Definition of Sleep Apnea

Sleep apnea is a sleep disorder where breathing is shallow or interrupted while you’re sleeping. This is a fairly common problem, but it can be serious and can lead to various health problems if not treated.

There are two main types of sleep apnea, obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA, which is the most common kind, involves a blockage of the airway so not enough air is taken in during sleep. In CSA, the problem is caused by the brain not signaling the muscles to breathe normally.

There is also mixed sleep apnea, which is a combination of CSA and OSA.

Symptoms of Sleep Apnea

There are several possible signs and symptoms of sleep apnea. These include:

  • Snoring, especially loud and frequent snoring

  • Frequent headaches in the morning

  • Fatigue and sleepiness during the day

  • Insomnia

  • High blood pressure

  • Waking up feeling short of breath

  • Waking up with a sore throat or dry mouth

  • In children - hyperactivity, breathing through the mouth, difficulty concentrating at school

None of these symptoms necessarily means you have sleep apnea, but they can all be associated with this condition.

Diagnosis of Sleep Apnea

Because most of the symptoms of sleep apnea occur during sleep, diagnosing this condition can be a little tricky. Very often, the symptoms of sleep apnea can also be caused by other conditions, such as chronic fatigue syndrome, side effects of medication, drug or alcohol abuse and other sleep disorders.

If you suspect sleep apnea, you may want to look for a questionnaire that will let you know if you have the risk factors and symptoms of this sleep disorder. If you do, you should seek medical help.

To diagnose sleep apnea, your doctor will first ask you some questions and give you a physical examination and look for abnormalities in your throat, such as enlarged tonsils. He or she will also consider if you have risk factors such as being overweight or a history or sleep apnea in your family.

The most effective way to diagnose any kind of sleep disorder is by an overnight study at a sleep center, called a polysomnography. This study measures brain waves using EEG, as well as heart rate and breathing patterns. This is the surest way to determine if you have sleep apnea or perhaps another sleep disorder.

Polysomnography is an expensive process, though, and can be inconvenient if you don’t live near a sleep center. For this reason, doctors can also provide patients with a home sleep apnea test. While this isn’t as thorough as the kind done at a hospital, it can monitor your breathing and the cost is only about a third of an overnight sleep study.

Facts and Statistics on Sleep Apnea

Although sleep apnea is a serious condition, it’s only been diagnosed relatively recently. The term wasn’t used in medical literature until 1965, although the symptoms were recognized long before then. Before it got it’s current name, it was sometimes referred to as Pickwickian syndrome. This comes from the Charles Dickens novel, The Pickwick Papers, where one of the characters has symptoms that perfectly describe obstructive sleep apnea.

One of the most dangerous aspects of sleep apnea is that it often goes undetected. A typical physical examination won’t reveal it, unless you already suspect it or your doctor is alert enough to ask you questions that might bring it to light.

Because sleep apnea is still not that widely recognized, many people with symptoms such as snoring don’t seek medical help. For this reason, collecting accurate statistics for this disorder can be problematic.

  • Approximately 20% of the population suffers from some type of sleep apnea

  • As much as 90% of all cases of sleep apnea remain undiagnosed

  • 50% of people with diabetes also suffer from sleep apnea

  • About 24% of males, 9% of females and 3% of children have sleep apnea

  • Obstructive sleep apnea accounts for 84% of all cases

  • Having sleep apnea doubles your risk of being involved in a car crash

Sleep Apnea Effects

Because it obstructs breathing, sleep apnea is a serious medical condition. Some of the possible long term effects of sleep apnea include:

  • Increased risk of heart disease, diabetes and stroke

  • High blood pressure

  • Falling asleep unexpectedly at home, at work or while driving

  • Depression and other mood disorders

  • Sexual dysfunction

  • Learning and memory problems

  • GERD -gastroesophageal reflux disease

  • Dementia

  • Bedwetting in children

  • Glaucoma and other eye diseases

  • Narcolepsy -excessive tiredness and sleepiness

These are some of the more serious possible effects of sleep apnea. Some of these, such as high blood pressure and GERD, can be both causes and effects of sleep apnea. For example, if you have sleep apnea, you’re more likely to develop GERD, and vice versa.

Because sleep apnea interferes with your normal sleep pattern, it can cause daytime tiredness and narcolepsy, which may cause you to fall asleep at unexpected times. It’s estimated that quite a few traffic accidents are caused by people who fall asleep at the wheel due to sleep apnea.

Of course, the above effects can have other causes as well. Most children with a bedwetting problem don’t have sleep apnea, but some do begin having this symptom after developing sleep apnea.

The effects of sleep apnea can potentially be fatal. While individual incidents don’t cause death, over time they can greatly increase the chances of potentially fatal conditions such as heart attacks and strokes.

Causes

There’s no single cause of sleep apnea, and doctors can’t always identify why people develop this sleep disorder. There are, however, definite risk factors that may contribute to your having sleep apnea. These include the following:

  • Being overweight or obese

  • Having a thick neck

  • Having a deviated septum, enlarged tonsils or adenoids

  • Smoking

  • Family history of sleep apnea

  • Bipolar disorder

  • GERT (gastroesophageal reflux disease)

Aside from this, men are more likely than women to develop sleep apnea. While sleep apnea can occur at any age, even in children, it’s most common in the middle aged and elderly. For reasons not yet understood, blacks, hispanics and Pacific Islanders are the races most likely to suffer from this sleep disorder.

