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There are very serious health consequences of prolonged sleep deprivation. Also, due to the nature of sleep apnea, blood oxygen levels are lower than normal for prolonged periods. This is damaging to both the brain and the heart.
Presently, this problem can be addressed in various ways. Initially, weight loss is attempted, as well as decreased alcohol consumption and smoking. Anyone with a slight insight on human nature can realize how unsuccessful this can be. Then surgery is often attempted to reduce obstruction in the airways. This usually provides some success, but the procedure is painful and often does not provide relief. The final solution is to use a CPAP machine. This is a forced air mask that is worn during sleep to insure proper inhalation.
What has continued to affect the appropriate treatment of this condition is that none of the above "solutions" actually addresses the cause of the problem. Being overweight does not cause the problem, and neither does smoking, drinking, or sleeping on one's back. So, what does cause it?
The Cause of Sleep Apnea
Our bodies have numerous control systems to regulate and maintain physiological conditions. For example, your body's core temperature is maintained with a control system that is always operating. The metabolism is regulated to smoothly and continuously provide enough heat from digestion and fat storage to maintain the desired body temperature. If the temperature gets too high, you begin to sweat. If the temperature gets too low, you burn more stored fat to release heat energy. This is an example of a "proportional" control system, meaning a system that makes continuous corrective actions proportionate to the "error" in the system. Your respiratory system is a similar system. As blood oxygen levels drop, your respirations become deeper and more regular, increasing heart rate.
Another type of system in the body is the "bi-valent system". This is a system that has two states, either active or inactive. A good example of this system is the gag reflex. If a foreign object advances down your throat, your body convulsively expels it by rapid contraction of the esophagus and stomach. This is not a response proportional to the amount of penetration, it is an all or nothing response. You either vomit, or you don't.
There are multiple control systems that work actively in your body, as well as protective systems as well. The two that I need to bring to your attention are directly relevant to the respiration system. One is proportional and the other is bi-valent. As previously mentioned, there is a control system that is responsible for regulating the blood oxygen level. It must be able to control the diaphragmatic muscles in order to regulate the depth of respiration. This is where the trouble begins.
When we start to fall asleep, we move from stage one (drowsiness) into stage 2 sleep, which is the transition stage before entering REM sleep. REM sleep (rapid eye movement) is where we dream. Dreaming is critical to a good night's sleep. When we enter stage two sleep, muscular activity is inhibited. This is a function that occurs primarily to keep the dreamer from physically acting out the movements of their dreams, since the part of the brain that controls muscular movement cannot tell the difference between you dreaming of walking down the stairs and the actual action of walking down the stairs. This muscular inhibition is very important, and is accomplished by suppressing the movement of signals from the brain along the spine. Unfortunately, problems develop as we age.
The first problem is that the muscles of the soft palate become weaker, allowing it to sag.
The second problem is that communication between the diaphragm and the brain becomes obstructed.
The result is that upon entering stage two sleep, the muscles holding the soft palate out of the air-way is reduced, allowing it to sag into the airway. While this is happening, the same inhibition of muscle movement is reducing the signals to the diaphragm on an already obstructed channel. As a result, breathing becomes shallower and shallower because of insufficient signal strength to the diamphragmic muscles.
This drops blood oxygen levels. The normal proportional control cannot maintain the desired level and a safety back-up system comes in. When the blood oxygen level gets low enough to cause the individual to suffer physiological damage, a bi-valent system intervenes and causes the body to make a large and immediate inhalation. This can suck the sagging-soft palate into the airway.
This causes the subject to awaken with a loud snort. Respiration becomes somewhat normal again as the sleeper escapes entry into stage two sleep. However, as they begin to drift off to sleep again, they once again move into stage two, the muscle palate sags, the signal to the diaphragm diminishes and the cycle begins again. The resulting snorts usually awakens the subject every minute or so.
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