Sleep-Related Breathing Disorders

During sleep, basic bodily functions continue as usual. However, sometimes things don’t go as they should, and breathing becomes irregular during sleep. This, in turn, affects sleep quality. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes a group of disorders called sleep-related breathing disorders. Let’s explore them in simple terms.

An interruption in breathing is called apnea. There are two types of apnea:

• obstructive apnea: Caused by the structure of the upper airways, which prevents proper airflow when lying down.
• central apnea: Caused by a communication issue between the central nervous system and the respiratory system.

If airflow is only partially blocked, it is called hypopnea rather than apnea.

A different condition occurs when breathing decreases overall, meaning the respiratory system fails to properly take in oxygen and expel carbon dioxide. This is known as hypoventilation.

To diagnose these disorders, doctors analyze a polysomnography test. This test records data on: breathing patterns, brain activity, oxygen levels, heart rate, limb movements, blood pressure.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Obstructive Sleep Apnea/Hypopnea is characterized by:

• at least 5 apnea and/or hypopnea episodes per hour of sleep, along with either:
  • disrupted nighttime breathing (e.g., snoring, gasping)
  • daytime sleepiness
• at least 15 apnea and/or hypopnea episodes per hour, regardless of other symptoms.

Central Sleep Apnea is characterized by:

• at least 5 central apneas per hour of sleep
• no other sleep disorder that could explain the symptoms.

Sleep-Related Hypoventilation is characterized by:

• episodes of reduced breathing with high carbon dioxide levels
• no other sleep disorder that could explain the symptoms.

Sources:

• American Psychiatric Association (2013) - Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• Bernhill, J. W. (2014) - DSM-5 Clinical Cases.

I also recommend watching this: https://youtu.be/gdOZHPGpSWs?si=ZFxM0WXvzOKIsuwD.

If you’d like me to explain another psychology topic in my own words, let me know in the comments!