Sleep apnea occurs when you regularly stop breathing for 10 seconds or longer during sleep. It can be mild, moderate, or severe, depending on the number of times in an hour that your breathing stops (apnea) or becomes very slow (hypopnea). Apnea episodes may occur from 5 to 50 times an hour.
There are three types of sleep apnea: obstructive sleep apnea, central sleep apnea, and mixed sleep apnea. This topic focuses on obstructive sleep apnea, which is also called OSA or simply sleep apnea.
What causes obstructive sleep apnea?
A blockage or narrowing of the airways in your nose, mouth, or throat generally causes obstructive sleep apnea (OSA). This usually occurs when the throat muscles and tongue relax during sleep and partially block the airway.
Sleep apnea can also occur if you have bone deformities or larger than normal tissues in your nose, mouth, or throat. For example, you may have large tonsils. During the day when you are awake and standing up, this may not cause problems. However, when you lie down at night, your tonsils can press down on your airway, narrowing it and causing sleep apnea.
Other factors that make sleep apnea more likely include being obese, using certain medicines or alcohol before bed, and sleeping on your back.
What are the symptoms of sleep apnea?
The main symptoms of sleep apnea are loud snoring and feeling very sleepy during the day. Your bed partner may notice periods when you stop breathing during sleep. Other symptoms may include tossing and turning during sleep, waking up with a headache, and feeling irritated and unrested.
Children who have sleep apnea nearly always snore. Other symptoms may include difficulty breathing during sleep and restless sleep during which your child wakes up often. However, children may not appear to be very sleepy during the day, which is a key symptom in adults. The only symptom of sleep apnea in some children may be that they do not grow as quickly as they should for their age.
Should I worry about sleep apnea?
When you stop breathing or breathe very slowly during your sleep, it may result in less oxygen in your blood. Over time, this lack of oxygen can lead to serious health problems. If you have sleep apnea, you may be more likely to get high blood pressure (hypertension), high blood pressure in your lungs (pulmonary hypertension), abnormal heart rate, heart failure, coronary artery disease (CAD), and stroke.
If you have sleep apnea, you may have difficulty concentrating and feel tired throughout the day. You may fall asleep during a conversation or while you are driving or working. You are also at higher risk for depression.
How is sleep apnea diagnosed?
Your doctor will examine you and ask you and possibly your sleeping partner questions about your lifestyle, snoring, sleep behavior, and how tired you feel during the day. If your doctor thinks you may have sleep apnea, he or she 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 slower breathing and how much oxygen you have in your blood during sleep. You may also have blood tests and X-rays.
How is sleep apnea treated?
If you have mild sleep apnea, you may be able to treat it on your own by losing weight, developing good sleep habits, and avoiding alcohol and certain medicines before bed. If you have moderate to severe sleep apnea, you may need to use a breathing device (continuous positive airway pressure [CPAP]) that prevents your airway from closing during sleep. If CPAP does not work, or if large tissues are blocking your airway, you may need surgery.
A blockage or narrowing of the airways in your nose, mouth, or throat generally causes obstructive sleep apnea (OSA). This usually occurs when the throat muscles and tongue relax during sleep and partially block the airway. When you stop breathing or have slowed breathing during your sleep, it may result in less oxygen in your blood.
Obstructive sleep apnea can also occur if you have bone deformities or enlarged tissues in your nose, mouth, or throat. For example, you may have enlarged tonsils. During the day when you are awake and standing up, this may not cause problems. However, when you lie down at night, the tonsils can press down on your airway, narrowing it and causing sleep apnea.
Other factors that may contribute to sleep apnea include:
•
Drinking alcohol, which affects the part of the brain that controls breathing. This may relax the breathing muscles and cause a narrowing of the airway and sleep apnea.
•
Obesity. Fat in the neck area can press down on the tissues around the airways. This narrows the airways and can cause sleep apnea. About 70% of people who have sleep apnea are obese.1
•
Some medicines that are taken for conditions such as allergies, depression, or anxiety. These medicines, especially sedatives, can also relax the muscles and tissues in the throat, causing it to narrow.
You can treat obstructive sleep apnea (OSA) at home if you have mild sleep apnea (5 or fewer apnea episodes per hour). Home treatment for sleep apnea includes:
•
Losing weight. Many people who have sleep apnea are overweight. Small studies have indicated that losing weight reduces the number of times per hour you stop breathing (apnea) or breathe very slowly (hypopnea).4 Experts agree that weight loss should be a component of managing sleep apnea.4
•
Limiting the use of alcohol and medicine. Drinking excessive amounts of alcohol or taking certain medicines, especially sleeping pills or sedatives, before sleep may make symptoms worse.
•
Getting plenty of sleep. Apnea episodes may be more frequent when you have not had enough sleep.
•
Sleeping on your side. Try sewing a pocket in the middle of the back of your pajama top, putting a tennis ball into the pocket, and stitching it closed. This will help keep you from sleeping on your back. Sleeping on your side may eliminate mild sleep apnea.5
If you are using a continuous positive airway pressure (CPAP) machine to help you breathe, use it every night. If you don't use it all night, every night, your symptoms will return right away.
You can help prevent obstructive sleep apnea (OSA) and snoring by:
•
Avoiding the use of alcohol and medicines, such as sleeping pills and sedatives, before bed. These can relax your throat muscles and slow your breathing.
•
Eating sensibly, exercising, and maintaining a weight that is as close as possible to a healthy body weight.
•
Sleeping on your side. Sleeping on your back can increase snoring. Try sewing a pocket in the middle of the back of your pajama top, putting a tennis ball into the pocket, and stitching it shut. This will help keep you from sleeping on your back. Sleeping on your side may eliminate mild sleep apnea.5
•
Quitting smoking. The nicotine in tobacco relaxes the muscles that keep the airways open. If you don't smoke, those muscles are less likely to collapse at night and narrow the airways.
•
Raising the head of your bed 4 in. (10 cm) to 6 in. (15 cm) by putting bricks under the legs of the bed. Using pillows to raise your head and upper body will not work.
•
Promptly treating breathing problems, such as a stuffy nose caused by a cold or allergies. Breathing problems can increase the risk of snoring. Avoid taking antihistamines because they can make you drowsy and make apnea episodes worse. Instead, use decongestants, which decrease drainage.
