Obstructive Sleep Apnea (OSA)

What it is/Causes

There is an intimate relationship between good sleep and good pain free health. Our brains are capable of tremendous activities and have the ability to juggle a balance of large varieties of chemicals needed to sustain and continue functions in the body it captains.

Simplistically, yet understandably is this brief description:

With chronic pain our brain starts the stimulation of chemicals to help us cope with the unrelenting pain. These chemicals have unpleasant side effects. We get irritable, forgetful, exaggerate the perception of pain that we actually and really do feel, we may have relationship changes, anxiety, panic attacks and insomnia.

The lack of proper sleep either from 1) chronic pain or 2) without pain but due to sleep disorders, creates a scenario that increases pain in both of these sleep disorder situations.

Why? We need REM sleep. REM sleep is the deepest level of sleep we attain. During REM sleep our brain basically calms down and in some cases paralyses the muscles in our body (except for those we need to keep working for sustaining life… like our breathing muscles and heart muscles). During this brief sleep event those inactive muscles are relaxed, cleansed by the circulatory system and get a rejuvenating tune up). If we lack proper amount of this deep sleep, we feel more pain. A body with both chronic pain and with sleep apnea has an unfortunate double whammy working against it for having a good day.

There are two main types of sleep apnea. "Central Sleep Apnea" appears to be related to a malfunction of the brain’s normal signal to breathe. It is less common than "obstructive sleep apnea" (OSA) which may represent cessation of breathing due to mechanical blockage of the airway.

OSA, the most common type of sleep apnea, occurs when air cannot flow into or out of the person’s nose or mouth, although efforts to breathe continue. In a given night, the number of involuntary breathing pauses – or "apneic events" – may be as high as 20 to 60 or more per hour. Snoring and choking between apneic events is common, although not everyone who snores has OSA. The frequent interruptions of deep, restorative sleep often lead to excessive daytime sleepiness and may be associated with early morning headache.

OSA occurs in all age groups and both sexes but is more common in men (it may be underdiagnosed in women) and possibly young African Americans. Early recognition and treatment is important because OSA may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke.

Once diagnosed, OSA is often managed through the use of a Continuous Positive Airway Pressure (CPAP) machine. Dental appliances that reposition the lower jaw and the tongue have been helpful, too.