Ashwin Lewis
Sleep is a period during which the brain engages in various activities necessary for life and closely linked to one's quality of life. During sleep, breathing patterns change depending on the sleep stage. In non-REM sleep, which constitutes about 80% of an adult's sleeping time, breathing is slow and regular. However, during REM sleep, breathing becomes faster, shallower, and less regular. Sleep disorders like obstructive sleep apnea (OSA) can cause breathing disturbances or interruptions during sleep, impacting overall health and well-being.
| Characteristics | Values |
|---|---|
| Sleep cycle | Non-REM sleep and REM sleep |
| Non-REM sleep | Slow and regular breathing |
| REM sleep | Faster, shallower and less regular breathing |
| REM sleep | Increased brain activity, oxygen levels are lower, carbon dioxide levels are higher |
| Sleep apnea | A common condition where breathing stops intermittently during sleep |
| Sleep apnea risk factors | Older age, male, obesity |
| Sleep apnea treatment | Lifestyle changes, CPAP devices, surgery |
| Sleep and health | Sleep impacts brain function, mental and physical health |
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What You'll Learn
- During REM sleep, breathing becomes shallow and irregular
- Sleep apnea causes breathing to stop intermittently
- Obstructive sleep apnea (OSA) is caused by narrowed airways
- Central sleep apnea occurs when the brain stops sending signals to breathing muscles
- During non-REM sleep, breathing is slow and regular
During REM sleep, breathing becomes shallow and irregular
Sleep is a period during which the brain engages in activities necessary for life and closely linked to one's quality of life. Throughout your sleep, the brain cycles repeatedly through two types of sleep: REM (rapid-eye movement) sleep and non-REM sleep. Non-REM sleep makes up about 80% of an adult's sleeping time, during which breathing is slow and regular. During this stage, the heart rate and breathing regulate, and the body temperature drops.
During REM sleep, the eyes move rapidly behind closed eyelids, and brain waves are similar to those during wakefulness. Breathing becomes faster and more shallow, and the body becomes temporarily paralysed as we dream. This irregular breathing may be due to the relaxation of throat muscles and reduced movement of the rib cage. The cycle then repeats, but with each cycle, less time is spent in the deeper third and fourth stages of sleep and more time in REM sleep.
Sleep apnea is a common condition that affects your breathing while you sleep. It occurs when the airway becomes blocked or narrowed, causing pauses in breathing. This can be due to the relaxation of throat muscles, which can cause the tissues to press on the windpipe and block airflow. Obstructive sleep apnea (OSA) is the most common form, affecting about 1 billion people worldwide. Central sleep apnea (CSA) occurs when the brain stops sending signals to the muscles that regulate breathing.
Treatment for sleep apnea aims to keep the airway open during sleep, such as using continuous positive airway pressure (CPAP) devices or surgery to remove excess tissue blocking the airway. Untreated sleep apnea can lead to serious health issues, including heart disease, high blood pressure, diabetes, and memory problems.
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Sleep apnea causes breathing to stop intermittently
Sleep apnea is a condition that affects your breathing while you sleep, causing you to stop breathing intermittently. It can prevent you from getting restful sleep and can have a significant impact on your physical and mental health. Sleep apnea can manifest in unusual breathing patterns, with breathing becoming faster and deeper, then shallower, until it stops momentarily and starts again. This condition can affect both children and adults, with risk factors including age, as the risk increases with age, and gender, as males are more likely to be diagnosed before the age of 50. Obesity is also a risk factor, although anyone of any body size can develop sleep apnea.
There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA occurs when the airway becomes blocked or narrowed during sleep, causing a pause in breathing. This happens when the muscles in the throat relax, allowing the surrounding tissue to press on and block the windpipe. People with OSA often exhibit loud snoring, interrupted by periods of silence when breathing stops, followed by a loud snort or gasp as they attempt to breathe again.
Central sleep apnea (CSA), on the other hand, is caused by the brain temporarily stopping sending signals to the muscles that regulate breathing. This results in the person with CSA stopping breathing during sleep, often without them realising it. CSA can also cause heavy snoring, similar to OSA.
Sleep apnea can be diagnosed with the help of a healthcare provider, who may use video and audio recordings of the patient sleeping to speed up the diagnostic process. The apnea/hypopnea index (AHI) is used to determine the severity of sleep apnea by measuring the average hourly number of apnea and hypopnea events. Treatment options for sleep apnea include lifestyle changes, such as avoiding sleeping on your back, losing excess weight, and Continuous Positive Airway Pressure (CPAP) therapy, which involves wearing a mask that pumps air under pressure into the airway to keep it open during sleep. In severe cases, surgery may be considered to remove excess tissue at the back of the throat or create an opening in the windpipe to bypass the blocked airway.
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Obstructive sleep apnea (OSA) is caused by narrowed airways
During sleep, the breathing rate and pattern change. Breathing slows down and becomes more regular during non-REM sleep, which makes up about 80% of an adult's sleeping time. During REM sleep, breathing becomes faster, shallower, and less regular. This change in breathing pattern is due to throat muscles relaxing and reduced rib cage movement.
