What Can Be Done for My Child’s Recurrent Ear Infections?
Some kids just seem to get ear infection after ear infection. In this month’s blog, Dr. Kushnick breaks down why — and what parents can do when antibiotics alone aren’t cutting it.
Understanding the Different Types of Sleep Apnea
An estimated 83 million American adults have obstructive sleep apnea (OSA), making it the most common form of sleep disordered breathing by far.
But sleep apnea doesn’t work the same way in everyone, and the type you have determines which treatment will work. What fixes OSA won’t necessarily help central sleep apnea (CSA), because the problems causing each type are fundamentally different.
At our Brooklyn, New York, office, Steven D. Kushnick, MD, evaluates patients with sleep apnea to identify what’s interrupting their breathing so he can develop a treatment plan based on the specific type they have.
Sleep apnea stops your breathing repeatedly during sleep
Sleep apnea creates repeated interruptions in breathing throughout the night. These pauses typically last 10 seconds or longer, and can happen dozens or even hundreds of times per night. Each time your breathing stops, your oxygen levels drop and your brain briefly wakes you up just enough to restart breathing.
You usually don’t remember these awakenings, but they fragment your sleep and prevent you from reaching the deep, restorative stages your body and brain need to stay healthy.
Over time, untreated sleep apnea increases your risk for high blood pressure, heart disease, stroke, and type 2 diabetes.
Obstructive sleep apnea blocks the airway
The most common type of sleep apnea is OSA, which occurs when the muscles in your throat relax too much during sleep, allowing the soft tissue at the back of your throat to collapse and block your airway.
Your chest and diaphragm keep trying to pull air in, but nothing gets through until your brain signals you to wake up slightly and reopen the airway. This pattern repeats throughout the night. Several factors increase your risk of OSA, including:
- Excess weight, particularly around the neck
- Large tonsils or adenoids
- A naturally narrow airway
- A thick neck
- Male gender
- Older age
- Family history of sleep apnea
- Nasal congestion from allergies or structural problems
Loud snoring is one of the most recognizable signs, though not everyone who snores has OSA — and not everyone with OSA snores.
Gasping or choking sounds during sleep, along with excessive daytime sleepiness, are strong indicators that your airway is getting blocked repeatedly.
Central sleep apnea affects brain signals
CSA is less common. Your airway stays open, but your brain temporarily stops sending signals to the muscles that control breathing. Without those signals, you simply don’t breathe until your brain restarts the process.
CSA often develops alongside certain medical conditions, such as:
- Heart failure
- Stroke
- Kidney disease
- Opioid use
- High altitude exposure
People with CSA may not snore as loudly as those with OSA, but they still wake up frequently throughout the night and experience severe daytime fatigue.
Complex sleep apnea combines both types
Complex sleep apnea, also called treatment-emergent central sleep apnea, happens when someone being treated for OSA develops CSA, as well. This sometimes shows up after starting continuous positive airway pressure (CPAP) therapy.
The CPAP machine opens the airway and resolves the obstructive component, but CSA begins appearing during sleep studies.
How Dr. Kushnick diagnoses sleep apnea
Dr. Kushnick evaluates your symptoms, medical history, and sleep patterns before recommending diagnostic testing. A sleep study, either in a lab or at home, monitors your breathing, oxygen levels, heart rate, and brain activity throughout the night.
The study shows how many times you stop breathing per hour, how long the pauses last, and whether your airway is collapsing or your brain is failing to signal your breathing muscles. This information determines which type of sleep apnea you have and guides treatment decisions.
Treatment options for each type of sleep apnea
CPAP therapy is often the most effective option for OSA. The machine delivers continuous air pressure through a mask, keeping your airway open throughout the night. Other options include oral appliances that reposition your jaw, weight loss if excess weight is contributing to airway collapse, and surgery to remove tissue or correct structural problems.
CSA usually requires managing the underlying condition causing it, like heart failure or opioid use. Adaptive servo-ventilation (ASV) devices adjust air pressure based on your breathing patterns and can help restart breathing when CSA occurs.
Complex sleep apnea may need switching from CPAP to a bilevel positive airway pressure (BiPAP) device or ASV, which adjusts pressure differently and can address both obstructive and central components of sleep disordered breathing.
Sleep apnea evaluation in Brooklyn, New York
Untreated sleep apnea worsens over time and increases your risk for serious health problems. Dr. Kushnick can determine which type you have and recommend an individualized treatment plan that restores normal breathing during sleep.
Ready to schedule a sleep apnea evaluation? We’re here to help. Call 718-250-8520 to make an appointment with Dr. Kushnick today, or book online at your convenience.
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