Sleep Apnea

What Is Sleep Apnea?

 

Sleep apnea is a common condition that occurs when your breathing stops and restarts many times while you sleep. This can prevent your body from getting enough oxygen. If someone tells you that you snore or gasp for air during sleep, you may want to talk to your healthcare provider. You may also want to ask your provider about sleep apnea if you experience other symptoms of poor sleep quality, such as excessive daytime sleepiness.

There are two types of sleep apnea.

  • Obstructive sleep apnea, also called OSA, happens when your upper airway becomes blocked many times while you sleep. The blockage can reduce or completely stop airflow. This is the most common type of sleep apnea. Factors such as obesity, large tonsils, or changes in your  hormone   levels can narrow your airway. Any of these factors could increase your risk for obstructive sleep apnea.
  • Central sleep apnea occurs when your brain does not send the signals needed to breathe. Health conditions that affect how your brain controls your airways and chest muscles can cause central sleep apnea.
What is sleep apnea? Learn about the symptoms and health effects of untreated sleep apnea.

To diagnose sleep apnea, your provider may have you do a sleep study. Breathing devices, such as continuous positive air pressure (CPAP) machines, and lifestyle changes are common sleep apnea treatments. If these treatments do not work, your provider may recommend surgery to correct the problem that is causing your sleep apnea. If your sleep apnea is not diagnosed or treated, you may not get enough quality sleep. This can lead to issues with concentrating, making decisions, remembering things, or controlling your behavior. Untreated sleep apnea increases the risk for stroke, heart attack, and other serious problems.

 

About 50 to 70 million Americans have a sleep disorder.

 

 

Symptoms

 

While asleep, you may have these symptoms of sleep apnea:

  • Breathing that starts and stops
  • Frequent loud snoring (more common in men)
  • Gasping for air

You may not know you have these symptoms until someone tells you. Or you may notice the following symptoms yourself:

  • Daytime sleepiness and tiredness, which can lead to problems with learning, focusing, and reacting
  • Dry mouth
  • Fatigue (more common in women)
  • Headache (more common in women)
  • Insomnia (more common in women)
  • Sexual dysfunction or decreased libido
  • Waking up often during the night to urinate

Children who have sleep apnea may be overactive and may experience bedwetting, worsening asthma, and trouble paying attention in school. Visit Sleep Apnea in Children to learn more.

Talk to your healthcare provider about your symptoms. You may need a sleep study to help diagnose the condition.

 

 

Diagnosis

 

Your healthcare provider will ask about your symptoms, risk factors, and whether you have a family history of sleep apnea.

Sleep study

Your healthcare provider will ask you to see a sleep specialist or go to a center for a sleep study. Sleep studies can help diagnose which type of sleep apnea you have and how serious it is.

Sleep diary

A sleep diary can help you track how long and how well you sleep, as well as how sleepy you feel during the day. These details can help your provider diagnose your condition.

Tests to look for other medical conditions

Your provider may order additional tests to check for other medical conditions that can cause sleep apnea. For example, they may order blood tests to determine your thyroid hormone levels or check for  polycystic ovary syndrome   (PCOS).

Your provider will also ask if you are using medicines, such as opioids, that could affect your sleep or cause breathing symptoms related to sleep apnea. They may also ask whether you have recently traveled to altitudes greater than 6,000 feet. Low oxygen environments can cause sleep apnea symptoms for a few weeks after traveling.

 

 

 

Causes and Risk Factors
 

What causes sleep apnea?

Obstructive sleep apnea is caused by conditions that block airflow through your upper airway during sleep. For example, your tongue may fall backward and block your airway.

Central sleep apnea is caused by problems with the way your brain controls your breathing while you sleep.

Your age, family history, lifestyle habits, other medical conditions, and some features of your body (for example, your neck or tongue) can raise your risk for sleep apnea. But healthy lifestyle changes can help lower your risk.

What raises the risk of obstructive sleep apnea?

Many conditions can cause obstructive sleep apnea. Some factors, such as unhealthy lifestyle habits, can be changed. Other factors, such as age and family history, cannot be changed.

