Sleep Apnea

Sleep apnea is a disorder in which breathing stops and starts during sleep. More than half of all cases are diagnosed in people age 40 or older. Sleep apnea is more common in men than women. It is a major cause of daytime sleepiness and can potentially have serious consequences.

Causes

Anyone can have sleep apnea, but you are at higher risk if you:

• Are male

• Are over age 40

• Snore loudly

• Are overweight or obese

• Have high blood pressure

• Have a structural abnormality in your nose, throat or other parts of your upper airway that causes blockage or have nasal allergies and/or chronic nasal congestion

• Have a family history of sleep apnea

• Use alcohol, tobacco or sleeping pills

Symptoms

If you or someone else notices you that you stop and start breathing while sleeping, you may have sleep apnea. Other signs and symptoms include:

• Excessive daytime sleepiness

• Poor concentration

• Depression or irritability

• Early morning headaches

Types of Sleep Apnea

There are two types of sleep apnea: obstructive, which is common, and central, which is extremely rare.

Obstructive sleep apnea occurs when the throat muscles and tongue relax during sleep. This can block the opening of your airway, causing breathing to become difficult or to stop altogether. When your brain senses you aren't getting enough oxygen, it briefly wakes you enough to resume breathing. This cycle can repeat itself as many as 20 or 30 times an hour. For most people with obstructive sleep apnea, each awakening is so brief they are not aware it happened. Although you may not be aware that your sleep was interrupted, this condition prevents you from reaching a deep, restful sleep. Most people with obstructive sleep apnea also snore, although not everyone who snores has sleep apnea.

Central sleep apnea is much less common than obstructive sleep apnea. This condition occurs when the brain fails to send the proper signals to the muscles that control breathing. Unlike the obstructive type, which is intermittent, central sleep apnea is a constant problem and is frequently present from birth.  Congenital central hypoventilation syndrome is an inherited condition that results in both daytime apnea and more profound apnea at night.  The responsible gene has been isolated.  Most people with central sleep apnea require assisted ventilation during sleep.

Treatment

If you have symptoms of sleep apnea, you may have a test called polysomnography. During this test, you are hooked up to equipment that records a variety of body functions during sleep such as pulse rate, respiratory rate, oxygen saturation and EEG activity. Early diagnosis and treatment of sleep apnea is important, because the condition may be associated with irregular heartbeat, high blood pressure, heart attack and stroke.

Treatment for sleep apnea varies, depending on your medical history, the physical examination and the results of your polysomnography.

The most common treatment for sleep apnea is continuous positive airway pressure (CPAP). In this treatment, you wear a mask over your nose during sleep, and slight pressure from a compressor forces air through the nasal passages. The air pressure is adjusted so it is just enough to prevent your throat from collapsing during sleep.

Some people who have sleep apnea may need surgery. Several surgical procedures can be used to increase the size of the airway. This may include the correction of structural deformities or the removal of:

• Adenoids and tonsils (especially in children)

• Nasal polyps (noncancerous tumors) or other growths

• Excess tissue in the airway

Self-Care

If you have obstructive sleep apnea, there are several steps you can take that may help your condition.

• Lose excess weight. Even a 10 percent weight loss can reduce the occurrence of sleep apnea. An ideal body mass index (BMI) is 18.5 to 24.9.  If your BMI is 25 or higher, losing weight may improve or stop sleep apnea.

• If you usually sleep on your back, try sleeping on your side. Special pillows and other devices are available to help you sleep in a side position.

• Don't use alcohol, tobacco, sleeping pills or other medication that cause drowsiness or sedation. These substances can make the airway more likely to collapse during sleep and prolong the periods of sleep apnea. Sleeping pills or sedatives can prevent you from waking up enough to breathe.