Sleep apnea is a common condition that affects millions of Americans and the following sleep apnea overview includes a description of this condition including its definition, sub-types, symptoms, causes, diagnosis, treatment, and consequences.
Sleep apnea is a chronic disorder in which one repeatedly stops breathing during the night. These events last 10 seconds or longer, and may occur hundreds of times per night. Someone with sleep apnea may experience loud snoring, brief pauses in breathing, and intermittent gasping. During apnea events, the oxygen level of the blood drops, the heart rate increases, and sleep becomes disrupted as the affected person wakes up to resume breathing. This can have significant consequences on one's health.
Sub-Types of Sleep Apnea
Sleep apnea is a generic term that includes any disorder that causes pauses in breathing during sleep. It may affect someone at any age, but the prevalence of sleep apnea peaks at middle age. There are a few major sub-types, including:
Sleep apnea is not the only problem that can lead to difficulties breathing during sleep. There are a few other problems that do not cause a complete pause in the breathing but may still be problematic, such as:
Symptoms of Sleep Apnea
Aside from the pauses in breathing which are typical of the disorder, there are many other common symptoms in sleep apnea. These symptoms may include:
- Loud, chronic snoring
- Choking or gasping during sleep
- Excessive daytime sleepiness
- Morning headache
- Memory or learning problems
- Feeling irritable
- Poor concentration
- Changes in mood, including depression
- Poor concentration
- Dry throat or mouth upon awakening
There are a few common causes of sleep apnea and situations that can make it worse, including:
- Being overweight or obese (including a large neck size)
- Abnormal upper airway anatomy (including deviated septum)
- Using medications, drugs, or alcohol
- Sleeping on back
- REM or dreaming sleep
How Common is Sleep Apnea?
Sleep apnea is actually relatively common. When sleep apnea is defined as having more than 5 apneic events per hour that result in a symptom (such as excessive daytime sleepiness), then some 2 to 9 percent of people would be afflicted with sleep apnea. When defined as having more than 5 apneic events per hour without self-reported symptoms, the prevalence is 9-24% in general population. Because cardiovascular complications of sleep apnea occur regardless of the presence of daytime symptoms such as sleepiness, the later is considered a true prevalence.
The prevalence increases from 18 to 45 years of age and then reaches a plateau from 55 to 65 years of age. It is approximately twice as common among men.
How to Diagnose Sleep Apnea
The diagnosis of sleep apnea relies on a careful history and physical examination by a qualified physician. Further testing is accomplished using a set of standard diagnostic tests, potentially including:
- Multiple Sleep Latency Testing (MSLT)
- Maintenance of Wakefulness Test (MWT)
- Overnight Oximetry
- Epworth Sleepiness Scale
- Sleep Log
Sleep apnea can be effectively treated in several ways. In general, most individuals will be tried on continuous positive airway pressure (CPAP). This requires choosing a CPAP mask. A similar treatment called bilevel positive airway pressure (BiPAP) is also sometimes used. It may take some time to get used to these therapies, and there are some guidelines that might help solve problems. There are some accommodations such as a chinstrap that can prevent mouth breathing. In addition, it is important to keep your CPAP clean. It is also possible to monitor your CPAP use.
For those who cannot tolerate CPAP, there are some alternative treatments to CPAP. These may include dental devices, positional therapy, or surgeries such as uvulopalatopharyngoplasty (UPPP). In some cases, stimulants such as Ritalin, Provigil, and Nuvigil may be necessary to treat persistent excessive daytime sleepiness. Even quirky alternatives such as playing the didgeridoo have been shown to be an effective treatment. Some individuals may find benefits from caffeine or even scheduled naps. As always, individuals with sleep disorders benefit from observing better sleep guidelines.
Consequences of Sleep Apnea
There can be serious consequences -- even deadly ones -- to untreated sleep apnea, such as:
- Stroke or transient ischemic attacks
- Coronary heart disease
- Heart failure
- Irregular heartbeat
- Heart attack
- High blood pressure
- Heartburn and reflux
- Erectile dysfunction
- Concentration and memory problems
- Sudden death
Sleep apnea is a relatively common disorder that involves pauses in breathing that occur during sleep. There are various sub-types of sleep apnea, and it may be more common in specific populations. The symptoms that result often include excessive daytime sleepiness, but there can also be serious -- and even deadly -- consequences. There are several conditions that may cause sleep apnea or make it worse. Diagnosis typically relies on a careful history and physical examination by a physician and a sleep study such as a polysomnogram. Treatment may be accomplished with the use of continuous positive airway pressure (CPAP) or other alternative therapies such as dental devices or even surgery. There may be certain accommodations that must be arranged in order to maximize therapy compliance. Fortunately sleep apnea can often be successfully treated with favorable results.
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