Obstructive sleep apnea (OSA) is a sleep disorder that disrupts breathing during sleep. It is caused by a blockage or narrowing of the upper airway, preventing air from moving through the windpipe. This blockage is typically caused by relaxed muscles and tissues blocking the airway, which can be exacerbated by sleeping on the back. People with OSA may experience frequent wake-ups at night, resulting in a lack of restful sleep.
OSA can affect anyone at any age or body size, but certain risk factors increase the likelihood of developing the condition. Obesity is the most common finding in individuals with OSA, and the condition is also associated with a large neck circumference. Structural abnormalities, such as an underbite, small lower jaw, large tongue, or large tonsils, can contribute to a narrowed airway. Genetic conditions, such as Down syndrome or Prader-Willi syndrome, can also increase the risk of OSA by affecting the development of the head and neck.
The condition can lead to a range of symptoms, including excessive daytime sleepiness, fatigue, and unrefreshing sleep. It can also cause more severe complications, such as arrhythmias and heart disease, if left untreated. Treatment options for OSA include lifestyle changes, such as avoiding alcohol before bedtime and losing excess weight, as well as continuous positive airway pressure (CPAP) therapy and, in some cases, surgery.
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Central sleep apnea occurs when the brain stops sending signals to breathing muscles
Sleep apnea is a condition that affects your breathing while you sleep, preventing restful sleep and impacting your physical and mental health. Central sleep apnea (CSA) occurs when the brain temporarily stops sending signals to the muscles that regulate breathing. This condition often occurs in people with certain medical problems, particularly those affecting the brainstem, which controls breathing. Conditions that can cause or lead to CSA include brain infections, strokes, or conditions of the cervical spine (neck).
CSA can also be caused by heart failure, which can be treated with devices such as nasal continuous positive airway pressure (CPAP) machines, bilevel positive airway pressure (BiPAP), or adaptive servo-ventilation (ASV). CPAP machines work by pumping pressurised air through a hose and mask into the airway to keep it open during sleep. The FDA has approved a medical device called the remede System to treat CSA, which is implanted in the chest and stimulates the nerve that controls breathing muscles when a pause in breathing is detected.
CSA can be diagnosed through a polysomnogram, which involves wearing sensors that monitor heart rate, breathing, blood oxygen levels, and brain waves. A home sleep apnea test does not involve brain wave monitoring and cannot diagnose CSA. A healthcare provider may also recommend a sleep study (polysomnography) to confirm CSA. Treatment options for CSA depend on the underlying cause and may include managing any underlying conditions, changing sleeping positions, or using devices to aid breathing during sleep.
The symptoms of CSA include episodes of disrupted breathing during sleep, with breathing patterns that alternate between deep and heavy breathing and shallow or no breathing. CSA can cause unusual breathing patterns during the day, with fast breathing that gets deeper and then shallower until breathing stops before starting again. CSA can lead to excessive daytime sleepiness or "microsleeps," which can be dangerous when driving or operating machinery. It can also cause arrhythmias and put stress on the heart, which can be life-threatening if left untreated.
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During non-REM sleep, breathing is slow and regular
During non-rapid eye movement (non-REM) sleep, breathing is slow and regular. Non-REM sleep accounts for about 80% of an adult's sleeping time. During this phase, nerve cells in the brain are less active, sending only a few messages. Brain activity is ramped up during REM sleep, along with blood flow to the brain and metabolism.
Non-REM sleep is further divided into four stages. The first stage comes between being awake and falling asleep. The second is light sleep, when heart rate and breathing regulate and body temperature drops. The third and fourth stages are deeper sleep, which precedes the REM phase.
During REM sleep, breathing becomes faster, shallower, and less regular. This may be due to throat muscles relaxing and reduced movement of the rib cage. Most people do not cough during REM sleep, as the cough reflex is suppressed.
Some individuals experience sleep apnea, a condition that affects breathing during sleep. Obstructive sleep apnea (OSA) occurs when the muscles in the throat relax, causing the tissues to press on the windpipe and block airflow. Central sleep apnea (CSA) is caused by the brain temporarily stopping sending signals to the muscles that regulate breathing. Untreated OSA may worsen heart disease and increase the risk of high blood pressure, diabetes, and heart problems.
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Frequently asked questions
Sleep apnea is a common condition that causes your breathing to stop intermittently while you sleep. It occurs when the muscles in your throat relax, causing the surrounding tissue to press on your windpipe and block air movement. This can lead to potentially serious health conditions, such as high blood pressure, diabetes, heart problems, and depression.
The most telltale symptom of sleep apnea is loud snoring, caused by air squeezing through a narrowed or blocked airway. This may be interrupted by long periods of silence, followed by a loud snort or gasp as you attempt to breathe again. Other symptoms include excessive daytime sleepiness, unusual breathing patterns, and sleep disturbances.
Treatment for sleep apnea aims to keep the airway open while sleeping to prevent breathing stoppages. Lifestyle changes, such as losing weight, avoiding alcohol before bedtime, and sleeping on your side, can help relieve mild sleep apnea symptoms. More severe cases may require continuous positive airway pressure (CPAP) therapy, where a mask is worn over the nose and/or mouth to pump air into the airway. In some cases, surgery may be an option to remove excess tissue blocking the airway.
