Living with an undiagnosed sleeping disorder can lead to serious side effects, especially when it’s paired with another underlying condition. While there are several different types of sleeping disorders to be aware of, sleep apnea can be especially problematic, especially for those living with spina bifida. To help you understand symptoms, treatment options, and prognosis, here’s some important information regarding the link between sleep apnea and spina bifida.
What is Sleep Apnea?
Sleep apnea is a sleeping disorder that’s characterized by repeated pauses in breathing throughout the night. There are two primary types of sleep apnea, obstructive and central. Obstructive sleep apnea occurs when the muscles in your throat relax to a point that causes a blockage which results in the inability to breathe. Central sleep apnea occurs when the brain doesn’t send the proper messages to the muscles that control breathing. There’s also the possibility that an individual suffers from complex sleep apnea syndrome, which is a mixture of both obstructive and central sleep apnea.
In obstructive sleep apnea, the brain eventually realizes that you’re not breathing and sends a signal to rouse you from sleep, so you can safely resume breathing. In central sleep apnea, the signals are interrupted, but your body will eventually wake up. Oftentimes, this is paired with shortness of breath or problems with falling back asleep.
There are several risk factors that increase an individual’s chance of developing sleep apnea. One of these risk factors is having an underlying medical condition, such as spina bifida.
What is Spina Bifida?
Spina bifida is a type of congenital birth defect that occurs when a baby’s spine and spinal cord don’t form properly. This usually occurs during the third and fourth weeks of pregnancy and can happen anywhere along the spine. Spina bifida is considered a <strong>neural tube defect (NTD) </strong> and can range from mild to severe. The three primary types of spina bifida include myelomeningocele, meningocele, and spina bifida occulta. <strong>Myelomeningocele is the most common type of spina bifida</strong>, but it’s also the most serious. Individuals with this type of spina bifida tend to have serious disabilities throughout their life. Myelomeningocele is characterized by a sac the protrudes through the opening of the back, which contains different parts of the spinal cord and spinal fluid. Meningocele is a type of spina bifida where there is a sac that protrudes, but no parts of the spinal cord are within it. Spina bifida occulta results in a small gap in the spinal cord, but there’s no sac present and very few health problems.
The cause of spina bifida is still largely unknown and close to 95% of babies born with this NTD have no family history of the disease. Factors that may increase the risk of having a baby with spina bifida include folate deficiencies, the use of anti-seizure medications, diabetes, obesity, and hyperthermia during pregnancy. If you’re worried about spina bifida, talk to your doctor about things you can do to reduce your risk.
How is Spina Bifida Related to Sleep Apnea
Since there are now many diagnostic tests that can identify spina bifida during pregnancy, treatment methods have become more optimistic. However, each individual’s treatment is different and is based on the type and severity of spina bifida.
Fetal surgery or infant surgery may help minimize severe disability throughout life, but there are symptoms that are likely to persist. One of which is sleep apnea. When sleeping disturbances occur from early life, they can disrupt physical and cognitive development and lead to more serious complications later on. Other ways that sleep apnea and spina bifida are related include the following:
Weight Gain
Individuals with spina bifida tend to experience higher rates of obesity, as severe cases of the condition can make it difficult to be physically active. Since weight is one of the biggest risk factors of developing obstructive sleep apnea, this increases the risk of individuals living with spina bifida suffering from this sleeping disorder. One of the best ways to reduce the risk of sleep apnea caused by obesity is to eat a healthy diet and undergo physical therapy with a professional to stay as active as you can.
Chiari II Malformation
Chiari II malformation is a type of abnormality within brain cell communication. In this instance, the back of the brain is affected, which is directly related to how the brain controls breathing during sleep. The Chiari II malformation is commonly found in individuals with spina bifida, especially those with myelomeningocele. Therefore, having this type of spina bifida severely increases an individual’s risk of having central sleep apnea.
Scoliosis
Scoliosis is a condition where the spine twists out of normal alignment and off to the side. It can range from mild and non-intrusive to severe. While individuals who experience a mild case of scoliosis don’t necessary need further treatment, more severe cases can have an impact on pulmonary function. Severe scoliosis can also restrict the movement of the lungs, leading to more rapid breathing and the inability to take deep breaths that often occur during REM sleep. Scoliosis is more common in individuals living with spina bifida than those without, thus furthering their risk of developing sleep apnea.
While individuals living with spina bifida have an increased risk of developing sleep apnea, that doesn’t mean there’s no hope. There are ways to treat sleep apnea and help reduce any negative complications associated with impaired sleep. See your doctor at the first sign of symptoms or if you think you may have another type of sleeping disorder.
How to Reduce the Impact of Sleep Apnea When Living with Spina Bifida
While it’s not yet possible to reverse spina bifida or certain associated symptoms, there are things you can do to help reduce the effects of sleep apnea or other sleeping disorders. The best way to do this is to take action early and treat both conditions to the best of your ability.
Get Medical Assistance
The most important step in treating sleep apnea while living with spina bifida is to get medical assistance from your doctor. It’s likely that you already have a specialist who's been helping you navigate life with spina bifida, so talking to them is ideal. This will help you get the proper diagnosis and find spina bifida-specific treatment options.
See a Sleep Specialist
Your doctor may also refer you to a sleep specialist to confirm the presence of a sleeping disorder. Even if your physician has an understanding about the relationship between spina bifida and sleep apnea, it’s important to confirm this occurrence with a sleep expert. This will help you ensure your efforts aren’t wasted during treatment.
Treat Sleep Apnea
Once you’ve received a diagnosis, your sleep specialist will provide you with key insight regarding how to get started with treatment. In mild cases of sleep apnea, your doctor may recommend a few lifestyle changes—especially losing weight or quitting smoking. You may also undergo an allergy test to determine if congestion is contributing to your sleeping disorders. To open up blocked airways and optimize your sleep schedule, your doctor may also have you wear a continuous positive airway pressure (CPAP) machine at night. This helps deliver air pressure that gently forces your airways open and prevents disruptions to breathing during the night. If you find a CPAP machine uncomfortable, talk to your doctor about trying alternative masks. There are also options for bilevel positive airway pressure (BPAP) machines or oral appliances.
Treat Spina Bifida
Finally, another way to help alleviate sleep apnea symptoms is to make sure you’re getting the proper treatment for spina bifida. While the most impactful treatments are either fetal surgery or infant surgery, as you get older lifestyle modifications can improve your quality of life and help you maintain a degree of independence. Regularly see your doctor to undergo physical rehabilitation, physical therapy, and occupational therapy. It’s also common for individuals with spina bifida to work with a dietician to ensure they receive adequate nutrients without gaining excess weight. All of these treatments can help you alleviate bothersome sleep apnea symptoms while improving your longevity and reducing the risk of further complications.
About Byram Healthcare and Apria
For the past 40 years, Byram Healthcare has been a leading provider of urological supplies, which can help make living with spina bifida more manageable. Contact Byram Healthcare today and see why customers have relied on our superior service to make things easy and hassle-free. If you’ve been diagnosed with sleep apnea, Apria offers a comprehensive range of products and services for respiratory therapy and obstructive sleep apnea treatment. Apria is part of the Byram Healthcare family.
Byram is a member of the National Association for Continence’s Trusted Partners Program, whose mission is to provide quality continence care through education, collaboration and advocacy. We are also a proud sponsor of the Spina Bifida Association of New York State, whose mission is to build a better and brighter future for all those impacted by Spina Bifida. We continue to build partnerships in the clinical community to ensure we focus on what’s best for the patient.