  • Age: Sleep apnea can occur at any age, but your risk increases as you get older. As you age, fatty tissue can build up in your neck and tongue.
  • Obesity: People with obesity can have increased fat deposits in their neck that can block their upper airway. Maintaining a healthy weight can help prevent or treat sleep apnea caused by obesity.
  • Large tonsils, neck, or tongue: These features can narrow your upper airway or make it more likely for your tongue to block your airway while you sleep.
  • Endocrine disorders or changes in your hormone levels: Your  hormone   levels can affect the size and shape of your face, tongue, and upper airway. People who have  polycystic ovary syndrome   (PCOS), low levels of  thyroid hormones  , or high levels of insulin or growth hormone have a higher risk for sleep apnea.
  • Family history and genetics: Sleep apnea can be  inherited  . Your  genes   help determine the size and shape of your skull, face, and upper airway. Your genes can also raise your risk for other health conditions, such as cleft lip and cleft palate and Down syndrome, which can lead to sleep apnea.
  • Heart or kidney failure: These conditions can cause fluid to build up in your neck, which can block your upper airway.
  • Lifestyle habits: Drinking alcohol and smoking can raise your risk for sleep apnea. Alcohol can make the muscles of your mouth and throat relax, which may close your upper airway. Smoking can cause  inflammation   in your upper airway, which affects breathing.
  • Sex: Sleep apnea is more common in men than women. Men are more likely to have serious sleep apnea and to be diagnosed with sleep apnea at a younger age than women.

What raises the risk of central sleep apnea?

 

The following factors can raise your risk for central sleep apnea.

  • Health conditions: Some conditions that affect how your brain controls your airways and chest muscles can raise your risk. These include heart failure, stroke, amyotrophic lateral sclerosis, and myasthenia gravis. Your hormone levels can also affect how your brain controls your breathing.
  • Opioid use: Opioid use disorder or long-term use of prescribed opioid-based pain medicines can cause problems with how your brain controls sleep.
  • Family history and genetics: Your genes can affect how your brain controls your breathing during sleep. Genetic conditions, such as congenital central hypoventilation syndrome, can raise your risk.
  • Lifestyle habits: Drinking alcohol and smoking can affect how your brain controls sleep, or the muscles involved in breathing.
  • Premature birth: Babies born before 37 weeks of pregnancy have a higher risk for breathing problems during sleep. In most cases, the risk decreases as the baby gets older.
  • Sex: Central sleep apnea is more common in men than women.
  • Age: As you get older, normal changes in how your brain controls breathing during sleep may raise your risk for sleep apnea.

 

Can you prevent sleep apnea?

 

You may be able to prevent obstructive sleep apnea by making healthy lifestyle changes. These changes include adopting a heart-healthy diet, aiming for a healthy weight, quitting smoking, and limiting alcohol intake.

 

Treatment

 

If a sleep study shows that you have sleep apnea, your healthcare provider may talk to you about making lifelong healthy lifestyle changes. You may also benefit from a positive airway pressure or oral device, or other treatments to keep your airways open while you sleep.

 

Healthy lifestyle changes

To help treat your sleep apnea, healthy lifestyle changes can be very effective. These include getting regular physical activity, maintaining healthy sleeping habits and a healthy weight, limiting alcohol and caffeine intake, and quitting smoking. Your provider may also recommend that you sleep on your side — not on your back — as this can help keep your airway open while you sleep.

 

Positive airway pressure (PAP)

A PAP machine is the most common treatment for sleep apnea. There are different types of PAP machines. Talk to your provider about which type is most appropriate for you.

  • A continuous PAP (CPAP) machine provides constant air pressure through your mouth and/or nose to keep your airways open and help you breathe during sleep.
  • A bilevel PAP (BPAP) machine is like a CPAP machine, but it delivers different pressure based on whether you are inhaling or exhaling.
  • An auto-adjusting PAP (APAP) machine automatically adjusts the air pressure you receive during sleep.

PAP machines often work best when they are paired with healthy lifestyle changes.

Side effects may include congestion, dry eyes or mouth, nosebleeds, or a runny nose. If you experience stomach discomfort or bloating, you should stop using your PAP machine and contact your healthcare provider.

Living With Sleep Apnea has information about what to do if you have problems or side effects from your PAP device.

 

Medicines

The FDA recently approved a weight loss medicine for people with moderate to severe sleep apnea and obesity. This medicine is injected under the skin. If you receive this treatment, your healthcare provider will also recommend physical activity and a healthy eating plan. The medicine may cause serious side effects in some cases. Tell your provider if you have a personal or family history of depression, thyroid tumors  , kidney disease, or diabetic retinopathy.

 

Oral devices

If you have sleep apnea, your provider may prescribe an oral device if you do not want to use or cannot tolerate a CPAP machine. You may be referred to a dentist or orthodontist. They will custom fit a device to your mouth so that it is comfortable and teach you how to use it for best results.

Oral devices (also called oral appliances) are placed in the mouth to prevent blocked airways while you sleep.

There are two types of oral devices.

