Sleep Apnea

Black woman sleeping while lying on sideSleep apnea is a common disorder that can be very serious.

In sleep apnea, your breathing stops or gets very shallow while you are sleeping.
Each pause typically lasts 10-20 seconds or more. These pauses can occur 20 to
30 times or more an hour.

The most common type of sleep apnea is
obstructive sleep apnea. During sleep, enough air cannot flow into your lungs
through your mouth and nose even though you try to breathe. When this happens,
the amount of oxygen in your blood may drop. Normal breaths then start again
with a loud snort or choking sound.

Your sleep is not restful because:

  • These brief episodes of increased airway resistance (and breathing pauses)
    occur many times
  • You may have many brief drops in your oxygen levels of the blood.
  • You move out of deep sleep and into light sleep several times during the
    night, resulting in poor sleep quality.

When your sleep is upset
throughout the night, you can be very sleepy during the day.

  • People with sleep apnea often have loud snoring. However, not everyone who
    snores has sleep apnea. Some people with sleep apnea don’t know they snore.
  • Sleep apnea happens more often in people who are overweight, but even thin
    people can have it.
  • Most people don’t know they have sleep apnea. They don’t know that they are
    having problems breathing while they are sleeping.
  • A family member and/or bed partner may notice the signs of sleep apnea
    first.

Untreated sleep apnea can increase the chance of having high
blood pressure and even a heart attack or stroke. Untreated sleep apnea can also
increase the risk of diabetes and the risk for work-related accidents and
driving accidents.

What Causes Sleep Apnea?

Sleep
apnea happens when enough air cannot move into your lungs while you are
sleeping.

When you are awake and normally during sleep, your throat
muscles keep your throat open and air flows into your lungs. However, in
obstructive sleep apnea, the throat briefly collapses, causing pauses in your
breathing. With pauses in breathing, your oxygen level in your blood may drop.
This happens when:

  • Your throat muscles and tongue relax more than is normal.
  • Your tonsils and adenoids are large.
  • You are overweight. The extra soft tissue in your throat makes it harder to
    keep the throat area open.
  • The shape of your head and neck (bony structure) results in somewhat smaller
    airway size in the mouth and throat area.

With the throat frequently
fully or partly blocked during sleep, enough air cannot flow into your lungs,
even though efforts to breathe continue. Your breathing may become hard and
noisy and may even stop for short periods of time (apneas).

Central
apnea is a rare type of sleep apnea that happens when the area of your brain
that controls your breathing doesn’t send the correct signals to the breathing
muscles. There is then no effort to breathe at all for brief periods. Snoring
does not typically occur in central apnea.

Who Gets Obstructive
Sleep Apnea?

Anyone can have obstructive sleep apnea.

It is estimated that more than 12 million Americans have obstructive
sleep apnea. More than half the people who have sleep apnea are overweight, and
most snore heavily.

Adults most likely to have sleep apnea:

  • Snore loudly
  • Are overweight
  • Have high blood pressure
  • Have decreased size of the airways in their nose, throat, or mouth. This can
    be caused by the shape of these structures or by medical conditions causing
    congestion in these areas, such as hay fever or other allergies.
  • Have a family history of sleep apnea.

Sleep apnea is more common
in men. One out of 25 middle-aged men and 1 out of 50 middle-aged women have
sleep apnea that causes them to be very sleepy during the day. Sleep apnea is
more common in African Americans, Hispanics, and Pacific Islanders. If someone
in your family has sleep apnea, you are more likely to develop sleep apnea than
someone without a family history of the condition.

Obstructive sleep
apnea can also occur in children who snore. If your child snores, you should
discuss it with your child’s doctor or health care provider.

What
Are The Signs and Symptoms of Sleep Apnea?

The most common signs of
sleep apnea are:

  • Loud snoring
  • Choking or gasping during sleep
  • Fighting sleepiness during the day (even at work or while driving)

Your family members may notice the symptoms before you do. You will
likely not otherwise be aware that you have problems breathing while asleep.

Others signs of sleep apnea may include:

  • Morning headaches
  • Memory or learning problems
  • Feeling irritable
  • Not being able to concentrate on your work.
  • Mood swings or personality changes, perhaps feeling depressed
  • Dry throat upon awaking
  • Frequent urination at night.

How Is Sleep Apnea
Diagnosed?

Some of the ways to help doctors diagnose sleep apnea
include:

  • A medical history that includes asking you and your family questions about
    how you sleep and how you function during the day
  • Checking your mouth, nose, and throat for extra or large tissues, for
    example tonsils, uvula (the tissue that hangs from the middle of the back of the
    mouth), and soft palate (roof of your mouth in the back of your throat)
  • A sleep recording of what happens with your breathing.

A sleep
recording is a test that is often done in a sleep center or sleep laboratory,
which may be part of a hospital. You may stay overnight in the sleep center,
although sleep studies are sometimes done in the home. The most common sleep
recording used to find out if you have sleep apnea is called a polysomnogram
(poly-SOM-no-gram) or PSG. This test records:

  • Brain activity
  • Eye movement
  • Muscle activity
  • Breathing and heart rate
  • How much air moves in and out of your lungs while you are sleeping
  • The percent of oxygen in your blood

A PSG is painless. You will go
to sleep as usual. The staff at the sleep center will monitor your sleep
throughout the night. The results of your PSG will be analyzed by a sleep
medicine specialist to see if you have sleep apnea, how severe it is, and what
treatment may be recommended.

In certain circumstances, the PSG can be
done at home. A home monitor can be used to record heart rate, how air moves in
and out of your lungs, the amount of oxygen in your blood, and your breathing
effort. For this test, a technician will come to your home and help you apply
the monitor you will wear overnight. You will go to sleep as usual, and the
technician will come back the next morning to get the monitor and send the
results to your doctor.

Once all your tests are completed, the sleep
medicine specialist will review the results and work with you and your family to
develop a treatment plan. In some cases, you may also need to see another
physician for evaluation of:

  • Lung problems (pulmonologist)
  • Problems with the brain or nerves (neurologist)
  • Heart or blood pressure problems (cardiology)
  • Ear, nose, or throat problems (ENT)
  • Psychologist or psychiatrist

How Is Sleep Apnea
Treated?

Treatment is aimed at restoring regular nighttime
breathing and relieving symptoms such as very loud snoring and daytime
sleepiness.

If you have mild sleep apnea, some changes in daily
activities or habits may be all that are needed:

  • Avoid alcohol, smoking, and medications that make you sleepy. They will make
    it harder for your throat to stay open while you sleep.
  • Lose weight if you are overweight. Even a little weight loss can improve
    your

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