Effects of Sleep Apnea on Adults

Effects of Sleep Apnea on Adults
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Abstract
Sleep apnea is a common disease characterized by apnea, hypopnea of the upper airway, with a decrease in the oxygen concentration when one sleeps. The disease can affect all age groups leading to cognitive problems in children, adolescents, and adults. This condition has been associated with a high prevalence, and its diagnosis has proved problematic since its signs and symptoms often masquerade as other diseases. As much as the disease has also gained popularity and increased attention from researchers, little is known about the effects of the disease on cognitive functioning and life quality in adults. Sleep apnea negatively impacts an individual’s psychological and physical functioning, including life quality. Impaired cognitive functioning constitutes one of the primary ramifications of sleep apnea. It was also established that sleep apnea culminates in executive attention, memory, and functions. The hypothesis I adopt in this research is that patients diagnosed with sleep apnea are likely to record an overall low quality of life and cognitive functioning compared to the healthy control cluster. I will also adopt a cross-sectional study design, with a sample size of 130, with 65 acting as a control group. In data analysis, I will use SPSS 17 to gain an understanding of descriptive and inferential statistics. The study is expected to establish that sleep apnea undermines the patient’s cognitive functioning and quality of life.
Introduction
Humans spend nearly a third of their lifespans either sleeping or trying to get sleep (Garbarino et al., 2021). However, some abnormalities are induced during sleep, often referred to as sleep-disordered breathing (SDB), with sleep apnea being the most common. Marin-Oto et al. (2019) state that a temporary and recurring halt of breathing caused by repetitive upper airway closure during sleep is a common feature of sleep apnea. The main characteristics of the condition include apneic episodes, which is the stopping of airflow for nearly 10 seconds during sleep, and hypopnea, which is the reduction in the respiratory airflow, combined with a blood oxygen saturation decrease. There are three types of sleep apnea: obstructive sleep apnea (OSA), central sleep apnea (CSA), and complex sleep apnea. OSA is the most prevalent, and it happens when the throat muscles close the airway despite breathing attempts. CSA, on the hand, occurs when the brain does not send the appropriate signals to the muscles to control breathing. Lastly, complex sleep apnea happens as a combination of OSA and CSA. According to Benjafield et al. (2019), sleep apnea has a prevalence of 50% in some countries, while overall, over 1 million people are affected. Among the affected population, males are most likely to get the condition compared to women. However, it is important to note that even children are susceptible to the disease. Sleep apnea is often associated with obesity, smoking, genetics, and gender. Despite the growing number of people with the condition and increased research, sleep apnea still records a high number of diagnoses even in developed countries because its signs and symptoms, including loud snoring, choking during sleep, excessive daytime sleepiness, and insomnia, often masquerade themselves as other conditions such as mental illness and fatigue.
The increase in prevalence and misdiagnosis means that many people have been affected by the disease’s effects without an idea of what they are suffering from. Therefore, this research aims to understand the impact of sleep apnea on the quality of health of adults. I hypothesize that patients with sleep apnea, due to the lower oxygen intake levels during sleep, develop many complications that affect their overall health quality and cognitive functioning. To test my hypothesis, I will utilize a cross-sectional study design with a control group. I will also administer questionnaires and cognitive tests to determine the effect of the disease. Some of the problems I will likely encounter include data accuracy, which I will place as an assumption. Therefore, I assume that the data provided in the questionnaires is truthful. Another challenge is the confounding factors. Sleep apnea is caused by other conditions, such as obesity and lifestyle factors, which are not controllable. The research will be relevant for sleep apnea patients, especially ensuring they do not experience the detrimental health effects related to the illness. It will also apply to healthcare professionals since it will contribute to the growing literature about the disease and reduce the sequelae of the condition. Primary care physicians and specialists will be sufficiently informed of diagnostics approaches to identifying persons with this disease, including the ability to use overnight polysomnography for diagnosis. Finally, this research will also be relevant to society since, with increased information on the condition, many people will have a good quality of life, as compared to before.
Background/Rationale
The history of apnea can be characterized by increasing recognition and understanding. In 1837, Charles dickens first introduced the condition through his novel “The Posthumous Papers of the Pick wick Club.” In the novel, Mr. Pickwick is obese and shows symptoms of what would come to be termed sleep apnea. Mr. Pickwick snored heavily; hence, the Pickwickian syndrome was introduced (though the term is not currently used). Osler and Bruwell first identified the Pickwickian syndrome as part of an obesity triad. OSAS was later discovered as an entity in the 1960s when Gasustaut and colleagues conducted polygraphic studies of patients with Pickwickian syndrome (Malhotra et al., 2021). Later on, Dr. Gulleminault et al. marked a new era in sleep apnea research. For instance, in 1977, they studied the trend in sleep apnea in patients with shy-Drager syndrome and found an association between the two. According to them, this was known as sleep apnea syndrome. Later in 1981, a breakthrough in treating the disease was introduced by Sullivan et al. (1981), known as CPAP, and UPPP was introduced by Fujita et al. (1981). Young et al. (1993) tried to create a link between the prevalence of the disease in women and men and found that 24% of the men were commonly associated with the disease, compared to 9% in the women population. Additional research has since followed regarding the disease, such as developing the STOP-BANG questionnaire as a screening tool for sleep apnea.
The incidence of OSA is rising, with the condition now affecting 20 to 30 percent of males and 10 to 15 percent of females in America (Barletta et al., 2019). Interestingly, OSA is more prevalent in specific populations (i.e., African Americans, Hispanics, and Asians), with 70 to 80 percent prevalence with respect to cases investigated for bariatric surgery and 60 to 70 percent in cerebrovascular disease (Barletta et al., 2019). Despite the rising prevalence and well-established risk factors for sleep apnea, an estimated less than 5 percent of adult Americans are treated or have their conditions clinically managed (Barletta et al., 2019).
Accordingly, research indicates massive economic implications of sleep apnea. The American Academy of Sleep Medicine (AASM) described undiagnosed OSA as a hidden health crisis contributing to the rising healthcare costs for Americans. Sullivan and Frost computed that the annual economic cost of undiagnosed OSA among adult Americans is roughly $149.6 billion. The approximated costs encompass $86.9 billion in productivity loss, $6.5 million in workplace-related accidents, and 26.2 billion in car accidents (American Academy of Sleep Science, 2023). In addition, unt...