What is Sleep Apnea?
Obstructive sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep.
Several types of sleep apnea exist, but the most common type is obstructive sleep apnea, which occurs when your throat muscles intermittently relax and block your airway during sleep.
The most noticeable sign of obstructive sleep apnea is snoring, although not everyone who has obstructive sleep apnea snores. You may have sleep apnea if you snore loudly and you feel tired even after a full night’s sleep. If you think you might have sleep apnea, see your doctor.
Treatment is necessary to avoid heart problems and other complications. Anyone can develop obstructive sleep apnea, although it most commonly affects older adults. It’s also especially common in people who are overweight.
Obstructive sleep apnea treatment may involve using a CPAP device to keep your airway open or undergoing a procedure to remove tissue from your nose, mouth or throat. Obstructive sleep apnea occurs when the muscles that support the soft tissues in your throat, such as your tongue and soft palate, temporarily relax. When these muscles relax, your airway is narrowed or closed, and breathing is momentarily cut off.
Sleep Apnea can affect you in many ways. Symptoms can be as common as snoring while sleeping to as extreme as falling asleep while driving. If you experience any of the below conditions, talk to your doctor about Sleep Apnea diagnosis and treatment options.
- Fall asleep while driving
- Excessive daytime sleepiness (hypersomnia)
- Loud snoring
- Observed episodes of breathing cessation during sleep
- Abrupt awakenings accompanied by shortness of breath
- Awakening with a dry mouth or sore throat
- Morning headache
- Frequent urination at night
- Difficulty staying asleep (insomnia)
Consult a medical professional if you experience, or if your partner observes, the following:
- Snoring loud enough to disturb your sleep or that of others
- Shortness of breath that awakens you from sleep
- Intermittent pauses in your breathing during sleep
- Excessive daytime drowsiness, which may cause you to fall asleep while you’re working, watching television or even driving a vehicle
Many people don’t think of snoring as a sign of something potentially serious, and not everyone who has sleep apnea snores. But be sure to talk to your doctor if you experience loud snoring, especially snoring that’s punctuated by periods of silence. With sleep apnea, snoring typically is loudest when you sleep on your back, and it quiets when you turn on your side. Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. Excessive daytime drowsiness (hypersomnia) may be due to other disorders, such as narcolepsy.
Your doctor may make an evaluation based on your signs and symptoms or may refer you to a sleep disorder center (Sleep Lab). There, a sleep specialist can help decide whether you need further evaluation. The evaluation may involve overnight monitoring of your breathing and other body functions during sleep. Sleep Apnea is generally diagnosed using one of three types of overnight sleep studies:
Nocturnal polysomnography. During this test, you’re hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep. This can help your doctor rule out other conditions — such as periodic limb movements or narcolepsy — that can also cause excessive daytime sleepiness, but require different treatment.
Oximetry. This screening method involves using a small machine that monitors and records your blood oxygen level while you’re asleep. A simple sleeve fits painlessly over one of your fingers to collect the information overnight in a sleep lab. If you have sleep apnea, the results of this test will often show drops in your blood oxygen level during apneas and subsequent rises with awakenings.
Portable cardiorespiratory testing. Under certain circumstances, your doctor may provide you with at-home tests to diagnose sleep apnea. These tests usually involve oximetry, measurement of airflow and measurement of breathing patterns. Your doctor may also refer you to an ear, nose and throat doctor (otolaryngologist) to rule out any anatomic blockage in your nose or throat.
For milder cases of obstructive sleep apnea, your doctor may recommend lifestyle changes, such as losing weight or quitting smoking. If these measures don’t improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments are available. PAP therapy is the most common and successful treatment for Obstructive Sleep Apnea, and is designed to help open up a blocked airway during sleep. In other cases, dental devices or surgery may be an option.
Sleep Apnea Therapies
If you have moderate to severe sleep apnea, you may benefit from a machine that delivers positive air pressure (PAP) through a mask placed over your nose while you sleep.
The most common type is called continuous positive airway pressure, or CPAP (SEE-pap). With this treatment, the pressure of the air breathed is continuous and somewhat greater than that of the surrounding air, which is just enough to keep your upper airway passages open. This prevents apnea and snoring. Alternatively, your doctor might prescribe Auto-adjusting Positive Airway Pressure (APAP). APAP works much the same as CPAP, except with APAP the pressure delivered throughout the night adjusts according to your needs rather than delivering a consistent pressure throughout. This can result in a more comfortable therapy experience.
Although PAP is the most consistently successful and most commonly used method of treating sleep apnea, some people find it cumbersome and uncomfortable at first. With some practice and help from our CPAP Specialists, most people learn to adjust the mask to obtain a comfortable and secure fit. You may need to try different types to find a suitable mask. If you’re having particular difficulties tolerating pressure, there are machines that have special adaptive pressure functions to improve comfort. Some people also benefit from using a humidifier and/or heated tubing along with their CPAP system.
Don’t stop using the CPAP machine if you experience problems. Check with our PAP specialists at FPM Solutions to see what adjustments you can make to improve your comfort. In addition, contact your doctor if you still snore despite treatment or begin snoring again. If your weight changes, your doctor may need to adjust the pressure settings.
Another option is wearing a mouthpiece designed to keep your throat open. While positive airway pressure is nearly always an effective treatment, oral appliances are a successful alternative for some patients. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.
Others hold your tongue in a different position. If you and your doctor decide to explore this option, you’ll need to see a dentist experienced in dental sleep medicine appliances for the fitting and follow-up therapy.
A number of devices are available from your dentist. You may need to try different devices before finding one that works for you. Because oral appliances aren’t as consistently effective as CPAP, close follow-up is needed to ensure successful treatment of sleep apnea.
The goal of surgery for sleep apnea is to remove excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea. Speak with your doctor about the benefits and risks associated with such a procedure.