Topic Overview
What is sleep apnea?
Sleep
apnea means that you often stop breathing for 10 seconds or longer during
sleep. The problem can be mild to severe, based on the number of times each
hour that you stop breathing or how often your lungs don't get enough air. This
may happen from 5 to 50 times an hour.
This topic focuses on
obstructive sleep apnea, which is the most common type.
A less
common type of apnea, called central sleep apnea, can occur in people who have
had a stroke, have heart failure, or have a brain tumor or infection. Even
though this topic isn't about central sleep apnea, some of the treatments
discussed here may also help treat it. Talk with your doctor to find out more
about central sleep apnea.
What causes obstructive sleep apnea?
Blocked or narrowed airways in
your nose, mouth, or throat can cause sleep apnea. Your airway can become
blocked when your throat muscles and tongue relax during sleep.
Sleep apnea can also occur if you have large
tonsils or adenoids or a large
uvula. During the day, when you are awake and standing
up, these may not cause problems. But when you lie down at night, they can
press down on your airway, narrowing it and causing sleep apnea. Sleep apnea
can also occur if you have a problem with your jawbone.
In
children, the main cause of sleep apnea is large
tonsils or adenoids
.
Sleep apnea is more likely to occur if you are
overweight, use certain medicines or alcohol before bed, or sleep on your
back.
See pictures of
normal and blocked airways
during sleep.
What are the symptoms?
The main symptoms of sleep apnea that you may
notice are:
- Being so sleepy during the day that you fall
asleep while working or driving.
- Feeling tired in the
morning.
- Waking up with a headache.
Your bed partner may notice that while you sleep:
- You stop breathing.
- You often
snore loudly.
- You gasp or choke.
- You toss and turn.
Children who have sleep apnea:
- Nearly always snore.
- May have a
hard time breathing during sleep.
- May be restless during sleep and
wake up often.
But children may not seem very sleepy during the day (a key
symptom in adults). The only symptom of sleep apnea in some children may be
that they do not grow as quickly as most children their age.
Should you worry about sleep apnea?
If you have
sleep apnea, you may not be sleeping as well as you could. And you may be more
likely to end up with serious problems such as:
-
High blood pressure
.
-
High blood pressure in your lungs
.
- An
abnormal heart rhythm,
heart failure,
coronary artery disease (CAD), or
stroke.
-
Depression
.
How is sleep apnea diagnosed?
Your doctor will probably examine you and ask about your past health. He
or she may also ask you or your sleeping partner about your snoring and sleep
behavior and how tired you feel during the day.
Your doctor may
suggest a
sleep study. A sleep study usually takes place at a
sleep center, where you will spend the night. Sleep studies find out how often
you stop breathing or have too little air flowing into your lungs during sleep.
They also find out how much oxygen you have in your blood during sleep. You may
have blood tests and X-rays.
How is it treated?
You may be able to treat mild sleep apnea by
making changes in how you live and the way you sleep. For example:
- Lose weight if you are overweight.
- Sleep on your side and not your back.
- Avoid alcohol
and medicines such as
sedatives before bed.
If you have moderate to severe sleep apnea, you may be able
to use a machine that helps you breathe while you sleep. This treatment is
called
continuous positive airway pressure, or CPAP (say
“SEE-pap”). Sometimes medicine that helps you stay awake during the day may be
used along with CPAP. If CPAP doesn't work, or if your tonsils, adenoids,
uvula, or other tissues are blocking your airway, your doctor may suggest
surgery to open your airway.
Frequently asked questions
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Being diagnosed:
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Malhotra A, White DP (2002). Obstructive sleep apnea.
Lancet, 360(9328): 237–245.
Guilleminault C, Abad VC (2004). Obstructive sleep
apnea syndromes. Medical Clinics of North America,
88(3): 611–630.
Arzt M, et al. (2005). Association of sleep-disordered
breathing and the occurrence of stroke. American Journal of Respiratory and Clinical Care Medicine, 172(11): 1447–1451.
Roizenblatt S, et al. (2006). A double-blind,
placebo-controlled, crossover study of sildenafil in obstructive sleep apnea.
Archives of Internal Medicine, 166(16):
1763–1767.
American Academy of Pediatrics (2002). Clinical
practice guideline: Diagnosis and management of childhood obstructive sleep
apnea. Pediatrics, 109(4): 704–712.
Hensley M, Ray C (2006). Sleep apnea. Clinical Evidence (15): 1–18.
Silverberg DS, et al. (2002). Treating obstructive
sleep apnea improves essential hypertension and quality of life.
American Family Physician, 65(2): 229–236.
Buchwald H, et al. (2004). Bariatric surgery: A
systematic review and meta-analysis. JAMA, 292(14):
1724–1737.
Giles TL, et al. (2006). Continuous positive
airways pressure for obstructive sleep apnoea in adults. Cochrane Database of Systematic Reviews (4). Oxford: Update
Software.
Norman D, et al. (2006). Effects of continuous
positive airway pressure versus supplemental oxygen on 24-hour ambulatory blood
pressure. Hypertension, 47(5): 840–845.
Milleron O, et al. (2004). Benefits of obstructive
sleep apnoea treatment in coronary artery disease: A long-term follow-up study.
European Heart Journal, 25(9): 728–734.
Littner M, et al. (2001). Practice parameters for the
use of laser-assisted uvulopalatoplasty: An update for 2000. Sleep, 24(5): 603–619.
Schwartz JRL, et al. (2003). Modafinil as adjunct
therapy for daytime sleepiness in obstructive sleep apnea: A 12-week,
open-label study. Chest, 124(6): 2192–2199.
Hirshkowitz M, et al. (2007). Adjunct armodafinil
improves wakefulness and memory in obstructive sleep apnea/hypopnea syndrome.
Respiratory Medicine, 101(3): 616–627.
Sundaram S, et al. (2006). Surgery for the treatment
of obstructive sleep apnoea. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.