  • Mandibular repositioning mouthpieces cover the upper and lower teeth and hold the lower jaw in place. They prevent the jaw from sliding backward and blocking the upper airway.
  • Tongue-retaining devices are mouthpieces that hold the tongue in a forward position to prevent it from blocking the upper airway.

Another type of device is used while you are awake.

  • Removable tongue muscle stimulators are mouthpieces that stimulate and tone the tongue. These are typically used once a day while you are awake. They can help prevent your tongue from falling backward and blocking the airway during sleep.

 

Therapy for your mouth and facial muscles

Exercises for your mouth and facial muscles, called orofacial therapy, may also be an effective treatment for sleep apnea in children and adults. This therapy helps to strengthen and reposition the tongue and muscles that control your lips, tongue, upper airway, and face.

 

Surgical procedures

Surgical options for sleep apnea include:

  • Hypoglossal nerve stimulation to stimulate the nerve under your tongue and keep your airways open. A device is implanted under the skin of your chest and connects to the nerve in your mouth.
  • Tonsillectomy to remove your tonsils
  • Surgery to remove tissue from your mouth and throat, to help make your upper airway larger
  • Upper or lower jaw advancement to move your upper jaw and lower jaw forward, to help make your upper airway larger
  • Weight-loss surgery (also called bariatric surgery) if obesity contributes to your sleep apnea and other treatments do not work

 

Living with sleep apnea

 

If you have been diagnosed with sleep apnea, you will need to schedule regular checkups to make sure that your treatment is working. You may need to repeat your sleep study during this period, especially if you gain or lose a lot of weight.

 

How sleep apnea affects your health

Untreated sleep apnea prevents you from getting enough rest, which can cause problems with concentrating, remembering things, making decisions, or controlling your behavior.

Sleep apnea affects many parts of your body. It can cause low oxygen levels during sleep and prevent you from getting enough quality sleep. Also, it takes a lot of effort to restart breathing many times during sleep, and this can damage your organs and blood vessels.

These factors may raise your risk for the following conditions:

 

Using and maintaining your PAP machine

It is important to use your PAP machine for all sleep, including naps. If you are traveling, bring your breathing device with you. Be patient, as it may take time to adjust to breathing with the help of a PAP machine.

  • Adjust the mask every night while lying down with the machine on to ensure it fits properly.
  • Wear your mask for part of the day, such as while watching TV, to get used to how it feels.

Talk to your healthcare provider if you have any of the following problems:

  • You feel claustrophobic or are bothered by the noise. Your provider can suggest a different type of mask or PAP machine. They may also adjust the settings, such as having the machine ramp up over time while you fall asleep.
  • Your mask does not stay on or fit well, or it leaks air.
  • You have difficulty falling or staying asleep.
  • You have dry mouth or a stuffy or runny nose. Your provider may recommend a humidifier or nasal spray.

Your provider may ask you to try different masks or nasal pillows, types of PAP machines, or machine pressure and timing settings.

It is also important to take proper care of your PAP machine:

  • Clean your mask and wash your face before you put on the mask. This can help make a better seal between the mask and your skin. You may need to try a different breathing device that has a humidifier chamber or provides bi-level or auto-adjusting pressure settings.
  • Know how to set up and properly clean all parts of your machine. Be sure to refill prescriptions on time for all of the device's parts that need to be replaced regularly, including the tubes, masks, and air filters.

Your healthcare provider, and possibly your insurance provider, may check the data from your PAP machine. This data shows how often you use your device and whether it is working properly. Your insurance provider may use the data to determine whether they will cover the device.

 

Using and caring for your oral device

If you are using an oral device, you may need to see your dentist after 6 months and then every year. Your dentist will check whether the device is working correctly and whether it needs to be adjusted or replaced.

Ask your dentist how to properly care for your oral device. If it does not fit right or your symptoms do not improve, let your dentist know. It is common to feel some discomfort after a device is adjusted until your mouth and facial muscles get used to the new fit.

 

Information to help you stay safe

 

Sleep apnea can raise your risk for complications if you are having surgery, and it can affect your ability to drive well.

  • If you need medicine to make you sleep during surgery, or pain medicine after surgery, tell your healthcare provider that you have sleep apnea. Your provider may have to take extra steps to make sure that your airway stays open during the surgery and that the pain medicine doesn't make it harder for your airway to stay open.
  • Untreated sleep apnea can make you sleepy during the day and make it difficult for you to pay attention and make decisions while you drive. This can cause road accidents. Pay attention to your symptoms and do not drive if you feel tired or sleepy.

 


 

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Most recent revision April 01, 2025 02:41:41 PM