Can’t Sleep?

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea. The main types of sleep apnea are:

• Obstructive sleep apnea (OSA), which is the more common form that occurs when throat muscles relax and block the flow of air into the lungs.
• Central sleep apnea (CSA), which occurs when the brain doesn’t send proper signals to the muscles that control breathing.
• Hypopnea, which is a partial blockage of the airway that causes shallow breathing or abnormally low breathing during sleep.

Symptoms of Sleep Apnea

The symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common symptoms of obstructive and central sleep apneas include:

• Loud snoring.
• Episodes in which you stop breathing during sleep — which would be reported by another person.
• Gasping for air during sleep.
• Awakening with a dry mouth.
• Morning headache.
• Difficulty staying asleep, known as insomnia.
• Excessive daytime sleepiness, known as hypersomnia.
• Difficulty paying attention while awake.
• Irritability.

Causes of Sleep Apnea

Obstructive sleep apnea

This type of sleep apnea happens when the muscles in the back of the throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate called the uvula, the tonsils, the side walls of the throat and the tongue. When the muscles relax, your airway narrows or closes as you breathe in. You can’t get enough air, which can lower the oxygen level in your blood. Your brain senses that you can’t breathe and briefly wakes you so that you can reopen your airway. This awakening is usually so brief that you don’t remember it. You might snort, choke or gasp. This pattern can repeat itself 5 to 30 times or more each hour, all night. This makes it hard to reach the deep, restful phases of sleep.

Central sleep apnea

This less common form of sleep apnea occurs when your brain fails to send signals to your breathing muscles.

Risks of Sleep Apnea

Sleep apnea can lead to a number of health problems if left untreated:

• High blood pressure or heart problems: Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. If you have obstructive sleep apnea, your risk of high blood pressure (hypertension) is greater than if you don’t.
• Type 2 diabetes: Sleep apnea is also associated with insulin resistance and type 2 diabetes.
• Metabolic syndrome: This disorder is a collection of other conditions that increase your risk of heart disease. Conditions include high blood pressure, abnormal cholesterol levels, high blood sugar and an increased waist circumference.
• Complications with medications and surgery: Obstructive sleep apnea is also a concern with certain medications and general anesthesia.

Diagnosis and Treatment

If you think you might have sleep apnea, see your health care provider. Treatment can ease your symptoms and might help prevent heart problems and other complications.

Diagnosis

To diagnose your condition, your doctor might make an evaluation based on your signs and symptoms or may refer you to a sleep disorder center for additional testing.

Treatment

Treatment options for obstructive sleep apnea include:

• Continuous positive airway pressure (CPAP). If you have moderate to severe sleep apnea, you might benefit from using a machine that delivers air pressure through a mask while you’re sleeping. With CPAP, the air pressure is somewhat greater than that of the surrounding air and is just enough to keep your upper airway passages open, preventing snoring and apnea.
• Other devices. Other devices may help keep your airway open during sleep. Oral appliances are one option if you can’t tolerate CPAP. A dentist or orthodontist can custom-fit an oral appliance that adjusts your lower jaw and tongue to help keep your airway open.
• Surgery. In some cases, removing excess tissue from the throat or repairing abnormalities in the nose may fix the problem

Conclusion

Sleep apnea is a serious sleep disorder that can lead to a number of health problems if left untreated. The main types of sleep apnea are obstructive sleep apnea (OSA), central sleep apnea (CSA), and hypopnea. Symptoms of sleep apnea include loud snoring, episodes in which you stop breathing during sleep, gasping for air during sleep, awakening with a dry mouth, morning headache, difficulty staying asleep, excessive daytime sleepiness, difficulty paying attention while awake, and irritability. If you think you might have sleep apnea, see your health care provider. Treatment can ease your symptoms and might help prevent heart problems and other complications.