The most common type of sleep apnea is obstructive sleep apnea. The throat is usually fully or partly blocked during sleep, and not enough air can flow into your lungs through your mouth and nose even though your efforts to breathe continue. When this happens, the amount of oxygen in your blood may drop. Your breathing may become hard and noisy and may even stop for short periods of time. Norrmal breaths then start again with a loud snort or choking sound. People with sleep apnea often snore loudly; however, not everyone who snores has sleep apnea.
Central apnea is a rare type of sleep apnea that happens when the area of your brain that controls your breathing doesn't send the correct signals to the breathing muscles. There is then no effort to breathe at all for brief periods. Snoring does not typically occur in central apnea.
With either type of apnea, your sleep is not restful because the pauses in breathing and subsequent drops in blood oxygen levels cause you to move out of deep sleep and into light sleep several times during the night. This can cause you to be very sleepy during the day.
Untreated sleep apnea can increase the chance of having high blood pressure, diabetes, a heart attack, a stroke, and work-related and automobile accidents.
Anyone can have obstructive sleep apnea.
It is estimated that more than 12 million Americans have obstructive sleep apnea. More than half the people who have sleep apnea are overweight, and most snore heavily.
Adults most likely to have sleep apnea include those who:
- Snore loudly
- Are overweight
- Have high blood pressure
- Have decreased size of the airways in their nose, throat, or mouth. This can be caused by the shape of these structures or by medical conditions causing congestion in these areas, such as hay fever or other allergies.
- Have a family history of sleep apnea.
Sleep apnea is more common in men. One out of 25 middle-aged men and 1 out of 50 middle-aged women have sleep apnea that causes them to be very sleepy during the day. Sleep apnea is more common in African Americans, Hispanics, and Pacific Islanders. If someone in your family has sleep apnea, you are more likely to develop sleep apnea than someone without a family history of the condition.
Obstructive sleep apnea can also occur in children who snore. If your child snores, you should discuss it with your child's doctor or health care provider.
The most common signs of sleep apnea are loud snoring, choking or gasping during sleep, and fighting daytime sleepiness (even at work or while driving).
Others signs of sleep apnea may include morning headaches, memory or learning problems, irritability, inability to concentrate on your work, mood swings or personality changes, dry throat upon awaking, and frequent urination at night.
Family members or bed partners are usually the first ones to notice that the person snores and stops breathing while sleeping. It is important for people with sleep apnea to get medical help. They are at higher risk for car crashes and work-related accidents and other medical problems due to their sleepiness.
In order to diagnose sleep apnea, doctors will obtain a detailed medical history by asking you and your family questions about how you sleep and how you function during the day. They will also check your mouth, nose, and throat for extra or large tissues, such as the tonsils, uvula (the tissue that hangs from the middle of the back of the mouth), and soft palate (roof of your mouth in the back of your throat)
In addition, a sleep test to assess what happens with your breathing while you sleep is often necessary. This test is often done in a sleep center or sleep laboratory, which may be part of a hospital. You will probably stay overnight in the sleep center, although sleep studies are sometimes done in the home. The most common sleep recording used to diagnose sleep apnea is called a polysomnogram (poly-SOM-no-gram) or PSG. This test records brain activity, eye movement, muscle activity, breathing and heart rate, the amount of air that moves in and out of your lungs while you are sleeping, and the percent of oxygen in your blood.
Once all your tests are completed, the sleep medicine specialist will review the results and work with you and your family to develop a treatment plan.
Treatment is aimed at restoring regular nighttime breathing and relieving symptoms such as very loud snoring and daytime sleepiness.
If you have mild sleep apnea, some changes in daily activities or habits may be all that are needed:
- Avoid alcohol, smoking, and medications that make you sleepy. They will make it harder for your throat to stay open while you sleep.
- Lose weight if you are overweight—even a little weight loss can improve your symptoms.
- Sleep on your side instead of your back. Sleeping on your side may help keep your throat open.
People with moderate or severe sleep apnea will need to make these lifestyle changes as well, but they will also need additional treatments such as continuous positive airway pressure (CPAP), the use of a mouthpiece, or even surgery.
CPAP is the most common treatment for sleep apnea. During sleep, you will wear a mask over your nose that blows air into your throat at a pressure level that is right for you. The increased airway pressure acts to keep the throat open while you sleep. The air pressure is adjusted so that it is just enough to stop these airways from briefly getting too small during sleep.
Sleep apnea will return if CPAP is stopped or if it is not used correctly. Usually, a technician comes to your home to bring the CPAP equipment. The technician will set up the CPAP machine and make adjustments based on your doctor's orders.
CPAP treatment may cause side effects in some people, including dry or stuffy nose, irritation of the skin on your face, bloating of your stomach, sore eyes, and headaches.
A mouthpiece may be helpful in some people with mild sleep apnea. Some doctors may also recommend this if you snore loudly but do not have sleep apnea.
A dentist or orthodontist will make you a custom-fitted plastic mouthpiece. The mouthpiece will adjust your lower jaw and your tongue to help keep the airway in your throat open while you are sleeping. Air can then flow easily into your lungs because there is less resistance to breathing.
Possible side effects of the mouthpiece include damage to your teeth, gums, and jaw.
You will need to follow up with your dentist or orthodontist to check for any side effects and to be sure that your mouthpiece fits properly.
Some people with sleep apnea may benefit from surgery. The type of surgery depends on the cause of the sleep apnea:
Currently, there are no medications for the treatment of sleep apnea.
Sleep apnea can be very serious. It is important that people with sleep apnea see their doctor to treat and control this disorder. Treatment may improve the person's overall health and happiness, and the quality of sleep both for the patient and the entire family.
Sleep Apnea At A Glance
- Sleep apnea is a common breathing disorder that can be very serious.
- In sleep apnea, your breathing stops or gets very shallow for periods of 10 seconds or longer many times during the night.
- Most people with sleep apnea regularly snore loudly.
- Loud snoring and choking or gasping during sleep and being sleepy during the day are the most common signs of sleep apnea.
- Having a physical exam and providing your doctor with information about your sleep will help to diagnose sleep apnea. Your doctor may also want you to have special sleep tests.
- Treatment is aimed at restoring regular nighttime breathing and relieving symptoms such as loud snoring and daytime sleepiness. Treatment will also help associated medical problems such as high blood pressure and reduce the risk for heart attack and stroke.
Source: National Institutes of Health
