What is Sleep Apnea?

Sleep apnea is a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour. Similarly, each abnormally low breathing event is called a hypopnea. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or "sleep study."

There are three forms of sleep apnea: central (CSA), obstructive (OSA), and complex or mixed sleep apnea constituting 0.4 percent, 84 percent and 15 percent of cases respectively. In CSA, breathing is interrupted by a lack of respiratory effort; in OSA, breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common. OSA is linked to such health risks as high blood pressure, stroke, cardiovascular disorder, diabetes and depression.

Regardless of type, an individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years (or decades) without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.

Sleep Apnea Symptoms

It is relatively difficult to identify sleep apnea alone, since the most prominent symptoms occur during sleep. A solution is to record yourself during sleep, ask a bed partner to monitor your sleep, or participate in a sleep study at a local hospital. The major symptoms of sleep apnea are as follows:

  • Pausing when snoring followed by choking or gasping after the pauses
  • Consistent sleepiness throughout the day
  • Headaches or dry mouth upon waking up
  • Inability to concentrate, including learning and memory issues
  • Waking up frequently to urinate
  • Mood swings, irritability, or depression

Not everyone who snores has sleep apnea, and not everyone who has sleep apnea snores during the night. The biggest sign to test if you have sleep apnea or you just snore is how you feel throughout the day. Normal snoring should not interfere with sleeping patterns, so you shouldn’t feel exhausted during the daytime.

Any person can have sleep apnea, but there are certain risk factors that are associated with sleep apnea that put people at a higher risk.

You have a higher risk for obstructive sleep apnea if you are:

  • Overweight
  • Male
  • Over 65 years old
  • A smoker
  • Related to someone with sleep apnea

You have a higher risk for central sleep apnea if you are:

  • Male
  • Over 65 years old

Central sleep apnea is often associated with serious illness such as heart disease, stroke, neurological disorder or brainstem injury.

Treatments for Sleep Apnea

Sleep apnea is a treatable condition and there are multiple treatments that can be done at home such as lifestyle changes or medically. Treatment options include:

  • Lose weight. People who are overweight have extra tissue in the back of their throat, which can block the airway.
  • Quit smoking. Smoking contributes to sleep apnea by increasing inflammation in the throat and airway.
  • Avoid alcohol and sedatives. These drugs will relax the muscles of the throat and can cause difficulty breathing or worsen sleep apnea symptoms.
  • Sleep on your side. Avoid sleeping on your back where gravity is working against you.
  • Use a nasal dilator. Nasal dilators are helpful to open up nasal passages during sleep.
  • Medical treatment with CPAP. A Continuous Positive Airflow Pressure (CPAP) is used commonly for moderate to severe sleep apnea. The CPAP device has a mask that provides a constant stream of air that keeps your airway passages open when you sleep.
  • Medical treatment with BPAP. Bilevel Positive Airway Pressure (BPAP) devices are used for those who cannot adapt to using CPAP. This device automatically adjusts pressure while you’re sleeping, providing more on the inhale and less on the exhale.
  • Mandibular repositioning or tongue retaining device. These two common oral devices open the airway by bringing the jaw lower or moving the tongue forward during sleep.
  • Surgical options. Surgery to increase the size of the airway can reduce sleep apnea episodes.

If you have further questions or concerns about whether or not you have sleep apnea or what you should do about it, give Mina Levi DDS a call at (415) 513-5066 or request an appointment here.