What is Sleep Apnea?

Sleep apnea (sleep-disordered breathing) is a serious and common sleep disorder affecting about 50% of men and 23% of women. Its name comes from a Greek word, apnea, meaning “without breath.” People with sleep apnea stop breathing hundreds of times during the night. The breathing pauses last at least 10 seconds, often dropping blood oxygen levels below 80%.

The main symptoms of sleep apnea are persistent loud snoring at night and daytime sleepiness. Another symptom is frequent long pauses in breathing during sleep, followed by choking and gasping for breath. People with sleep apnea don’t get enough restful sleep, and their daytime performance is often seriously affected. Moderate to severe sleep apnea has been shown to increase the risk of high blood pressure, heart disease, heart attack, and stroke by 5 to 10 times normal. It can also cause people to grind their teeth at night and wake with a sore jaw and headaches. However, it can be diagnosed and treated.

Who Gets Sleep Apnea?

Sleep apnea occurs in all age groups and both sexes but is more common in men, people who are overweight or obese, and older persons. The disorder is made worse by fat buildup in the tongue, neck or loss of muscle tone with aging. People most likely to have or develop sleep apnea include those who snore loudly and are overweight, have high blood pressure, or have some other limitation in size of the upper airways. However, we occasionally see young, skinny, fit people with severe sleep apnea. To learn more please click here.

What Causes Sleep Apnea?

Intermittent (comes and goes) blockage in some parts of the upper airways, often due to the throat muscles and tongue relaxing during sleep, can cause sleep apnea. When the muscles of the soft palate at the base of the tongue and the uvula (the small fleshy tissue hanging from the centre of the back of the throat) relax and sag, the airway becomes blocked. The blockage makes breathing laboured and noisy and even stops it altogether.

What Are The Effects of Sleep Apnea?

During the pauses in breathing, the oxygen level in your blood drops. Your brain reacts to the drop in oxygen by waking you enough to resume breathing (and snoring), but not necessarily enough to fully awaken you. The cycle of snoring, not breathing, waking, and resuming breathing means that you do not get good quality sleep. Because of this, you may often feel very sleepy during the day, find it hard to concentrate, and your daytime performance may suffer.

The effects of sleep apnea range from annoying to life threatening. They include depression, high blood pressure, irritability, sexual dysfunction, learning and memory problems, and falling asleep while at work, on the phone, or driving. People with severe sleep apnea are two to three times more likely to have automobile crashes. Risk for heart attacks, high blood pressure, heart failure, and stroke also increase with sleep apnea.

How do I Know if I Have Sleep Apnea?

People with sleep apnea are often not aware that they have it. You should suspect sleep apnea if you often feel sleepy during the day, and you have been told that you snore loudly and frequently, or seem to have trouble breathing during the night.

Your bed partner may notice your heavy snoring and struggles to breathe during sleep. Co-workers or friends may notice that you tend to fall asleep during the day at inappropriate times. If you think that you have sleep apnea, it is important that you see a doctor for evaluation of the sleep problem.

How is Sleep Apnea Diagnosed?

In addition to your primary care provider, a sleep medicine specialist needs to be involved in the diagnosis, as well as treatment. Diagnosis of sleep apnea is not simple because there can be many different reasons for disturbed sleep. If sleep apnea is suspected, the sleep medicine specialist will need to perform a sleep study. This usually means going to a sleep centre, where tests are done while you sleep. This test is called polysomnography, which records a variety of body functions during sleep. These recordings can sometimes be done at home.

How is Sleep Apnea Treated?

The specific therapy for sleep apnea is based on your medical history, physical exam, and the results of polysomnography or other tests.

Possible treatments for sleep apnea include:

  • Behavioural changes such as weight loss, learning to sleep on one’s side instead of the back and avoiding alcohol, sleeping pills, and smoking. In milder cases, behavioural changes may be enough to stop sleep apnea.
  • Nasal Continuous Positive Airway Pressure (CPAP) therapy, is generally required for successful treatment. In CPAP therapy, a mask is worn over the nose while sleeping, and a machine supplies pressurized room air to the mask through a flexible tube. The pressurized air keeps the airway open. There are various types of CPAP machines.
  • An oral or dental device that holds the tongue or jaw forward.
  • Surgery. Some of the more common procedures include removal of adenoids and tonsils, especially in children; removal of nasal polyps or other growths; and correction of structural deformities.
  • Medications are generally not effective in the treatment of sleep apnea. However, if nasal congestion is contributing to breathing problems, decongestants may help.

Can Sleep Apnea be Prevented?

Avoiding weight gain as you age, singing and sleeping on your side are the best ways to prevent sleep apnea naturally. Avoiding the use of alcohol and sedating medicines may also help.