Sleep Apnea: The Sleep (and Breath) Interrupter
A Disorder That Impairs Breathing During Sleep
Obstructive sleep apnea is a chronic sleep disorder that is highly disruptive to healthy, restful sleep. Estimates suggest that sleep apnea is present in at least 25 million adults. Men are regarded at higher risk than women for this disorder. However, scientific research also indicates that sleep apnea is significantly underdiagnosed, especially in women.
Sleep Apnea Basics
A form of sleep-disordered breathing, obstructive sleep apnea involves periods of compromised or interrupted breathing during sleep. These pauses in breathing occur when the airway narrows or collapses during sleep. Full or partial obstruction of the airway leads to periods of diminished breathing (hypopnea) or to complete cessation of breath (apnea). These breathing pauses may last a few seconds or as long as a minute or more before regular breathing resumes.
Often, the interrupted breathing will end with the sleeper making a loud snort or choking sound. These episodes of poor breathing frequently cause the sleeper to wake, though he or she may not remember being roused from sleep. As a result of diminished breathing, less oxygen enters the blood, diminishing supply to the brain and the rest of the body.
Sleep Apnea Symptoms
Sleep apnea disrupts nightly rest and can interfere with daily life, compromising energy, mood, and mental function.
Common Symptoms of Sleep Apnea
- Excessive daytime fatigue and sleepiness
- Headaches, especially in the morning
- Cognitive impairment: trouble with concentration, memory, learning
- Emotional difficulties: anxiety, depression, mood swings, irritability
- Snoring, which may be accompanied by pauses and outbursts of choking or snorting
Some people who experience snoring with obstructive sleep apnea aren’t aware of their snoring or breathing difficulties. Bed partners are often the ones to notice the choking, gasping, and loud snoring that frequently accompanies sleep apnea.
Sleep Apnea: What are the Risks?
Left untreated, obstructive sleep apnea undermines health and increases risks for other medical conditions, including:
- Cardiovascular disease: high blood pressure, heart attack, heart disease, stroke, irregular heartbeat
- Type 2 diabetes
- Pulmonary hypertension
- Eye problems
- Sleep Apnea Diagnosis and Treatment
Severity of sleep apnea is most often measured and diagnosed by the number of apnea or hypopnea episodes that occur within an hour. People with mild sleep apnea experience between 5-14 episodes of interrupted breathing in an hour, while those with moderate sleep apnea will experience 15-29. Severe sleep apnea includes 30 or more apneas or hypopneas an hour. Additional tests used in sleep apnea diagnosis measure other breathing changes and levels of oxygen in the blood.
There are a number of ways to treat sleep apnea effectively, reducing or eliminating symptoms and lowering risks for related medical conditions.
Lifestyle changes. As majority of people with sleep apnea are also overweight. Losing weight can reduce or eliminate sleep apnea, diminish snoring, lessen daytime fatigue, and improve sleep. Quitting smoking and reducing or eliminating alcohol can also improve sleep apnea symptoms.
Positional therapy. For many people with obstructive sleep apnea, the symptoms are significantly worse when they sleep on their backs. Switching to a side-sleeping position can reduce or eliminate breathing problems and snoring for some people. Specially designed pillows that support the head and neck can also help to keep the airway open during sleep. Sleeping with the head elevated can also help. Positional therapy will not work for all cases of sleep apnea, and is often most effective with mild cases of the disorder.
CPAP. Continuous positive airway pressure is the most effective treatment for sleep apnea. The device, worn at night, guides a constant stream of air through the airway, preventing its narrowing or collapse and enabling normal breathing. CPAP is usually the best treatment option for more severe cases of sleep apnea.
Oral appliances. Different types of mouthpieces worn during sleep can help to keep the airway open. These devices typically work by either moving the lower jaw slightly forward, or holding the tongue down and in place to enable unobstructed breathing. Oral appliances can be a useful treatment for sleep apnea in people who don’t tolerate CPAP. These forms of treatment have been demonstrated effective, especially for mild and moderate sleep apnea.
Identifying and treating sleep apnea can make an enormous difference to your health, your sleep, and the quality of your daily life. If you are experiencing symptoms of obstructive sleep apnea, ask your physician for a referral to a sleep specialist.
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