Sleep Apnea

What is sleep apnea?

Sleep apnea is a serious, potentially life-threatening condition. It’s far more common
than thought. It happens in all age groups and both genders, but it’s more common in
men. Over 20 million Americans have sleep apnea.

Sleep
apnea is a breathing disorder characterized by brief interruptions of breathing during
sleep. There are 3 types of sleep apnea:

  • Obstructive
    sleep apnea
    happens when air can’t flow into or out of the nose or mouth
    although efforts to breathe continue.
  • Central sleep apnea happens
    when the brain fails to send the right signals to the muscles to start breathing.
    Central sleep apnea is less common than obstructive sleep apnea.
  • Complex sleep apnea. This is a mix of symptoms
    found in both central and obstructive sleep apnea.

Sleep
apnea causes involuntary breathing pauses or “apneic events” during a single night’s
sleep. There may be as many as 20 to 30 or more events per hour. Between events you may
snore. But, not everyone who snores has sleep apnea. Sleep apnea may also make you feel
like you are choking. The frequent interruptions of deep, restorative sleep often lead
to early morning headaches and excessive daytime sleepiness.

During the apneic event, you can’t breathe in oxygen or exhale carbon dioxide. This
results in low levels of oxygen and increased levels of carbon dioxide in the blood.
This alerts the brain to resume breathing and cause an arousal. With each arousal, a
signal is sent from the brain to the upper airway muscles to open the airway. Breathing
is resumed, often with a loud snort or gasp. Frequent arousals, although necessary for
breathing to restart, prevent restorative, deep sleep.

Early
recognition and treatment of sleep apnea is important, as it may be associated with:

  • Irregular heartbeat
  • High
    blood pressure
  • Heart
    attack
  • Stroke
  • Daytime
    sleepiness
  • Increased risk of motor vehicle accidents

What causes sleep apnea?

Certain mechanical and structural problems in the airway cause the interruptions in breathing during sleep. Apnea happens:

  • When
    the throat muscles and tongue relax during sleep and partially block the opening of
    the airway
  • When the
    muscles of the soft palate at the base of the tongue and the uvula relax and sag, the
    airway becomes blocked, making breathing labored and noisy and even stopping it
    altogether
  • In
    overweight people when an excess amount of tissue in the airway causes it to be
    narrowed
  • With a
    narrowed airway, the person continues his or her efforts to breathe, but air can’t
    easily flow into or out of the nose or mouth

Who is at risk for sleep apnea?

Sleep apnea seems to run in some families, suggesting a possible genetic basis. People most likely to have or develop sleep apnea include those who:

  • Snore loudly
  • Are overweight
  • Have high blood pressure
  • Have some physical abnormality in the nose, throat, or other parts of the upper airway

Use of alcohol and sleeping pills increases the frequency and duration of breathing pauses in people with sleep apnea.

What are the symptoms of sleep apnea?

In
either form of sleep apnea, your breathing pauses a number of times during sleep. These
are called apneic events. There may be as many as 20 to 30 or more events per hour.
Between events, you may snore. But, not everyone who snores has sleep apnea. Sleep
apnea may also cause a choking sensation. When breathing restarts, you may snort or
gasp. These frequent breaks in deep, restorative sleep often lead to headaches
and excessive daytime sleepiness.

Other symptoms include dry mouth or sore throat and problems paying attention.

How is sleep apnea diagnosed?

A
primary healthcare provider, pulmonologist, neurologist, or other healthcare provider
with specialty training in sleep disorders may make a diagnosis and start treatment.
Several tests are used to evaluate sleep apnea, including:

  • Polysomnography. This test is done in a sleep lab. It records a variety of
    body functions during sleep. This includes the electrical activity of the brain, eye
    movement, muscle activity, heart rate, respiratory effort, air flow, and blood oxygen
    levels.
  • Home sleep apnea test. This is a portable device that can diagnose sleep
    apnea. Your doctor will arrange for you to take it home to wear during sleep and then
    it returned to the office where results are processed.