Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. There are 3 types of sleep apnea—Obstructive, Central and Complex. Obstructive Sleep Apnea (OSA) is the most common and results from the airway collapsing or becoming blocked during sleep. Central Sleep Apnea is less common and refers to when your brain stops sending signals to your breathing muscles. Complex Sleep Apnea is when someone has both Obstructive and Central Sleep Apnea.
According to the National Sleep Foundation, it is estimated that over 18 million American adults have sleep apnea. Often it is the person’s partner who first notices symptoms of sleep apnea—snoring, stoppages in breathing and/or gasping for air. Frequent awakenings from sleep apnea often result in a poor night’s sleep and feeling excessively tired throughout the day. Other symptoms include snoring, high blood pressure and in many cases an exhausted partner who also doesn’t sleep well. Untreated sleep apnea can be very dangerous or deadly, most notably increasing the patient’s risk of diabetes, heart attack and stroke.
If you think you have sleep apnea, the first step is to contact your Primary Care Physician. After discussing your symptoms, your doctor may refer you to a sleep medicine physician to have a sleep test. During the sleep test, the sleep lab will measure the number of apneas (pauses in breathing) and hypopneas (overly shallow periods of breathing) in an hour and how long the pauses last (generally 10 seconds or longer). You will receive your Apnea-Hypopnea Index (AHI) score which determines the severity of sleep apnea. A score of 5 to 15 indicates mild sleep apnea, a score of 16 to 30 indicates moderate sleep apnea and a score of 30 or more indicates severe sleep apnea. A score less than 5 indicates you do not have sleep apnea. The sleep test will also help the sleep medicine physician determine the type of sleep apnea you have.
Based on your diagnosis, your doctor may first recommend some lifestyle changes including losing weight, sleeping on your side, stopping smoking and avoiding alcohol or drugs. They also may prescribe Continuous Positive Airway Pressure (CPAP). The CPAP is worn while you sleep and provides a constant flow of pressurized air to keep the airway open during sleep. Given the success of CPAP therapy, it is often the first treatment recommended to patients suffering from sleep apnea. Unfortunately, however, some people are unable to sleep with the CPAP due to feeling claustrophobic or never getting comfortable enough to sleep well. Those patients often look for an alternative treatment option.
For patients with mild or moderate Obstructive Sleep Apnea, the use of a mandibular advancement device can be effective. It works by holding the jaw in a more forward position to prevent the airway from being obstructed. Other forms of treatment may also include surgery to remove excess tissue in the airway, surgery to remove tonsils and/or adenoids or use of a nasal pressurized airway device.
Sleep apnea can be a dangerous and potentially deadly medical condition and symptoms should not be dismissed. If you are concerned that you or your partner may have sleep apnea, contact your Primary Care Physician to have it checked out.