Many of the 2 to 4 percent of adults with sleep apnea don't know they have it. They go for years feeling unrested, often until a bed partner complains. The symptoms of sleep apnea - loud snoring, snorting, and gasping for air - are more likely to trouble one's bed partner. But the dangers are real. Don't ignore sleep apnea. Untreated, sleep apnea can lead to high blood pressure, heart disease, and stroke. Daytime drowsiness can also affect your quality of life, your work performance and it can cause traffic accidents.
What is sleep apnea?
Sleep apnea is a sleep disorder in which there are repeated pauses in breathing or shallow breathing during sleep. There are two types:
- Obstructive sleep apnea. This is the most common type. Soft tissue in the back of the mouth relaxes and blocks the airway during sleep. This type is common in adults who are overweight, but it can also be seen in children with large tonsils.
- Central sleep apnea. The other type is central sleep apnea. With this, the area of the brain that controls respiration does not send the correct signals to the breathing muscles during sleep.
Obstructive and central sleep apnea can occur together.
What are sleep apnea symptoms?
Not all people who snore have sleep apnea, but almost everyone with sleep apnea snores, and usually very loudly. Their breathing stops for several seconds and they switch from deep to light sleep, almost waking up. These breathless pauses can happen from several times a night to as many as 30 times in an hour. This makes sound sleep difficult. But, it's common for someone with sleep apnea to be unaware that their sleep was disturbed. In addition to loud snoring and breathless pauses, someone with sleep apnea may also:
- Choke or gasp
- Toss and turn during sleep
Other symptoms include:
- The need to urinate frequently during sleep
- Not feeling rested upon awakening
- Morning headaches
- Falling asleep during the day
- Trouble concentrating
How is sleep apnea diagnosed?
To find out if you have sleep apnea, your doctor will first ask about your symptoms, whether you snore, wake up frequently at night, and about how you feel during the day. This may include talking with someone who shares your bed or room.
Based on your history, your doctor may refer you to a sleep specialist. This is usually a neurologist or a pulmonologist (lung specialist) trained to evaluate and treat sleep disorders. The specialist may suggest a sleep study. The most common study for diagnosing sleep apnea is called a polysomnogram. While you sleep, the polysomnogram monitors:
- Vital signs, such as breathing, heart rate and blood pressure
- Brain activity
- Eye movement
- Breathing movement
- The amount of oxygen in your blood
This test is often done at a sleep center, where you spend the night while you are being monitored. A limited study may be done at home using portable equipment.
How is sleep apnea treated?
The goal of sleep apnea treatment is to restore normal breathing at night so that you can sleep soundly and feel well-rested during the day. Treatment depends on the severity of your condition and may include:
- Oral appliances. Mild sleep apnea can sometimes be treated successfully with an oral device that your dentist or orthodontist can custom fit for you. The device works by adjusting your lower jaw and tongue to keep you throat open while you sleep. It is worn only during sleep. You need routine checkups with your dentist to make sure the mouthpiece fits properly.
- Continuous positive airway pressure (CPAP). This is a machine that you keep at your bedside. Air flows gently through a tube attached to a face mask that you wear while asleep. The flowing air into the mouth exerts positive pressure that keeps the back of the throat (or airway) open. The device can be adjusted so that you will have the best results.
- Procedures. For more severe sleep apnea, several procedures or surgery may help. Surgical therapy may reconstruct or remove structures in the throat, mouth, or nose that block the airway at night. One procedure removes tissue from the back of the mouth. In another, the jaw is moved forward. Removal of tissue can be done with laser or radio frequency energy, but these methods are usually combined with other treatments.
What else do I need to know about sleep apnea?
You can do a number of things on your own:
- Reach and maintain a healthy weight if you are overweight. Being overweight or obese often contributes to obstructive sleep apnea. Losing even a small amount of weight can go a long way to relieve sleep apnea.
- Avoid alcohol and sedating medication. Drinking alcohol-containing beverages at night and taking sleeping aids can relax the throat and cause snoring.
- Don't sleep on your back. This tends to make sleep apnea worse. Some people ping a tennis ball-filled sock to the back of their nightshirt to keep them from sleeping on their back.
- Inform any treating doctors about sleep apnea. Tell your doctor that you have sleep apnea before any procedure that requires general anesthesia. He or she can take extra steps to keep your airway open.
Created on 03/01/2011
Updated on 03/03/2011
- National Institute of Neurological Disorders and Stroke. Sleep apnea information page.
- American Sleep Apnea Association. Tired of the sleepiness?
- Epstein LJ, Kristo D, Strollo PJ Jr, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. Journal of Clinical Sleep Medicine. 2009;5(3):263-276.
- National Heart Lung and Blood Institute. Sleep apnea.