Definition 

Sleep apnea is a condition in which breathing is repeatedly interrupted during sleep. The time period for which the breathing stops or decreases is usually less than a second to 30 seconds. When these episodes occur repeatedly, sleep apnea can seriously disrupt the quality of sleep.

Blocked Airway 

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Causes 

There are three types of respiratory events:

  • Obstructive apnea—caused by a temporary, partial, or complete blockage of the airway
  • Central apnea—caused by a temporary failure to make an effort to breathe
  • Mixed apnea—combination of the first two types

Risk Factors 

These factors increase your chance of developing sleep apnea. Tell your doctor if you have any of these risk factors:

  • Sex: male
  • Overweight
  • Large neck circumference
  • Age: middle to older age
  • Family history of apnea
  • Structural abnormalities of the nose, throat, or other part of the respiratory tract. Examples include:
  • Hypothyroidism
  • Medications: sedatives and sleeping aids
  • Alcohol consumption
  • Smoking

Symptoms 

Symptoms include:

  • Fatigue and sleepiness during waking hours
  • Loud snoring
  • Breathing that stops during the night (noticed by the partner)
  • Repeated wakening at night
  • Unrefreshing sleep
  • Morning headaches
  • Poor concentration or problems with memory
  • Irritability or short temper

People with chronic untreated sleep apnea may be at risk for:

Diagnosis 

An overnight sleep study is used to help diagnose sleep apnea.

Overnight Sleep Study (Polysomnography) 

This test helps detect the presence and severity of sleep apnea. During sleep, it measures your:

  • Eye and muscle movements
  • Brain activity (electroencephalogram)
  • Heart rate
  • Breathing (pattern and depth)
  • Percent saturation of your red blood cells with oxygen

Other Studies 

In addition to sleep studies, your doctor may order:

Treatment 

There are a number of treatment options for sleep apnea, including:

Behavioral Therapy 

  • Lose weight if you are overweight.
  • Avoid using sedatives, sleeping pills, alcohol, and nicotine, which tend to make the condition worse.
  • Try sleeping on your side instead of your back.
  • Place pillows strategically so you are as comfortable as possible.
  • For daytime sleepiness, practice safety measures, such as avoiding driving or operating potentially hazardous equipment.

Mechanical Therapy 

Continuous positive airway pressure (CPAP) entails wearing a mask over your nose and/or mouth during sleep. An air blower forces enough constant and continuous air through your air passages to prevent the tissues from collapsing and blocking the airway. In some cases, dental appliances that help keep the tongue or jaw in a more forward position may help.

Surgery 

In some cases, surgery may be recommended. It is most often beneficial in pediatric patients. Surgery can be used to:

  • Remove excess soft tissue from the nose and/or throat
  • Reposition the jawbone and tongue
  • Create an opening in the windpipe for unobstructed breathing (in life-threatening cases)

Medications 

Only used in central apnea, acetazolamide (Diamox) may help improve the ability to regulate breathing. Overall, there is not a lot of evidence to support the use of medications to treat sleep apnea.

Supplemental oxygen may be given if blood levels of oxygen fall too low during sleep, even after opening the airway.

Prevention 

You may be able to prevent the onset of sleep apnea by maintaining a healthy weight. Avoid alcohol, nicotine, and sedatives, which may contribute to airway obstruction.