Sleep apnea is a serious sleep disorder that occurs when a person's breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times. This means the brain -- and the rest of the body -- may not get enough oxygen.
There are two types of sleep apnea:
- Obstructive sleep apnea (OSA): The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
- Central sleep apnea: Unlike OSA, the airway is not blocked but the brain fails to signal the muscles to breathe due to instability in the respiratory control center.
Am I at Risk for Sleep Apnea?
Sleep apnea can affect anyone at any age, even children. Risk factors for sleep apnea include:
- Male gender
- Being overweight
- Being over the age of forty
- Having a large neck size (17 inches or greater in men and 16 inches or greater in women)
- Having large tonsils, a large tongue, or a small jaw bone
- Having a family history of sleep apnea
- Gastroesophageal reflux, or GERD
- Nasal obstruction due to a deviated septum, allergies, or sinus problems
What Are the Effects of Sleep Apnea?
If left untreated, sleep apnea can result in a growing number of health problems including:
- High blood pressure
- Heart failure, irregular heart beats, and heart attacks
- Worsening of ADHD
In addition, untreated sleep apnea may be responsible for poor performance in everyday activities, such as at work and school, motor vehicle crashes, as well as academic underachievement in children and adolescents.
Sleep Apnea Symptoms
Common sleep apnea symptoms include:
- Waking up with a very sore and/or dry throat
- Loud snoring
- Occasionally waking up with a choking or gasping sensation
- Sleepiness or lack of energy during the day
- Sleepiness while driving
- Morning headaches
- Restless sleep
- Forgetfulness, mood changes, and a decreased interest in sex
- Recurrent awakenings or insomnia
Sleep Apnea Tests and Diagnosis
A polysomnogram -- or sleep study -- is a multiple-component test that electronically transmits and records specific physical activities while you sleep. The recordings are analyzed by a qualified sleep specialist to determine whether or not you have sleep apnea or another type of sleep disorder.
If sleep apnea is determined, you may be asked to return to the lab for further evaluation in order to determine the best treatment option.
What to Expect During a Sleep Study
On the night of your sleep study, you will be assigned to a private bedroom in a sleep center or hospital. Near the bedroom will be a central monitoring area, where the technicians monitor sleeping patients.
You will be hooked up to equipment that may look uncomfortable. However, most people fall asleep with little difficulty.
Equipment Used for a Sleep Study
During a sleep study, surface electrodes will be put on your face and scalp and will send recorded electrical signals to the measuring equipment. These signals, which are generated by your brain and muscle activity, are then recorded digitally. Belts will be placed around your chest and abdomen to measure your breathing. A bandage-like oximeter probe will be put on your finger to measure the amount of oxygen in your blood.
Other Tests and Equipment Used for Sleep Apnea
- EEG (electroencephalogram) to measure and record brain wave activity.
- EMG (electromyogram) to record muscle activity such as face twitches, teeth grinding, and leg movements, and to determine the presence of REM stage sleep. During REM sleep, intense dreams often occur as the brain undergoes heightened activity.
- EOG (electro-oculogram) to record eye movements. These movements are important in determining the different sleep stages, particularly REM stage sleep.
- ECG (electrocardiogram) to record heart rate and rhythm.
- Nasal airflow sensor to record airflow.
- Snore microphone to record snoring activity.
Sleep Apnea Treatments
Sleep apnea treatments range from conservative measures -- such as losing weight if you are overweight or changing sleep positions -- to surgery
Behavioral Modifications for Sleep Apnea
In mild cases of sleep apnea, conservative therapy may be all that is needed. Conservative approaches include:
- Losing weight
- Avoiding alcohol and sleeping pills
- Changing sleep positions to promote regular breathing
- Stop smoking. Smoking can increase the swelling in the upper airway which may worsen both snoring and apnea.
- Avoid sleeping on your back
Continuous Positive Airway Pressure (CPAP)
Continuous positive airway pressure -- also called CPAP -- is a treatment in which a mask is worn over the nose and/or mouth while you sleep. The mask is hooked up to a machine that delivers a continuous flow of air into the nostrils. The positive pressure from air flowing into the nostrils helps keep the airways open so that breathing is not impaired. CPAP is considered by many experts to be the most effective treatment for sleep apnea.
Sleep Apnea and Dental Devices
Dental devices can be made that help keep the airway open during sleep. Such devices can be specifically designed by dentists with special expertise in treating sleep apnea.
Surgery for Sleep Apnea
If you have a deviated nasal septum, markedly enlarged tonsils, or a small lower jaw with an overbite causing the throat to be abnormally narrow, surgery may be needed to correct sleep apnea.
The most commonly performed surgical procedures for sleep apnea include:
- Nasal surgery: Correction of nasal obstructions such as a deviated septum.
- Uvulopalatopharyngoplasty (UPPP): A procedure that removes soft tissue on the back of the throat and palate, increasing the width of the airway at the throat opening.
- Mandibular maxillar advancement surgery: Invasive surgery to correct certain facial abnormalities or throat obstructions that contribute to sleep apnea.
Other Treatment Options for Sleep Apnea
There are minimally invasive office procedures -- such as the pillar palatal implant, somnoplasty, and injection snoreplasty -- that are designed to reduce and stiffen the soft tissue of the soft palate. While these procedures have been effective in treating snoring, their long-term efficacy in treating apnea has not yet been determined.
Sleep Apnea - Home Treatment
- Losing weight. Many people who have sleep apnea are overweight. Small studies have shown that losing weight reduces the number of times an hour that you stop breathing (apnea) or that the airflow to your lungs is reduced (hypopnea).5 Experts agree that weight loss should be part of managing sleep apnea.5
- Limiting the use of alcohol and medicine. Drinking excessive amounts of alcohol or taking certain medicines, especially sleeping pills or sedatives, before sleep may make symptoms worse.
- Getting plenty of sleep. Apnea episodes may be more frequent when you have not had enough sleep.
- Sleeping on your side. Try this: Sew a pocket in the middle of the back of your pajama top, put a tennis ball into the pocket, and stitch it closed. This will help keep you from sleeping on your back. Sleeping on your side may eliminate mild sleep apnea.6 You can try using a special pillow (called a cervical pillow) when you sleep. A cervical pillow can help your head stay in a position that reduces sleep apnea.
If you are using a continuous positive airway pressure (CPAP) machine to help you breathe, use it every night. If you don't use it all night, every night, your symptoms will return right away.