Sleep Apnea

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention | Organizations

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Definition

Sleep apnea is a condition in which breathing is repeatedly interrupted during sleep. The time period during which the breathing stops usually lasts from 10 to 30 seconds. When these episodes occur repeatedly, sleep apnea can seriously disrupt the quality of sleep.

Causes

There are three types of sleep apnea:

Obstructive Sleep Apnea – caused by a temporary, partial, or complete block in the airway

Central Sleep Apnea – caused by a temporary failure of the brain to send signals to the muscles that control breathing

Mixed Sleep Apnea - combination of the first two types

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Sex: male
• Overweight
• Age: middle age
• Structural abnormalities of the nose, throat, or other part of the respiratory tract. Examples include:
  • Allergies
  • Polyps
  • Enlarged tonsils
  • Deviated septum
• Hypothyroidism
• High blood pressure
• Heart disease

Symptoms

Symptoms include:

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

Diagnosis

Diagnosis of sleep apnea may be difficult since there are many possible causes of disturbed sleep.

Overnight Sleep Study

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

• Eye and muscle movements
• Brain activity
• Heart rate
• Breathing
• Blood gases, such as oxygen

Multiple Sleep Latency Test

This test measures the speed with which you fall asleep. During the test, you are given several opportunities to fall asleep at times when you would normally be awake. Most people take about 20 minutes to fall asleep. If it takes less than 5 minutes to fall asleep, you are likely to have a sleep disorder.

Treatment

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

Behavioral Therapy

• Lose weight if you are overweight.
• Stop 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. This includes not driving or operating potentially hazardous equipment without getting permission from your doctor.

Mechanical Therapy

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

Surgery

Surgery may be needed in certain situations. Surgery can:

• Remove excess soft tissue from the throat
• Reposition the jawbone
• Create an opening in the windpipe for unobstructed breathing (in very severe cases)

Medications

Acetazolamide – may help improve the ability of the brain to regulate breathing

Supplemental Oxygen – may be given if blood levels fall too low during sleep

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.

Organizations

American Sleep Apnea Association
http://www.sleepapnea.org/

National Sleep Foundation
http://www.sleepfoundation.org/

SOURCES:

American Sleep Apnea Association

"Who Should Get Treated for Sleep Apnea?" Annals of Internal Medicine, June 5, 2001.

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Last reviewed June 2001 by Medical Review Board