Sleep apnea refers to non-breathing episodes during sleep, occurring as frequently as several hundred times per night. Although the individual may have had a full night’s sleep, he or she still feels tired during the day. Sleep apnea is surprisingly common and can progress in severity and become life-threatening if not detected and properly treated.
There are 2 types of sleep apnea. Obstructive sleep apnea is the most common. It is caused by an obstruction from the tonsils, uvula, or fatty tissue, or by involuntary muscle relaxation which blocks airflow during sleep. The second and much less common type, central sleep apnea, is caused by the brain failing to send proper signals to regulate breathing.
Sleep Apnea Symptoms
Sleep apnea is often accompanied by snoring, disturbed sleep and daytime sleepiness. Many people with sleep apnea do not even know they have the condition. Usually a sleep partner or other family members hear the loud snoring, gasping and snorting.
Other symptoms include:
- Morning headaches, dry mouth or cough
- High blood pressure
- Feeling depressed, moody or irritable
- Difficulty concentrating
- Nocturnal snorting, gasping or choking (may wake yourself up)
All of the muscles in the body relax during sleep. In people without obstructive sleep apnea, the throat muscles relax but do not block the airways. In patients with obstructive sleep apnea, the airways become temporarily blocked or narrowed during sleep, preventing air from flowing normally into the lungs.
Sleep Apnea Risk Factors
More than 20 million Americans suffer from sleep apnea. Although it seems to be more common in middle-aged men and affects 40 percent of people over age 60, anyone at any age can develop sleep apnea.
Sleep apnea is a potentially life-threatening condition that requires immediate medical attention. The risks of undiagnosed obstructive sleep apnea include heart attack, stroke, impotence, irregular heartbeat, high blood pressure and heart disease.
In addition, obstructive sleep apnea causes daytime sleepiness that can result in accidents, lost productivity and interpersonal relationship problems. The severity of the symptoms may be mild, moderate or severe. Sleep apnea is a progressive condition that gets worse with age and should not be taken lightly.
Sleep Apnea Diagnosis
Your health care provider will take your medical and sleep history and do a physical exam. If symptoms suggest sleep apnea or another sleep disorder, further diagnostic testing may be performed. You may be referred to a sleep specialist at an accredited sleep disorders center for an overnight sleep test (polysomnography).
Further tests may include:
- Electrocardiogram (ECG)
- Computed tomography scans (CTs)
- Thyroid function studies
- Magnetic resonance imaging scans (MRIs)
Sleep Apnea Treatment
Treatments for sleep apnea vary and depend on the causes and type of sleep apnea you have.
Mild sleep apnea is usually treated with behavioral changes such as:
- Avoiding alcohol or medicines that make you sleep before bedtime.
- Sleeping on your side instead of your back.
- Losing excess weight.
Dental devices (oral mouth devices) can help in some instances. These devices help keep the airway open and may help reduce snoring.
For moderate-to-severe sleep apnea, the most effective treatment is continuous positive airway pressure (CPAP). CPAP treatment includes using a machine and mask to blow air through your airway to keep it open. For more severe apnea, there is a Bi-level (Bi-PAP) machine. The Bi-level machine is different in that it blows air at 2 different pressures. When a person inhales, the pressure is higher and in exhaling, the pressure is lower. Your sleep provider will “prescribe” your pressure and your home health care company will set it up and provide training in its use and maintenance.
Surgery may be an option for some people. It is often a last resort if other treatments did not work and you have severe symptoms. Surgery may be used to:
- Remove extra tissue at the back of the throat
- Correct problems with the structures in the face
- Create an opening in the windpipe to bypass the blocked airway if there are physical problems
- Remove tonsils and adenoids
Treating the condition that is causing central sleep apnea can help manage symptoms. For example, if central sleep apnea is due to heart failure, the goal is to treat the heart failure itself. Devices used during sleep to aid breathing may be recommended. Some types of central sleep apnea are treated with medicines that stimulate breathing.
Wake Forest Baptist Sleep Disorders Center
The Wake Forest Baptist Sleep Disorders Center is accredited by the American Academy of Sleep Medicine. Our multidisciplinary team is made up of board-certified sleep specialists from neurology, pulmonary disease and pediatrics. Our team of sleep experts performs sleep studies and multiple sleep latency tests (MSLT), and provides education, advice and assistance to patients and referring physicians regarding the latest testing and treatments available for all types of sleep disorders.