Sleep apnea is a severe sleeping disorder characterized by an interruption in breathing or shallow breathing while an individual is asleep. Each interruption can happen many times in a night and may take a few seconds to a few minutes. It is common among adults and becoming more common among children. If left untreated, it can lead to severe health conditions such as high blood pressure, type 2 diabetes, and stroke.
There are three types of sleep apnea:
Obstructive sleep apnea (OSA). This is the most common form caused by blockage of the airway, usually when the throat muscle relaxes. People of any age can be affected. However, it is more common among 55 to 60 years old.
Central sleep apnea (CSA). This happens when the brain fails to transmit signals to the muscles that control breathing. CSA affects less than 1% of people.
Mixed sleep apnea. This occurs when an individual has central sleep apnea and obstructive sleep apnea.
Obstructive sleep apnea occurs when the muscles in the back of your throat relax, causing a blocked airway.
Some factors can predispose an individual to this form of sleep apnea; this factor includes:
- Nasal congestion
- A narrowed airway
- Family history
- Use of alcohol or sedatives
Central Sleep Apnea (CSA) occurs when the brain’s area that controls your breathing does not function correctly during sleep.
Factors that can predispose an individual to such conditions include:
- Heart disorder
- Using narcotics pain medications
- Loud snoring
- Morning headaches
- Attention problems
- Excessive daytime sleepiness and fatigue
- Awakening with a dry mouth or a sore throat
- Episodes of breathing cessation
- Awakenings at night accompanied by short breath
Sleep apnea may be diagnosed by the assessment of symptoms and risk factors. Such assessment may involve overnight monitoring of your sleeping and other body activities while sleeping.
The standard test for sleep apnea is polysomnography, also called sleep study. In polysomnography, you are observed overnight while connected to many sensors.
During this study, the following information is recorded:
- Sleep stages
- Heart rate
- Blood oxygen level
- Muscle activity
- Waves and breathing rate
- Eye movements
- Audio recording of the loudness of snoring
For some, Home Sleep Apnea Testing (HSAT) may be done. The severity is determined by the number of apnea episodes per hour.
- For normal, 0-5 apnea episodes per hour
- Mild, 5-15 episodes per hour
- Moderate, 16-30 episodes per hour
- Severe, more than 31 episodes per hour
If you have obstructive sleep apnea, an ear, nose, and throat doctor may have to test you to rule out any blockage in your nose or throat.
Your doctor may suggest only lifestyle changes such as smoking cessation, losing weight, and treating your nasal congestion for less severe cases.
If these measures don’t improve your symptoms, several other available treatments can be used.
Continuous positive airway pressure (CPAP), oral appliances, or expiratory positive airway pressure (EPAP) can all be used to open blocked airways.
Surgery may be recommended after all other treatments have failed.
Surgical options may include tissue removal, implants, jaw repositioning, or creating a new passageway.
For central and mixed sleep apnea, treatment may include:
- Supplemental oxygen
- Adaptive servo-ventilation
- Continuous positive airway pressure (CPAP)
- Bilevel positive airway pressure