Sleep Apnea

What is sleep apnea?

Sleep apnea is a serious sleep problem. If you have it, you stop breathing for more than 10 seconds at a time many times while you sleep. Another term for this problem is obstructive sleep apnea.

Sleep apnea affects between 2 and 10% of people. It is more common in men than in women. It is also more common in people who are overweight, but there are many people with normal weight who have sleep apnea.

How does it occur?

During normal sleep, throat muscles relax. If, when this happens, there is too little room inside your throat, or too much tissue pressing on the outside of your throat, your airway can become blocked. This blockage stops the movement of air and the amount of oxygen in your blood drops. The drop in oxygen causes the brain to send a signal for you to wake up so that you open up the airway in your throat and start breathing again. If you have sleep apnea, this cycle may repeat as often as 50 or more times an hour. Generally you will not remember waking up but the many arousals will make you sleepy the next day.

Being overweight may cause a narrowing of your airway. Other possible causes of sleep apnea are:

• tobacco smoking
• drinking a lot of alcohol
• lung disease
• an abnormal sleep pattern because of an irregular work schedule or rotating shift work.

Some people inherit a tendency to have sleep apnea.

What are the symptoms?

If you have sleep apnea, your body gets less oxygen when you sleep and you don't sleep well. Common symptoms of sleep apnea are:

• loud snoring interrupted with pauses in breathing, followed by loud gasps
• not feeling rested when you wake up in the morning
• morning headaches
• tiredness or sleepiness during the day
• trouble concentrating
• anxiety, irritability, or depression
• a strong desire to take afternoon naps
• sleepiness while driving.

Many people who snore do not have sleep apnea, but nearly everyone who has sleep apnea snores. If you snore and feel you do not usually get a good night's rest, you should ask your health care provider if you might have sleep apnea.

How is it diagnosed?

Your health care provider may:

• Ask you about your health history and your family's health history.
• Examine you, especially your throat and nasal passages.
• Order blood tests, including a check of the function of your thyroid gland.
• Do a sleep study at a sleep disorders clinic or sleep lab. Your heart rate, brain waves, chest movement, and blood oxygen levels will be measured while you sleep. The study will help determine if the movement of air slows during sleep or if your air movement stops completely during sleep. It will also show how often this happens during sleep.

How is it treated?

It is very important to treat sleep apnea. Untreated sleep apnea can have very serious long-term effects on your health. It may increase your risk of high blood pressure, heart attacks, and sudden death. Effective treatment of sleep apnea may result in normal blood pressure, relief of fatigue, and weight loss.

The most common treatment is use of a machine that sends pressurized air into your nose and throat at night. How much pressure you need is determined by the sleep study. Your health care provider will carefully supervise your use of this breathing machine because minor adjustments may need to be made so it works right for you. This treatment is called continuous positive airway pressure (CPAP).

If you have pressure on your throat because of excess fatty tissue in your throat, your health care provider may suggest a weight-loss program. It may be hard for you to lose weight because you are extremely tired and lack energy to exercise. Use of the breathing machine may help you rest well enough to begin changes in your diet and to increase your physical activity so you can lose weight.

Surgery may be an option if you cannot use the breathing machine regularly and properly. A surgical treatment might include changing the position of the air passage in the nose or removing the tonsils.

Other possible treatments currently being studied are:

• medicines that change the brain chemistry and help muscle tone increase during sleep
• pacemakers that sense when blockages are occurring and stimulate throat muscles to open up the throat before you wake up.

It is too early to say if these experimental treatments will become acceptable treatments of sleep apnea.

How long will the effects last?

If your sleep apnea is caused by a reversible problem, such as overweight or something that can be corrected with surgery, your sleep apnea can be cured. For most people, however, sleep apnea will always be a problem and the CPAP machine will need to be used regularly to get good quality sleep and to prevent the serious complications of sleep apnea.

How can I take care of myself?

• If you think you may have sleep apnea, see your health care provider.
• If you are being treated for sleep apnea, make sure you go to all your follow-up appointments with your provider. If you lose or gain a lot of weight or have new symptoms, talk to your provider to see if you need to change your treatment.

How can I help prevent sleep apnea?

Proper weight control, exercise (according to your health care provider's recommendations), good sleeping habits, not smoking, and avoiding excessive alcohol use will help you have general good health and may help prevent sleep apnea.

For more information, call or write:

American Academy of Sleep Medicine
Phone: (708) 492-0930
Web site: http://www.aasmnet.org
Professional society representing practitioners of sleep medicine and sleep research