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Sleep Apnea: Symptoms and New Treatments

Monday, July 13, 2015 9:17 AM

More than 18 million American suffer from sleep apnea, a condition in which breathing is interrupted during sleep. Anthony Barber, DO, neurologist at the NorthShore Sleep Center, answers questions about the condition, some of the treatment options, and tips for how to best manage it:

What causes sleep apnea?
Obstructive sleep apnea is caused by a collapse in the muscles in the back of the throat (upper portion of the airway) while asleep. This area is prone to collapse because it is held open only by muscle without any bony/solid structure. All of our muscles relax while asleep at night so a collapse occurs in all individuals, if the airway is crowded or narrowed to begin with then that collapse results in the blockage.

What are the most common signs for sleep apnea? Can it be caused by stress?
Stress cannot cause sleep apnea. Typical signs include sleepiness, un-refreshing sleep, morning headaches, trouble maintaining sleep, heart burn at night or morning, sweating while asleep. Sleep apnea can potentially result in hypertension, diabetes, stroke, heart attack and increased risk of dementia.

Can sleep apnea be cured or only managed?
The only true cure is a tracheostomy (creating a hole in the neck). Other structural surgeries may also result in a "cure", but this is only about 45% of the time. Significant weight loss may also result in getting rid of sleep apnea, but weight isn't the only cause, so it may result in only lowering the severity of the sleep apnea.

Can one (non-clinician) distinguish between snoring and apnea without doing a sleep study?
Not really, unless long pauses in the breathing are noted at night. Diagnosis of obstructive sleep apnea centers on if breathing while asleep is causing dips in the blood oxygen levels and/or short awakenings (called arousals). These events need to average 5 or more per hour to meet criteria for sleep apnea.

What is involved in a sleep study? How long does it take? Does insurance generally cover it?
Insurance question depends on why the study is being ordered and dependent upon insurance plan. Two types of studies are performed. A lab study is when you come into a sleep lab at night (between 8:30 and 9:30 pm) and meet with a sleep tech who is in the lab the whole night. You have your own room with a normal bed (looks like a hotel room, kind of). You'll be hooked up to monitors on your scalp, with a belt around the waist and chest. There are a lot of wires that get plugged into a box outside of bed (box is moveable if you need to use restroom). You'll sleep until 6 am. The other type is a home study in which you pick up a device, take it home, and wear it while sleeping then bring back to the lab the next day. A home study is approved for certain patient populations, but is less sensitive.

What else is available for patients who do not like the cpap machines?
Alternatives to CPAP that insurance covers: an oral appliance (device worn while asleep that brings your lower jaw forward to help open back of airway), surgery (see above). Provent therapy is another option but not covered by insurance.

You can find more information about sleep apnea and how to get tested at the NorthShore Sleep Center.

Read more answers from Dr. Barber on sleep apnea in our Sleep Apnea Chat.