There are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea. If left untreated, it can increase your risk of long-term health problems, such as heart disease and type 2 diabetes. This article will focus on obstructive sleep apnea and teach you how to recognize the warning signs and seek proper treatment.
Obstructive sleep apnea OSA is the most common type of sleep apnea. It occurs when the tongue falls back onto the soft palate the area at the back of the mouth and top of the throat. The soft palate pushes to the back of the throat, fully or partially blocking the airway. OSA is associated with poor long-term health outcomes. This includes a higher risk of many health complications , such as high blood pressure , heart attacks, strokes, depression , and early death.
And it can also pose short-term health dangers. The main symptoms of OSA include:. For example, your blood pressure readings may increase as a result of OSA. If you're experiencing these symptoms, "You should talk with your primary care doctor or see a sleep specialist for further care," Holfinger says. In most cases, physicians will conduct a sleep study to diagnose sleep apnea. Other risk factors, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed.
Heathy lifestyle changes can decrease your risk for developing sleep apnea. Sleep apnea can occur at any age. The risk for sleep apnea increases as you get older. In younger adults, sleep apnea is more common in men than in women, but the difference decreases later in life. Normal age-related changes in how the brain controls breathing during sleep partially explain the increased risk as you get older.
Another possible reason is that as we age, more fatty tissue builds up in the neck and the tongue. Drinking alcohol, smoking, and overweight or obesity can increase your risk for sleep apnea. Researchers have identified family history as a risk factor for sleep apnea, but maintaining a healthy lifestyle can decrease this risk.
Studies in twins have shown that sleep apnea can be inherited. Some of the gene related to sleep apnea are associated with the structural development of the face and skull and with how the brain controls sleep and breathing during sleep.
Some genes are also associated with obesity and inflammation. In the United States, sleep apnea is more common among blacks, Hispanics, and Native Americans than among whites. To screen for sleep apnea, your doctor will review your medical history and symptoms.
To prevent sleep apnea, your doctor may recommend healthy lifestyle changes. To screen for sleep apnea or other sleep disorders, your doctor may ask you about common signs and symptoms of this condition, such as how sleepy you feel during the day or when driving, and whether you or your partner has noticed that you snore, stop breathing, or gasp during your sleep.
Your doctor may ask questions to assess your risk for developing this condition and take your physical measurements. Your doctor will also want to see whether you have any complications of undiagnosed sleep apnea, such as high blood pressure that is difficult to control.
If the screening suggests a sleep breathing disorder, you may get a referral to a sleep specialist to help confirm a diagnosis. If you are concerned about having risk factors for developing sleep apnea, ask your doctor to recommend healthy lifestyle changes, including eating a heart-healthy diet , aiming for a healthy weight , quitting smoking , and limiting alcohol intake. Your doctor may recommend that you sleep on your side and adopt healthy sleep habits such as getting the recommended amount of sleep.
Common sleep apnea signs and symptoms are snoring or gasping during sleep; reduced or absent breathing, called apnea events; and sleepiness. Undiagnosed or untreated sleep apnea prevents restful sleep and can cause complications that may affect many parts of your body. Common signs of sleep apnea:. Common symptoms of sleep apnea:. Did you know that sleep apnea symptoms may be different for women and children compared with men?
Women who have sleep apnea more often report headache, fatigue, depression, anxiety, insomnia, and sleep disruption. Children may experience bedwetting, asthma exacerbations, hyperactivity, and learning and academic performance issues.
This increases your blood pressure and heart rate and wakes you from sleep so that your upper airway can open. These cycles of decreased and increased blood oxygen levels can cause inflammation that may contribute to atherosclerosis, the buildup of plaque in blood vessels, which can increase the risk of heart attack or stroke. Chronic inflammation can also damage the pancreas and lead to type 2 diabetes.
Your doctor may diagnose sleep apnea based on your medical history, a physical exam, and results from a sleep study. Before diagnosing you with sleep apnea, your doctor will rule out other medical reasons or conditions that may be causing your signs and symptoms.
During the physical exam, your doctor will look for signs of other conditions that can increase your risk for sleep apnea, such as obesity, large tonsils, narrowing of the upper airway, or a large neck circumference.
A neck circumference greater than 17 inches for men or 16 inches for women is considered large. Your doctor will check your lungs, heart, and neurological systems to see whether you have any common complications of sleep apnea. To diagnose sleep apnea or another sleep disorder, your doctor may refer you to a sleep specialist or a center for a sleep study. Sleep studies can be done in a special center or at home. Studies at a sleep center can:.
Your doctor may be able to diagnose mild, moderate, or severe sleep apnea based on the number of sleep apnea events you have in an hour during the sleep study.
Visit Sleep Studies for more information. Did you know that sleep studies can help determine which type of sleep apnea you have? Sleep studies can monitor the movement of your muscles and help determine breathing patterns and whether you have obstructive or central sleep apnea. Sleep studies of patients with obstructive sleep apnea often show an increase in breathing muscle activity when muscles try to open an obstructed upper airway. In contrast, sleep studies of patients with central sleep apnea tend to show decreased activity in chest muscles, which can lead to periods of slowed or no breathing.
Your doctor may order the following tests to help rule out other medical conditions that can cause sleep apnea:. Your doctor will also want to know whether you are using medicines, such as opioids, that could be affecting your sleep or causing breathing symptoms of sleep apnea. Your doctor may want to know whether you have traveled recently to altitudes greater than 6, feet, because these low-oxygen environments can cause symptoms of sleep apnea for a few weeks after traveling.
