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. If you have sleep apnea, your body gets less oxygen when you sleep and you don’t sleep well. Another term for this problem is obstructive sleep apnea.

Sleep apnea is more common in men than in women, and in people over the age of 50. It’s also more common in people who are overweight, but many people with normal weight have sleep apnea.

It is very important to treat sleep apnea. Untreated sleep apnea may increase your risk of high blood pressure, heart attacks, strokes, and sudden death.

What is the cause?

During normal sleep, throat muscles relax. If you have sleep apnea, your airway closes down when this happens. The closing of your airway slows or stops the movement of air, and the amount of oxygen in your blood drops. The drop in oxygen causes your brain to send a signal for you to wake up and start breathing again. This cycle of not breathing and then waking up to breathe may happen as often as 50 or more times an hour. This condition may also cause you to snore loudly. Generally you will not remember waking up but you may feel tired and sleepy during the day.

Things that can cause or worsen sleep apnea are:

• A narrow airway, from being overweight or having a narrow bone structure in your neck
• A partial blockage of the airway from polyps (noncancerous growths), tumors, or enlarged tonsils
• Smoking
• Drinking alcohol
• Allergies or nasal congestion
• Use of some medicines
• Heartburn

Sometimes sleep apnea runs in families.

What are the symptoms?

Symptoms may include:

• Loud snoring followed by pauses in breathing and loud gasps
• Not feeling rested when you wake up
• Morning headaches
• Feeling tired and sleepy during the day
• Trouble concentrating
• Anxiety, irritability, or depression

Many people who snore do not have sleep apnea, but nearly everyone who has sleep apnea snores.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history, and will examine you. Your healthcare provider may suggest that you have a sleep study in a sleep lab or in your home. For the sleep study, you will have a continuous, all-night recording of your breathing, eye movements, muscle tone, blood oxygen levels, heart rate and rhythm, and brain waves. The study will show if the movement of air slows or stops while you sleep. It will also show how often this happens during sleep.

How is it treated?

The most common treatment is use of a machine that uses pressure to send air into your nose and throat and helps you breathe better while you sleep. This treatment is called continuous positive airway pressure (CPAP). There are several types of CPAP machines. Your sleep specialist can advise which machine will work best for you and help you learn how to use it.

How much pressure you need from the machine is determined by the sleep study. You may need follow up visits with a sleep specialist to see if adjustments to the CPAP machine are needed.

If you cannot use CPAP, a mouth guard that moves the lower jaw forward may help. Your dentist can make a guard for you.

If you are overweight, your healthcare provider may suggest a weight-loss program. You may have trouble losing weight because you are always tired and lack energy to exercise. Use of the CPAP machine may help you feel more rested, have more energy, and be able to make changes so that you can lose weight.

If you smoke, quitting smoking may help improve your sleep apnea.

Sleep apnea may sometimes be treated with surgery. Several kinds of surgery may help:

• Removing polyps or opening the sinus passages in your nose
• Removing your tonsils
• Moving the back of your tongue forward
• Putting in plastic rods to stiffen the roof of your mouth

If your sleep apnea can be treated with surgery or if it is caused by being overweight and you lose weight, sleep apnea can be cured. For most people, however, sleep apnea will be a long time problem and the CPAP machine will need to be used for the rest of their lives.

How can I take care of myself?

Follow the directions from your healthcare provider for using and cleaning the machine. Do not change the CPAP settings without your healthcare provider’s approval. Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider:

• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent sleep apnea?

Talk to your healthcare provider about your concerns and your lifestyle habits. This may help you to identify causes for your sleep problem and will help you know what you can do to help prevent sleep apnea. This may include:

• Eat a healthy diet.
• Try to keep a healthy weight. If you are overweight, lose weight.
• Stay fit with the right kind of exercise for you.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.

You can get more information from:

• American Academy of Sleep Medicine
  708-492-0930
  http://www.aasmnet.org