Sleep Apnea


What Is Sleep Apnea?

Sleep apnea affects 2% to 9% of adults (1) in the U.S. Patients experience very shallow breathing, or pauses in breathing that can last 10 or more seconds (2). These breathing difficulties can occur several times per hour (3). Obstructive sleep apnea (OSA), the most common type, occurs among men about 4 times more than women. It is also 7 times more common among people with obesity.

Obstructive sleep apnea (4) (OSA), the most common type, occurs when the airway collapses or becomes blocked during sleep. During healthy sleep, your throat muscles typically relax and stay open to allow for more airflow. For some people, the upper tissues constrict when the throat relaxes. This tightening of the airway momentarily stops them from breathing, which is referred to as an apnea (5). When air does squeeze through, the result is usually loud snoring, snorting, or choking before breathing resumes. Although sleepers with OSA tend to snore loudly, snoring is not automatically a sign of OSA.

There is also central sleep apnea, during which the brain fails to send the right signals to the breathing muscles. This causes brief moments of lapsed breathing. Causes of central sleep apnea (6) include stroke, brain infection, neck issues, severe obesity, and some narcotic painkillers.

Mixed sleep apnea (7) is the third type of apnea, consisting of both obstructive and central factors that cause breathing disruptions. Some people with both types of sleep apnea also suffer from obesity hypoventilation syndrome. This condition occurs when hindered breathing reduces oxygen and increases carbon dioxide (8) in the blood.

What Are the Signs of Sleep Apnea?

Because sleep apnea only happens during sleep, most sufferers do not realize they have it. A partner or family member might be the first to notice the condition, especially if it results in loud and frequent snoring. People with central sleep apnea generally do not snore rhythmically (9). Instead, they experience irregular rhythms and interruptions in their breathing.

Another common symptom of both types of sleep apnea is excessive daytime sleepiness (EDS). This condition causes a person to be regularly tired during the day, even when getting enough sleep at night. Sleep apnea can also affect mood, hinder concentration and memory, and cause irritability and depression. Some sufferers wake up with a headache or excessive mouth dryness (10).

Who Is at Risk for Developing Sleep Apnea?

Males tend to suffer from sleep apnea more often than women, as do people who are overweight. The research is still unclear as to whether sleep apnea is genetic. However, first-degree relatives of sufferers (11), such as children or siblings, are 50% more likely to develop this condition.

Physical characteristics can put a person at risk for sleep apnea, such as having a narrow airway, large tonsils, or large adenoids. A larger-than-usual tongue can also be a risk factor, as it can block the airway during sleep. Having a short lower jaw compared to an upper jaw or a larger neck might also increase the chance of experiencing sleep apnea.

How Does Sleep Apnea Affect Your Health?

Sleep apnea has several health effects. For instance, breathing interruptions during sleep can limit the supply of oxygen to the brain. Consequently, the brain works harder to get more oxygen by coaxing the affected person into breathing again, which results in snorting, gasping, or choking.

Because of these frequent interruptions, sufferers tend to wake unrefreshed and feel tired throughout the day. Fatigue or EDS can impact their cognitive and physical ability, putting them at greater risk for accidents, car crashes, and other injuries.

Research has correlated sleep apnea with stroke, heart disease, and high blood pressure, though treatment for sleep apnea can reduce the risk of blood pressure and cardiac problems. Other physical issues stemming from this condition include depression, irritability, forgetfulness, and persistent headaches. Sufferers might also lose interest in sex or suffer diminished work performance.

When Should You See a Doctor about Sleep Apnea?

People with persistent fatigue should consider talking to their doctor about whether sleep apnea is to blame. A family member or partner who notices a person's loud snoring or paused breathing during sleep should also suggest speaking to a doctor.

During a doctor visit, a physician typically asks the patient about their sleep patterns and habits, instances of daytime sleepiness, and family history of sleep apnea. The doctor will also examine their mouth, throat, and neck.

A sleep study can confirm an OSA diagnosis, especially if the sleep apnea is mild. During the overnight sleep study, the patient sleeps with monitors on the head, body, and one hand. The monitors typically track blood oxygen levels, brain waves, breathing rhythms, and eye movements.

What Are the Treatments for Sleep Apnea?

Some people with sleep apnea benefit from behavioral changes, such as quitting smoking, losing weight, or reducing alcohol consumption. People who take muscle relaxants or sedatives might also consider cutting their dosage. Alcohol and sleep medications before bedtime can also worsen sleep apnea symptoms.

When lifestyle changes are not enough, special devices or pillows might help. For instance, a dental apparatus can open a sleeper's airway by keeping the jaw positioned forward. A pillow that prevents people from sleeping on their backs might also reduce symptoms.

For more severe sleep apnea cases, a doctor might prescribe a continuous positive airway pressure (CPAP) machine. A CPAP machine provides pressurized air through a sleeper's airway via a face or nose mask attached to a tube, keeping the throat open. CPAP therapy is the most effective non-surgical treatment (12) for OSA if a patient uses it regularly.

Oxygen treatment during sleep can help treat central sleep apnea. People with this type of apnea who take narcotic medicines might also get relief from cutting down their dosage.

Another type of intervention is surgery. One such procedure involves implanting a device in the upper chest that sends a signal to the throat muscles if it detects irregular breathing. Other surgeries can expand the airway by removing extra throat tissue, opening the windpipe, or removing the adenoids or tonsils.

Sleep apnea can disrupt a sleeper's normal breathing and get in the way of a good night's rest. Excessive sleepiness during the day might not necessarily be due to sleep apnea, but no one needs to live with it. A visit to the doctor can identify any underlying problems and start the process of sleep apnea treatment.

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