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Published on: Jun 13, 2006
Last modification: Jun 13, 2006
Differences between Sleep Apnea and Sleep Enuresis
by SirGan|
There are many sleep disorders and among them-definitely, the two most common are sleep apnea and sleep enuresis. Their only similarity is that they happen during the night, although, the whole pathophysiological process is completely different!
Sleep apneaSleep apnea, also called childhood obstructive sleep apnea syndrome is characterized by episodic upper airway obstruction that occurs during sleep. Apnea is Greek word for "breath lost"! The airway obstruction may be complete or partial. Sleep disruption leaves some children with daytime somnolence, difficulty waking in the morning, and disturbed concentration. Complaints of nocturnal enuresis, nightmares, and morning headaches may occur.
Types of sleep apnea
Incidence of the sleep apneaObstructive apnea is believed to affect approximately 4% of men and 2% of women in the United States. Now- it is estimated that about 18 million Americans have sleep apnea. Obstructive sleep apnea occurs two to three times more often in older adults and is twice as common in men as in women.
Most common symptomsThe signs and symptoms of obstructive and central sleep apnea can vary and this could turn into real diagnostic problem because it is making the type of sleep apnea more difficult to determine. The most common signs and symptoms of obstructive and central sleep apnea include:
Some additional symptoms that may accompany the sleep apnea are:
What is causing sleep apnea?
It is proven that obstructive sleep apnea occurs when the muscles in the back of throat relax.
Central sleep apnea is condition which is far less common then the obstructive type! It usually occurs when patient’s brain fails to transmit signals to the breathing muscles. Patients usually awake with shortness of breath. People with central sleep apnea may be more likely to remember awakening than people with obstructive sleep apnea are.
Risk factorsObstructive sleep apnea
Central sleep apnea
Diagnosis of sleep apneaThere are three tests which are commonly used to detect sleep apnea:
During this test, patient it attached to equipment that monitors heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels all through the night.
Although most people don’t know much about this method- it is rather simple! This screening method involves using a small machine that monitors and records patient’s oxygen level while patient’s asleep. A simple sleeve fits painlessly over one of fingers to collect the information overnight at home.
This test monitors patient’s brain waves and can reveal repeated awakenings associated with sleep apnea.
Possible complicationsThere are several complications that could occur when someone has sleep apnea:
Treatment of sleep apneaTherapies
When patient is being diagnosed with sleep apnea, he or she may benefit from a machine that delivers air pressure through a mask placed over your nose. There is only one problem - although it is very good method of treating sleep apnea, many people find it uncomfortable.
There are certain dental devices which are designed to open the throat by bringing the jaw forward. It may be also used for relieving snoring and mild obstructive sleep apnea.
Surgery or other proceduresThe goal of surgery for sleep apnea is to remove excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea. Surgical options may include:
During this procedure, tissue from the rear of patient’s mouth and top of your throat is removed. Tonsils and adenoids usually are removed as well.
This procedure involves the use of a laser to remove part of soft palate and shorten the triangular piece of tissue hanging from your soft palate (uvula).
During this procedure doctor uses radiofrequency energy to remove tissue from uvula, soft palate and tongue, which may help decrease snoring and your risk of sleep apnea.
During this procedure, surgeon makes an opening in neck and inserts a metal or plastic tube through which you breathe.
Sleep enuresis – bedwettingSleep enuresis or nocturnal enuresis is one specific disorder which is characterized by persistent bed wetting during the sleep without any organic pathological cause after the age of 4-5 years.
Most children are toilet trained for daytime between the ages of 2 1/2 to 5 years, and night training usually follows around six months later. It is also called Enuresis nocturna, nocturnal bed-wetting, primary enuresis, familial, functional idiopatic, symptomatic, or essential enuresis, night-wetting…
PrevalenceIt is estimated that 15-20% of children wet their beds at age 5, about 5% at age 10, 2-3% at age 14 and 1-2% in young adulthood. It is slightly more common in younger males than females, but the ratio increases to 2:1 around age 11.
Types of sleep enuresis
Possible causes of sleep enuresisThere are many theories as to what causes enuresis.
There is no doubt that genetic or familial factors play an important part for many children. When both parents have, or have had enuresis, there is a higher chance that their children will.
Underlying emotional disturbances, behavioral (ADHD, dyspraxia etc.) and learning difficulties are all considered to play some role in the ethiopathogenesis of sleep enuresis.
Sleep depth arousal levels; a small bladder capacity; nocturnal polyuria, dysfunctional detrusor muscle; or dysfunctional perineal muscles may all be contributing factors.
Stress and illness may also play a significant part.
Diagnosis and prognosis of bedwettingThe appropriate diagnosis is necessary because there are specific criteria! To be considered sleep enuresis, there has to be at least two episodes per month in children 3 to 6 years and at least one episode per month for older individuals. Sleepwalking can also occur during an episode. The doctor may check for signs of a urinary tract infection, constipation, bladder problems, diabetes, or severe stress.
There is no doubt that bedwetting usually goes away on its own. Problem is that, until it does, it can be embarrassing and uncomfortable for almost any child. That’s why parents play a major role and it's a good idea to reassure a child that bedwetting is a normal part of growing up and that it's not going to last forever.
Treatment of sleep enuresisAlthough, most of the times, this condition resolves by it self but unfortunately, no one can tell you how long it will take for your child to reach that point. Approximately 20% of children cease wetting every year without treatment. Therefore, in the majority of cases, no treatment is necessary. The decision to treat a child should be made jointly by the family, patient, and physician.
In general, treatment is considered for relatively older children, those with secondary emotional problems, and children with more severe (frequent) enuresis. It is important to understand that no universally accepted treatment of enuresis is 100% successful. A full physical should be done to rule out medical conditions. There are various techniques used when medical conditions have been ruled out. The most common are:
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