoids). Central apnea that results from damage to the brainstem or other underlying neurologic disorder can be difficult to treat. Oxygen therapy alone may help with some central apneas.