From time to time, we all have those nights when restful sleep proves elusive and it’s a struggle to stay awake, alert, and productive the following day. But for the millions of Americans who suffer with sleep apnea, this battle against excessive sleepiness plays out every single day.
Sleep apnea is a chronic condition characterized by episodes of involuntary breathing cessation during sleep. These episodes commonly repeat as often as five to 30 times per hour but can be even more frequent.
Sleep apnea sufferers can experience a wide range of problematic symptoms, such as excessive daytime sleepiness, moodiness, irritability, memory problems, difficulty concentrating, depression, poor work or school performance, and an increased risk of vehicle or workplace accidents. Apnea can also worsen or increase the risk of certain serious health conditions, such as obesity, high blood pressure, diabetes, heart arrhythmias, heart attack, and stroke.
There are three distinct forms of sleep apnea, the most common by far being obstructive sleep apnea, or OSA, which occurs when the muscles in the back of the throat relax and the airway becomes blocked by excess tissue in the airway (for example, large tonsils or a prominent tongue base). The other two forms are central sleep apnea, a very rare form that occurs when the brain fails to send the right signals to the muscles that control breathing, and mixed sleep apnea, which combines both the obstructive and central forms.
When breathing stops during an apnea episode, the oxygen level drops, heart rate and blood pressure increase, and the sufferer wakes up just long enough for the throat muscles to open up and allow breathing to resume—but usually not long enough for the individual to become aware of waking. Then, he or she falls back asleep until the next episode.
Though apnea sufferers may not realize these episodes are occurring, their family members or bed partners are often fully aware of what’s going on. Typically, they’ll notice the individual snoring, a brief period of silence when breathing ceases, and then a sudden snorting or gasping sound before breathing resumes.
Most sleep apnea sufferers are snorers (though not all snorers have sleep apnea), and the condition is much more common in men than in women. According to the National Heart, Lung, and Blood Institute, other risk factors include increasing age; having unhealthy lifestyle habits such as drinking alcohol, smoking, or being overweight or obese; having a family history of or genetic predisposition to sleep apnea; and being African American, Hispanic, or Native American.
To diagnose sleep apnea, doctors look at a variety of factors, such as the patient’s medical and family history; a medical exam to check the patient’s mouth, nose, and throat for excess or prominent tissues (e.g., an enlarged soft palate or uvula); and the results of sleep studies, which record what is happening with the patient while he or she is asleep.
The most common sleep study is the polysomnogram, which is conducted overnight in a sleep center. During this procedure, the patient goes to sleep with sensors placed on various parts of the body to record information such as brain activity, blood oxygen level, blood pressure, heart rate, breathing rate, body position, eye movement, and other muscle activity. Doctors may also ask patients to complete a home-based sleep test using a portable monitor to aid in diagnosis.
Currently, the most common form of treatment for sleep apnea is continuous positive airway pressure, or CPAP, which is a small, portable machine that supplies positive air pressure through a face mask worn over the mouth and nose to help keep the airway open while sleeping.
In addition to CPAP, there are various other treatments and measures that can help apnea sufferers get a better night’s sleep. For example, a dentist or orthodontist can fabricate a customized oral appliance (somewhat like a sports mouthguard) that holds the lower jaw forward and pulls the base of the tongue away from the back of the throat, thereby helping to keep the airway open. Also, various surgical approaches can be helpful in some cases. Certain lifestyle changes, such as weight loss, alcohol avoidance, smoking cessation, or changing one’s sleeping position can greatly improve symptoms, as well.
It’s important for individuals with apnea to understand that their condition is not merely an inconvenience that deprives them of sleep, but a serious problem that puts their health at risk. If you or someone close to you is experiencing any of the symptoms described above, see a sleep specialist to determine whether apnea is the cause. The sooner the condition is properly managed, the sooner you can reclaim restful nights.