Treating Sleep Apnea

The most challenging aspect of sleep apnea is often diagnosing it. Once you’re aware that you have it, there are quite a few treatment options available. There’s no one best sleep apnea treatment for everybody, but with your doctor’s guidance you can find the best approach for you.

There are a variety of sleep apnea devices that can help prevent the symptoms and allow you to breathe freely at night. However, before you even look into these, it’s a good idea to follow some basic guidelines.

  • If you’re overweight, lose weight

  • If you’re a smoker, quit smoking

  • Follow a regular sleep schedule

  • Avoid alcohol, caffeine and sleeping pills at night

  • Sleep on your side, not on your back

  • Keep your nasal passages unobstructed; saline sprays, a netti pot or a humidifier can help

  • Use pillows to raise your head up several inches; a cervical pillow might be useful

Many sleep apnea solutions involve products that help you breathe normally during sleep. These may seem strange or awkward to use at first, but it’s possible to get used to them.

Nasal dilators are devices designed to help you stop snoring. There are both internal and external nasal dilators, but both kinds open the nasal passages to help you breathe freely.

A CPAP (continuous positive airway pressure) face mask can be helpful for overcoming sleep apnea. This is a full face mask that you wear when sleeping that ensures you get the right balance of oxygen and carbon dioxide when you sleep. There are also nasal pillow masks for those who prefer not to wear a full face mask. While these devices can be purchased online, you should consult with your doctor before buying one to make sure you get the right kind and one that fits you properly.

Another type of product that is sometimes used by people with sleep apnea is a chin strap or jaw supporter. These are simple and inexpensive devices that are worn to keep the jaw in a position where snoring is less likely to occur. Devices such as Zquiet and Kudo Snorefighter are designed to reposition the jaw in a way that opens nasal passages.

Sleep apnea pillows are shaped in a way to make snoring and breathing obstruction less likely. There are a variety of these on the market and come in different shapes and sizes.

For patients who can’t tolerate CPAP masks, certain dental devices can sometimes serve as an effective substitute. A mandibular advancement device (MAD) is a device that’s a lot simpler than its name implies. It looks like a mouthguard and keeps the lower jaw in a forward position to help keep the airways open when you sleep.

Another dental device sometimes used for sleep apnea is a tongue retraining device (TRD), a splint that keeps the tongue in place when you sleep to keep the airway open. While such dental devices can sometimes help, in general they are not as effective as CPAP masks.

Not everyone responds to the same sleep apnea products. Some people, for example, find that CPAP masks are too uncomfortable to sleep in, or that they leak. You may have to try several products before you find one that fits you just right. This is something to discuss with your doctor, who might also recommend other treatments as well.

Anyone who has tried CPAP or other sleep apnea devices and found them to be too difficult to use should stay open minded. This is a field where advances are being made all the time, and many innovative products have been introduced in the last few years.

Medication

Sleep apnea is one of the few medical conditions where medication is seldom recommended. One reason for this is that sedatives can actually make sleep apnea worse. Typical sleeping medications, such as Xanax, Zopilone or Xyrem, can actually constrict the breathing during the night, causing snoring and other sleep apnea symptoms.

The relationship between sleep apnea and antidepressants is fairly complex. Certain studies indicate that antidepressants sometimes relieve sleep apnea. In general, however, doctors seldom recommend this type of drug for such sleep disorders. It’s worth noting that sleep apnea is often linked with depression, so patients who are depressed might find relief from this condition when their sleep apnea is treated.

Home Remedies and Alternative Treatments

Aside from lifestyle changes and sleep apnea devices, there are also some home remedies and alternative treatments that some people find effective.

Acupuncture has recently been embraced by more mainstream doctors and health experts than ever before, and in some cases it can help control sleep apnea. Since acupuncture involves stimulating various energy centers of the body, a skilled acupuncturist may be able to relieve breathing obstructions.

Certain herbs are also sometimes recommended for sleep apnea. These include Valerian root, Passionflower and St. John’s Wort. Many herbs, especially Valerian, can have side effects and may not be compatible with any medications you’re taking.

Some alternative health practitioners recommend taking certain supplements for sleep apnea. Zinc may help some people sleep more soundly, but this is a mineral that you shouldn’t take too much of.

Another supplement that’s often taken for sleep disorders is melatonin, but you shouldn’t take this if you have sleep apnea without consulting with your doctor. Since sleep apnea can cause abnormalities in the body’s natural production of melatonin, whether or not it would be helpful to take it might depend on many factors, such as your age, gender and any other medical conditions you might have.

Homeopathic remedies are another possibility for treating sleep apnea, but there isn’t much evidence to show whether or not this is effective. If you are interested in pursuing this, there are homeopathic physicians who might recommend certain remedies as a supplement to any other treatment you are receiving.

One type of alternative treatment that is safe for anyone to try are throat exercises. One simple one is to recite all of the vowels for several minutes before going to bed. There are other throat exercises as well, and you can find more information on this if you’re interested. It should be noted, however, that these are mainly effective with mild cases of sleep apnea.

You should consult with your doctor before taking herbs or pursuing any other alternative treatments for sleep apnea.