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The Four Components of an Apnea Event
An apnea event is defined as "a complete cessation of airflow for at least ten seconds, or a hypopnea in which airflow decreases by fifty percent for ten seconds or decreases by thirty percent if there is an associated decrease in the oxygen saturation or an arousal from sleep. A hypopnea is a decrease that occurs in breathing but it is not as serious for a patient's health as an apnea is. In this case of hypopnea, the individual's breathing becomes shallower and slower but it does not stop all together. To give an example, if regular breathing is considered to be in the area of seventy to one hundred percent then a hypopnea in relation to this is twenty-six to sixty-nine percent.
There are four elements or components to an apnea event (sometimes referred to as an apneic event). In the first stage the airway of the sufferer caves in or collapses. Then in the second stage the patient attempts to breath but is unable to do so. Thirdly, the level of oxygen in the blood stream drops significantly and finally in the fourth stage, once the brain receives the message of the decreased oxygen level in the blood stream, it sends out the necessity for the person to wake up and resume regular breathing again. It is at this fourth stage that a sleep apnea sufferer's bed partner notices a silence in the person, which is then followed up by the person gasping or choking for air.
When an individual breathes normally air makes it way through the passages of the nose, then goes behind the palate, to the uvula and then to the tongue base. From there the breath maneuvers its way through the muscles of the throat, gets in between the vocal cords and finally arrives in the lungs.
Those who suffer from a deviated septum (meaning the "middle wall of the nose" is separated) can also suffer from a reduction in airflow. In this case the septum can be deviated on one side or both and this can cause a restricted amount of space in which air can flow through. The nose contains what are known as turbinates and these work very much like filters that restrict the flow of air when the nose is infected or swollen.
If an individual's palate or uvula (which is the piece of skin that is visible hanging from the back of the throat) are large or flop around a lot they can be prone to fall backwards in a patient's mouth and by do doing, make the air passage even smaller. When a person lies flat on their back, the tongue if it is large can also fall backwards in the throat and obstruct the flow of air. As well the "side walls of the throat" can come together on occasion and make it very difficult for the proper amount of air to get through.
It is important to remember that it is work of the muscles that control breathing that allow for the expansion of the chest and make it possible for the diaphragm to bring breathe in to the lungs. Negative pressure can make it possible for air to be sucked into the lungs far too quickly. The harder a person struggles to draw a breath, the more negative pressure is exerted on their chest. This causes the tissues of the airway to knit together very tightly. Upon waking in the night and not being able to breath, it is important to stay as calm as possible so as not to send your blood pressure into overdrive.
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