If you are diagnosed with sleep apnea, your doctor may make recommendations to help you maintain an open airway during sleep. These could include healthy lifestyle changes or a breathing device such as a positive airway pressure PAP machine, mouthpiece, or implant. Talk to your doctor. Depending on the type and severity of your sleep apnea and your needs and preferences, other treatments may be possible. To help control or treat your sleep apnea, your doctor may recommend that you adopt lifelong healthy lifestyle changes.
A breathing device, such as a CPAP machine, is the most commonly recommended treatment for patients with sleep apnea. If your doctor prescribes a CPAP or other breathing device, be sure to continue your doctor-recommended healthy lifestyle changes.
Read Living With to learn more about properly caring for your breathing device. Oral devices, also called oral appliances, are custom-fit devices that you typically wear while you sleep. There are two types of oral devices that work differently to open the upper airway while you sleep. Some hybrid devices have features of both types.
A new type of oral device was recently approved by the FDA for use while awake. The device delivers electrical muscle stimulation through a removable mouthpiece that sits around the tongue. You wear the mouthpiece once a day for 20 minutes at a time, for 6 weeks.
The device stimulates the tongue muscle while awake to help prevent the tongue from collapsing backward and obstructing the airway during sleep. Your doctor will recommend that you visit a dentist who will custom-make an appliance for you, make sure that it is comfortable, and teach you how to use it to get the best results. Implants can benefit some people with sleep apnea. Some devices treat both obstructive and central sleep apnea.
You must have surgery to place an implant in your body. The Food and Drug Administration has approved one implant as a treatment for sleep apnea. The device senses breathing patterns and delivers mild stimulation to certain muscles that open the airways during sleep. More research is needed to determine how effective the implant is in treating central sleep apnea. A nerve stimulator can also treat sleep apnea. This treatment also involves surgery. A surgeon will insert a stimulator for the hypoglossal nerve, which controls tongue movement.
Increasing stimulation of this nerve helps position the tongue to keep the upper airway open. Sleep Changes in Older Adults. What is sleep apnea? What causes sleep apnea? There are two kinds of sleep apnea: obstructive apnea and central apnea.
How is sleep apnea diagnosed? Can sleep apnea be prevented or avoided? There are things you can do to prevent sleep apnea. The following steps help many people: Stop all use of alcohol or sleep medicines. These relax the muscles in the back of your throat, making it harder for you to breathe.
If you smoke, quit smoking. If you are overweight, lose weight. Sleep on your side instead of on your back. Sleep apnea treatment Certain dental devices can be used to treat mild cases of obstructive sleep apnea. In very few cases, surgery is necessary to remove tonsils or extra tissue from the throat. Questions to ask your doctor Do I need a sleep study? What are the health risks associated with sleep apnea? What lifestyle changes can I make at home to help treat my sleep apnea? Be sure to discuss your options with your doctor and schedule follow-up appointments to check the fit, evaluate your treatment progress, and adjust or switch your mask if necessary.
Ease into it. Start by using your CPAP device for short periods. Try wearing it for a half hour or an hour while sitting up in bed watching TV or reading a book. Most devices can be programmed to start slowly and gradually increase air pressure. The goal is to be asleep before the machine reaches your prescribed pressure setting. Most people find this makes falling asleep much easier and more comfortable.
Reset the machine if air flow wakes you. If a high-pressure stream of air wakes you up, turn the CPAP device on and off to restart the ramp setting. Choose a CPAP device with a built-in humidifier. Most devices now include a built-in humidifier, which helps prevent the dryness and skin irritation that can sometimes occur. Also be sure to keep your humidifier tank full, keep your tubing and mask clean, and make sure your filter is clean. Nasal sprays and antihistamines also help.
Keep your device clean. Your sleep doctor and device manufacturer will give you detailed cleaning instructions. To ensure maximum comfort , ask your doctor about soft pads to reduce skin irritation, nasal pillows for nose discomfort, and chinstraps to keep your mouth closed and reduce throat irritation and dry mouth.
Mask the sound of the CPAP machine. Most new CPAP devices are quiet, but if the sound of your CPAP machine bothers you, try placing it beneath the bed and using a sound machine to muffle the noise. In addition to CPAP, there are other devices that a sleep specialist may recommend for sleep apnea treatment.
Expiratory positive airway pressure EPAP single-use devices fit over the nostrils to help keep the airway open and are smaller, less intrusive than CPAP machines. These may benefit people with mild-to-moderate obstructive sleep apnea. Adaptive servo-ventilation ASV devices can be used for treating central sleep apnea as well as obstructive sleep apnea.
Custom-made oral appliances are an increasingly popular means of treatment for sleep apnea. While there are many different oral appliances approved for sleep apnea treatment, most are either acrylic devices that fit inside your mouth, much like an athletic mouth guard, or fit around your head and chin to adjust the position of your lower jaw.
Two common oral devices are the mandibular advancement device and the tongue retaining device. These devices open your airway by bringing your lower jaw or your tongue forward during sleep. Since there are so many different devices available, it may take some experimentation to find the appliance that works best for you.
There are some potential side effects to oral appliances, including soreness, saliva build-up, and damage or permanent change in position of the jaw, teeth, and mouth. These could be more serious in poorly fitted devices.
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