Sleep Apnea

WHAT IS IT?

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. There are two main types of sleep apnea:

Obstructive sleep apnea

Obstructive sleep apnea occurs when the muscles in the back of your throat relax. Your airway narrows or closes and you aren’t able to breathe properly. Your brain senses this inability to breathe and briefly rouses you from sleep so that you can reopen your airway. You may make a snorting, choking, or gasping sound. This pattern can repeat itself several times an hour, all night long. The disruptions impair your ability to reach the restful phases of sleep.

People at greater risk of obstructive sleep apnea are those who are overweight, who have a thicker neck or who are bothered by nasal congestion. Men are more likely to develop it than women.

Central sleep apnea

Central sleep apnea, which is much less common, occurs when your brain fails to transmit signals to your breathing muscles. You may awaken with shortness of breath or have difficulty getting to sleep or staying asleep. The most common cause of central sleep apnea is heart failure. People with central sleep apnea may be more likely to remember awakening than people with obstructive sleep apnea.

SYMPTOM

Common signs and symptoms of obstructive and central sleep apnea include:

• Excessive daytime sleepiness
• Loud snoring, usually more prominent in obstructive sleep apnea
• Episodes of breathing cessation during sleep
• Abrupt awakenings with shortness of breath, usually more common with central sleep apnea
• Awakening with a dry mouth or sore throat
• Morning headache
• Difficulty staying asleep
• Attention difficulty

TREATMENT

Treatment for obstructive sleep apnea includes:

Continuous positive airway pressure (CPAP). A machine delivers air pressure through a mask placed over your nose while you sleep. The air pressure is somewhat greater than that of the surrounding air — just enough to keep your upper airway passages open. CPAP is the most common and reliable method of treating sleep apnea.

Adjustable airway pressure devices. They automatically adjust the pressure while you’re sleeping. Units that supply bilevel positive airway pressure (BPAP) provide more pressure when you inhale and less when you exhale.

Expiratory positive airway pressure (EPAP). Small, single-use devices are placed over each nostril before you go to sleep.

Oral appliances. They’re designed to keep your throat open. Some open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.

Surgery. Surgery is usually only an option after other treatments have failed. Surgical options include:

• Tissue removal. A surgeon removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well. This type of surgery may be more successful in stopping snoring than in treating sleep apnea.
• Jaw repositioning. Your jaw is moved forward, enlarging the space behind the tongue and soft palate, making obstruction less likely.
• Implants. Plastic rods are surgically implanted into the soft palate to help keep your airway open.
• Creating a new air passageway. In case of life-threatening sleep apnea, a surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe (tracheostomy). You keep the opening covered during the day, but at night uncover it to bypass the blocked airway in your throat.
• Other. Other types of surgery include surgery to remove polyps or straighten a crooked partition between your nostrils (deviated nasal septum) or to remove enlarged tonsils or adenoids.

Treatments for central sleep apnea generally involve treating the underlying medical condition. Using supplemental oxygen while you sleep may help. In some situations, CPAP or BPAP may be helpful.

   Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.