Obstructive Sleep Apnea
What Is Sleep Apnea?
Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.
Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into light sleep. As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.
Sleep apnea often goes undiagnosed as most people who have sleep apnea don’t know they have it because it only occurs during sleep. A family member or bed partner might be the first to notice signs of sleep apnea. Doctors usually can’t detect the condition during routine office visits.
The most common type of sleep apnea is obstructive sleep apnea. In this condition, the airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses.
When you try to breathe, any air that squeezes past the blockage can cause loud snoring. Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone. For example, small children who have enlarged tonsil tissues in their throats may have obstructive sleep apnea.
Who Is at Risk for Sleep Apnea?
- Obese or Overweight individuals
- Men> Women
- High Blood pressure
- Increasing Age
- Anatomically small Airways
- Enlarged tonsils in children or overweight children
- Sleep apnea also is linked to smoking, metabolic syndrome, diabetes and risk factors for stroke and heart failure.
- Race and ethnicity might play a role in the risk of developing sleep apnea. However, more research is needed.
What Are the Signs and Symptoms of Sleep Apnea?
Major Signs and Symptoms:
- Choking or gasping for Breath in the middle of the night
- Feeling tired or sleepy during the day an falling asleep when you are not active
- Morning headaches
- Memory or learning problems and not being able to concentrate
- Feeling irritable, depressed, or having mood swings or personality changes
- Waking up frequently to urinate
- Dry mouth or sore throat when you wake up
- In children, sleep apnea can cause hyperactivity, poor school performance, and angry or hostile behavior.
- Children who have sleep apnea also may breathe through their mouths instead of their noses during the day.
How Is Sleep Apnea Diagnosed?
Sleep apnea can be diagnosed based on medical and family histories, a physical exam, and sleep study results. Your primary care doctor may evaluate your symptoms first. He or she will then decide whether you need to see a sleep specialist.
Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung and nerve specialists and ear, nose, and throat specialists. Other types of doctors also can be sleep specialists.
There are different kinds of sleep studies. If your doctor thinks you have sleep apnea, he or she may recommend a polysomnogram (poly-SOM-no-gram; also called a PSG) or a home-based portable monitor.
How Is Sleep Apnea Treated?
Sleep apnea is treated with lifestyle changes, mouthpieces, breathing devices, and surgery. Medicines typically aren’t used to treat the condition.
The goals of treating sleep apnea are to:
- Restore regular breathing during sleep
- Relieve symptoms such as loud snoring and daytime sleepiness
Treatment may improve other medical problems linked to sleep apnea, such as High blood pressure. Treatment also can reduce your risk for heart disease, stroke, and diabetes.
If you have sleep apnea, talk with your doctor or sleep specialist about the treatment options that will work best for you. Lifestyle changes and/or mouthpieces may relieve mild sleep apnea. People who have moderate or severe sleep apnea may need breathing devices or surgery. If treatment and enough sleep don’t relieve your daytime sleepiness, your doctor will consider other treatment options.
If you have mild sleep apnea, some changes in daily activities or habits might be all the treatment you need.
- Avoid alcohol and medicines that make you sleepy. They make it harder for your throat to stay open while you sleep.
- Lose weight if you’re overweight or obese. Even a little weight loss can improve your symptoms.
- Sleep on your side instead of your back to help keep your throat open. You can sleep with special pillows or shirts that prevent you from sleeping on your back.
- Keep your nasal passages open at night with nasal sprays or allergy medicines, if needed. Talk with your doctor about whether these treatments might help you.
- If you smoke, quit. Talk with your doctor about programs and products that can help you quit smoking.
A mouthpiece, sometimes called an oral appliance, may help some people who have mild sleep apnea. Your doctor also may recommend a mouthpiece if you snore loudly but don’t have sleep apnea. If you use a mouthpiece, tell your doctor if you have discomfort or pain while using the device. You may need periodic office visits so your doctor can adjust your mouthpiece to fit better.
CPAP (continuous positive airway pressure) is the most common treatment for moderate to severe sleep apnea in adults. A CPAP machine uses a mask that fits over your mouth and nose, or just over your nose. The machine gently blows air into your throat. The pressure from the air helps keep your airway open while you sleep.
CPAP treatment may cause side effects in some people. These side effects include a dry or stuffy nose, irritated skin on your face, dry mouth, and headaches. If your CPAP isn’t adjusted properly, you may get stomach bloating and discomfort while wearing the mask.
Some people who have sleep apnea might benefit from surgery. The type of surgery and how well it works depend on the cause of the sleep apnea. Surgery is done to widen breathing passages. It usually involves shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw. Surgery to shrink or stiffen excess tissue is done in a doctor’s office or a hospital. Shrinking tissue may involve small shots or other treatments to the tissue. You may need a series of treatments to shrink the excess tissue. To stiffen excess tissue, the doctor makes a small cut in the tissue and inserts a piece of stiff plastic. Surgery to remove the tonsils, if they’re blocking the airway, might be helpful for some children. Your child’s doctor may suggest waiting some time to see whether these tissues shrink on their own. This is common as small children grow.
For more information, see the Snoring/ Sleep apnea patient tab.