Do I have Obstructive Sleep Apnea?
Living with the symptoms of a sleep disorder can leave you feeling Beyond Tired®. Learn more from the NSF here.
Loud snoring is only one of the signs of this serious sleep disorder. Learn the other symptoms and effects of sleep apnea and what your treatment options are.
Do you wake up in the morning feeling tired despite going to bed at a decent time and thinking you slept through the night? Has your partner told you that you were snoring all night?
If those situations sound familiar, you might be one of the millions of Americans suffering from sleep apnea, a serious medical disorder characterized by abnormal or interrupted breathing during sleep. Sleep apnea sufferers could experience hundreds of episodes of stopped breathing or irregular breathing each night. This disrupted sleep can cause fatigue throughout the day, leading to poor job performance as well as increasing the likelihood of car crashes and work-related accidents. Mental health can also suffer, leading to or increasing irritability, moodiness and depression. Sleep apnea can also put sufferers at increased risk for serious health issues including high blood pressure, cardiovascular conditions, stroke, Type 2 diabetes, liver problems, metabolic syndrome and complications with medications and surgery.
What Are the Two Forms of Sleep Apnea?
Obstructive sleep apnea (OSA) is the most common form of sleep apnea, and happens when the muscles in the back of your throat relax, causing the airway to narrow or close altogether when you breath in. Because this loss of air can reduce your blood oxygen level, your brain will send a signal to awaken you. Most sleepers won’t notice this sudden reaction although they could snort or choke for air in the process. These reactions can happen from five to 30 times or more per hour.
While loud snoring is a common symptom of obstructive sleep apnea (OSA), some sufferers of OSA don’t snore at all. However, they may experience other symptoms such as waking up with a dry mouth, daytime fatigue, headaches, irritability, lack of focus, night sweats, the frequent need to urinate, and sexual dysfunction.
Central sleep apnea, a less common form of apnea, is when your brain stops sending signals to your breathing muscles, stopping your breathing for short periods of time. These actions can make it more difficult to fall asleep or stay asleep. Sufferers might wake up with shortness of breath.
Regardless of the type of sleep apnea a person may have, the sleep disruptions they experience prevent them from reaping the health benefits of Stage 3 deep sleep, when muscle repair takes place and Stage 4 rapid eye movement (REM) sleep, which supports both short-term and long-term memory. That’s why a lack of deep and REM sleep can have significant negative consequences on long-term health.
Am I at Risk?
About 25 percent of men and 10 percent of women suffer from OSA (central sleep apnea is much less common). Risks increase for people over 50 and those who are overweight, but the condition can affect people of any age, including children. A family history of sleep apnea could increase your likelihood of developing sleep apnea. Existing medical conditions such as congestive heart failure, high blood pressure, Type 2 diabetes, stroke, Parkinson’s disease, polycystic ovarian syndrome, hormonal disorders, and chronic lung diseases such as asthma also can increase risk. Finally, the use of alcohol, tobacco, sedatives, narcotic pain medications, or tranquilizers could be connected with both types of sleep apnea.
How to Start Treatment
If someone in your home can watch you during sleep, have them observe your breathing patterns to see if you stop breathing or gasp for air, as those are signs of sleep apnea. If you are in fact experiencing these things, talk with your healthcare provider. They can schedule an evaluation with a sleep specialist, who can refer you for an overnight sleep study (officially known as a “polysomnogram”). This test will be done in a sleep center where a professional will measure your heart rate, breathing, air flow, blood oxygen, eye movements, and brain and muscle activity while you sleep. You’ll then receive a report about how often breathing stops or is disrupted during a typical sleep cycle. A home sleep test is another option that measures fewer functions but still can confirm a suspected sleep apnea diagnosis. Discuss with your healthcare provider to decide what might be best for you.
What Treatments Are Available?
If you’re diagnosed with OSA, depending on the severity of your condition, you might be able to treat it with a few lifestyle changes. Cutting back on alcohol, losing weight, and quitting smoking can help reduce sleep apnea. Sleeping on your side or stomach instead of on your back can also improve your breathing while asleep, and some might find relief through nasal sprays and breathing strips that cut down snoring and improve airflow. Your sleep specialist might also refer you to a dentist for a mouth appliance to keep the tongue in place or to adjust the jaw to keep the airway open during sleep.
Some patients with OSA or central sleep apnea may be treated using Continuous Positive Airway Pressure (CPAP) therapy, which involves wearing a mask over the nose and mouth while sleeping. These devices prevent your airway from closing by using air pressure to hold up airway tissues while you sleep. If CPAP isn’t effective for those with central sleep apnea, other breathing devices known as adaptive servo-ventilation (ASV) or bilevel positive airway pressure (BPAP) may be used. However, these are not recommended for people with heart failure, so be sure to talk with your healthcare provider about what might be right for you.
For cases that don’t improve through lifestyle changes or devices, surgery might be an alternative.
Common procedures that address OSA include surgeries to the nose, tongue, palate (soft tissue in the back of your mouth and throat) or the bones of your face, neck, and jaw. The aim of tongue surgery is to prevent the tongue from blocking the airway when it relaxes during sleep. There are several different palate surgeries and all aim to open or widen the airway. Common ones are tonsillectomy where large tonsils blocking the airway are removed and uvulopalatopharyngoplasty, or UPPP, where the throat’s tissue is surgically rearranged to create bigger airway. Skeletal surgery often involves changing the shape of the airway by moving the jawbone or partial removal of a bone in the chin and pulling the tongue and neck muscles forward to open up the airway.
Those with symptomatic heart failure who have central sleep apnea have a new surgical treatment option—the implantation of a nerve stimulator, similar to a pacemaker, in your chest. The device will stimulate your phrenic nerve to make you take a breath if it senses that you haven’t taken a breath in too long a period of time.
If you are experiencing any of the signs of sleep apnea, don’t disregard them. Talk to your healthcare provider for diagnosis and treatment. As part of Count On Sleep, NSF collaborates with the American Academy of Sleep Medicine and others on a CDC-funded awareness program to improve recognition of OSA. Learn from sleep medicine specialists how OSA is “More Than A Snore.”