Understanding Sleep Apnea

Sleep apnea is a sleep disorder in which breathing is interrupted during sleep. This interruption is caused by short (10-20 second) blocking of the upper airway. This blockage is caused by the short tissues at the back of the throat relaxing too much. Breathing interruptions can occur from five to 100 times per hour; fewer than five is considered normal.

Is Sleep Apnea Dangerous?

Yes. While a person with sleep apnea cannot suffocate – the brain will wake the person up enough to tighten the muscles at the back of the throat - there is an increased risk of sudden cardiac activity that can lead to abnormal heart rhythm and even death.

How Do I Know if I Have Sleep Apnea?

Sleep apnea may happen without the person being aware of the episodes.
The main symptom is overall fatigue, lack of energy and tiredness due to these sleep interruptions. People with sleep apnea do not spend enough time in the deeper stages of sleep. This can lead to moodiness, irritability and increased risk of accidents.

Snoring and Sleep Apnea

Often when breathing starts again, a person with sleep apnea will snort or snore loudly. While this is common, not everyone with sleep apnea will make these sounds.

Other Symptoms

Because of the repetitive awakenings and decreased amount of oxygen in the blood during sleep interruptions, a person with sleep apnea may also have some of the following symptoms:

* Morning headaches
* Problems with concentration
* Problems with memory
* Increased release of stress hormones, such as cortisol (which increases risk for stroke, heart attacks and other cardiovascular problems)

Who Gets Sleep Apnea?

Between five and 25 percent of Americans have sleep apnea, with almost 50 percent of those going undiagnosed. Sleep apnea is almost twice as common in men as it is in women, with one in 25 men having some form of sleep apnea (compared to one in 50 women). Three percent of children and 10 percent of adults over 65 have sleep apnea. Non-Caucasians are more likely to have sleep apnea.

Sleep Apnea Risk Factors

Risk factors for sleep apnea include:

* Being overweight, as extra fat tissue around the neck makes it harder to keep the airway open
* Throat and tongue muscles that “overrelax”
* A thicker neck and smaller head shape
* Congestion
* Family history of sleep apnea
* Enlarged tonsils and adenoids

Diagnosing Sleep Apnea

In addition to taking a detailed family history and examining your mouth, nose and throat for enlarged tissues, a doctor may use the following tests to diagnose sleep apnea:

* Polysomnogram (PSG): This test uses a device that records your breathing throughout the night.
* Multiple Sleep Latency Test (MSLT): This test, often done at a sleep center, involves timing how quickly you can fall asleep during the day. If you fall asleep fast, you are probably not getting enough sleep at night. This test is used when the PSG is normal, but the person is still excessively tired during the day.

Treating Sleep Apnea

Mild forms of sleep apnea can be treated by changing the way you sleep and other lifestyle behaviors. These changes include:

* Sleeping on your side to help your airway stay open
* Avoiding any medications, supplements or other substances that affect your breathing or make you too relaxed, including sleeping pills, herbal supplements and sedatives
* Losing weight, which will reduce the amount of tissue that can block your airway

More serious cases of sleep apnea can be treated by using devices that help keep the airway open throughout the night. These include:

* Continuous Positive Airway Pressure (CPAP) device: This device is a mask worn at night that keeps air flowing enough to prevent the airway from closing.
* Mouthpieces: Some people with sleep apnea find that the condition improves if they wear a specially-designed mouthpiece while they sleep. This mouthpiece helps to keep the throat open during sleep.
* Uvulopatatopharyngoplasty (UPPP): This is a long word for “removing the tonsils, adenoids, a part of the soft palate, uvula, and some soft tissue at the back of the throat” through surgery.

Sources

National Institutes of Health; National Heart, Lung and Blood Institute. Your Guide to Healthy Sleep. NIH Publication No. 06-5271.