Sleep apnea is a serious, potentially life-threatening condition that is
far more common than generally understood. Sleep apnea occurs in all age
groups and both genders. It is more common in men, although it may be
under-diagnosed in women and young African-Americans. It is estimated
that as many as 18 million Americans have sleep apnea.
Early recognition and treatment of sleep apnea is important, as it may
be associated with:
high blood pressure
What are the different types of sleep apnea?
Sleep apnea is a breathing disorder characterized by brief interruptions
of breathing during sleep. There are two types of sleep apnea:
central – occurs when the brain fails to send the appropriate
signals to the muscles to initiate breathing. Central sleep
apnea is less common than obstructive sleep apnea
obstructive – occurs when air cannot flow into or out of the
person's nose or mouth although efforts to breathe continue
Who is affected by sleep apnea?
Sleep apnea seems to run in some families, suggesting a possible genetic
basis. People most likely to have or develop sleep apnea include those
have high blood pressure
have some physical abnormality in the nose, throat, or other
parts of the upper airway
Use of alcohol and sleeping pills increases the frequency and duration
of breathing pauses in people with sleep apnea.
What are the characteristics of sleep apnea?
Sleep apnea is characterized by a number of involuntary breathing pauses
or "apneic events" during a single night's sleep—may be as many as 20 to
30 or more events per hour. These events are almost always accompanied
by snoring between apnea episodes (although not everyone who snores has
sleep apnea). Sleep apnea may also be characterized by choking
sensations. The frequent interruptions of deep, restorative sleep often
lead to early morning headaches and excessive daytime sleepiness.
During the apneic event, the person is unable to breathe in oxygen and
to exhale carbon dioxide, resulting in low levels of oxygen and
increased levels of carbon dioxide in the blood. The reduction in oxygen
and increase in carbon dioxide alert the brain to resume breathing and
cause an arousal. With each arousal, a signal is sent from the brain to
the upper airway muscles to open the airway; breathing is resumed, often
with a loud snort or gasp. Frequent arousals, although necessary for
breathing to restart, prevent a person from getting enough restorative,
What are the causes of sleep apnea?
Certain mechanical and structural problems in the airway cause the
interruptions in breathing during sleep. Apnea occurs:
when the throat muscles and tongue relax during sleep and
partially block the opening of the airway
when the muscles of the soft palate at the base of the tongue
and the uvula relax and sag, the airway becomes blocked, making
breathing labored and noisy and even stopping it altogether
in obese people when an excess amount of tissue in the airway
causes it to be narrowed
with a narrowed airway, the person continues his/her efforts to
breathe, but air cannot easily flow into or out of the nose or
How is sleep apnea diagnosed?
Diagnosis of sleep apnea is not simple because there can be many
different causes. Primary care physicians, pulmonologists, neurologists,
or other physicians with specialty training in sleep disorders may be
involved in making a definitive diagnosis and initiating treatment.
Several tests are available for evaluating a person for sleep apnea,
Polysomnography – a test that records a variety of body
functions during sleep, such as the electrical activity of the
brain, eye movement, muscle activity, heart rate, respiratory
effort, air flow, and blood oxygen levels
Multiple Sleep Latency Test (MSLT) – a test that measures the
speed of falling asleep. People without sleep problems usually
take an average of 10 to 20 minutes to fall asleep. Individuals
who fall asleep in less than 5 minutes are likely to require
some type of treatment for sleep disorders
Diagnostic tests usually are performed in a sleep center, but new
technology may allow some sleep studies to be conducted in the patient's
How is sleep apnea treated?
Specific treatment will be determined by your physician based on:
your age, overall health, and medical history
extent of the disease
your tolerance for specific medications, procedures, or
expectations for the course of the disease
your opinion or preference
Medications are generally not effective in the treatment of sleep apnea.
Therapy for sleep apnea is specifically designed for each individual
patient, and may include the following:
Oxygen administration may safely benefit certain patients, but
does not eliminate sleep apnea or prevent daytime sleepiness.
Its role in the treatment of sleep apnea is controversial.
Behavioral changes are an important part of a treatment program,
and in mild cases of sleep apnea, behavioral therapy may be all
that is needed. The patient may be advised to:
avoid the use of alcohol
avoid the use of tobacco
avoid the use of sleeping pills
lose weight if overweight (even a 10 percent
weight loss can reduce the number of apneic
events for most patients)
use pillows and other devices to help sleep in a
Physical or Mechanical Therapy
Nasal continuous positive airway pressure (CPAP)
is a procedure in which the patient wears a mask
over the nose during sleep, and pressure from an
air blower forces air through the nasal
Dental appliances that reposition the lower jaw
and the tongue have been helpful to some
patients with mild sleep apnea, or who snore but
do not have apnea.
Some patients with sleep apnea may need surgery. Examples of
these procedures include:
Common surgical procedures to remove of adenoids
and tonsils, nasal polyps or other growths or
tissue in the airway, and correction of
Uvulopalatopharyngoplasty (UPPP) – a procedure
used to remove excess tissue at the back of the
throat (tonsils, uvula, and part of the soft
Surgical reconstruction for deformities of the
lower jaw may benefit some patients.
Surgical procedures to treat obesity are
sometimes recommended for sleep apnea patients
who are morbidly obese.
For more information, call 1.866.CALL.MLH.