The following FAQ has been reviewed by Carl. E. Hunt,
M.D. of the National Center on Sleep Disorders Research, National
Heart, Lung, and Blood Institute, National Institutes of Health.
August 2002
See also…
Insomnia
Narcolepsy
Restless Legs Syndrome
Sleep Disorders
What is sleep
apnea? Sleep
apnea (sleep-disordered breathing) is a serious and common sleep
disorder affecting about 12 million Americans, according to the
National Institutes of Health (NIH). Its name comes from a Greek
word, apnea, meaning "without breath." People with sleep
apnea stop breathing briefly many times during the night. The
breathing pauses last at least 10 seconds, and there may be 20
to 30 or more pauses per hour.
The
main symptoms of sleep apnea are persistent loud snoring at night
and daytime sleepiness. Another symptom is frequent long pauses
in breathing during sleep, followed by choking and gasping for
breath. People with sleep apnea don't get enough restful sleep,
and their daytime performance is often seriously affected. Sleep
apnea may also lead to high blood pressure, heart disease, heart
attack, and stroke. However, it can be diagnosed and treated.
Who gets sleep apnea?
Sleep
apnea occurs in all age groups and both sexes but is more common
in men, people who are overweight or obese, and older persons.
The disorder is made worse by fat buildup in the neck or loss
of muscle tone with aging. People most likely to have or develop
sleep apnea include those who snore loudly and are overweight,
have high blood pressure, or have some other limitation in size
of the upper airways.
What causes sleep apnea?
Intermittent
(comes and goes) blockage in some part of the upper airways, often
due to the throat muscles and tongue relaxing during sleep, can
cause sleep apnea. When the muscles of the soft palate at the
base of the tongue and the uvula (the small fleshy tissue hanging
from the center of the back of the throat) relax and sag, the
airway becomes blocked. The blockage makes breathing labored and
noisy and even stops it altogether.
What are the effects
of sleep apnea?
During
the pauses in breathing, the oxygen level in your blood drops.
Your brain reacts to the drop in oxygen by waking you enough to
resume breathing (and snoring), but not necessarily enough to
fully awaken you. The cycle of snoring, not breathing, waking,
and resuming breathing means that you do not get good quality
sleep. Because of this, you may often feel very sleepy during
the day, find it hard to concentrate, and your daytime performance
may suffer.
The
effects of sleep apnea range from annoying to life threatening.
They include depression, high blood pressure, irritability, sexual
dysfunction, learning and memory problems, and falling asleep
while at work, on the phone, or driving. People with severe sleep
apnea are two to three times more likely to have automobile crashes.
Risk for heart attacks, high blood pressure, heart failure, and
stroke also increase with sleep apnea.
How do I know if I have
sleep apnea?
People
with sleep apnea are often not aware that they have it. You should
suspect sleep apnea if you often feel sleepy during the day, and
you have been told that you snore loudly and frequently, or seem
to have trouble breathing during the night.
Your
bed partner may notice your heavy snoring and struggles to breathe
during sleep. Coworkers or friends may notice that you tend to
fall asleep during the day at inappropriate times. If you think
that you have sleep apnea, it is important that you see a doctor
for evaluation of the sleep problem.
How is sleep apnea
diagnosed?
In
addition to your primary care provider, a sleep medicine specialist
needs to be involved in the diagnosis, as well as treatment. Diagnosis
of sleep apnea is not simple because there can be many different
reasons for disturbed sleep. If sleep apnea is suspected, the
sleep medicine specialist will need to perform a sleep study.
This usually means going to a sleep center, where tests are done
while you sleep. This test is called polysomnography, which records
a variety of body functions during sleep. These recordings can
sometimes be done at home.
How is sleep apnea treated?
The
specific therapy for sleep apnea is based on your medical history,
physical exam, and the results of polysomnography or other tests.
Possible
treatments for sleep apnea include:
Behavioral
changes such as weight loss, learning to sleep on one's side instead
of the back, and avoiding alcohol, sleeping pills, and smoking.
In milder cases, behavioral changes may be enough to stop the
sleep apnea.
Nasal
Continuous Positive Airway Pressure (CPAP) therapy, is generally
required for successful treatment. In CPAP therapy, a mask is
worn over the nose while sleeping, and a machine supplies pressurized
room air to the mask through a flexible tube. The pressurized
air keeps the airway open. There are various types of CPAP machines.
An
oral or dental device that holds the tongue or jaw forward.
Surgery.
Some of the more common procedures include removal of adenoids
and tonsils, especially in children; removal of nasal polyps or
other growths; and correction of structural deformities.
Medications
are generally not effective in the treatment of sleep apnea. However,
if nasal congestion is contributing to breathing problems, decongestants
may help.
Can
sleep apnea be prevented?
Avoiding
weight gain as you age is probably one of the best ways to prevent
sleep apnea. Avoiding the use of alcohol and sedating medicines
may also help.
For more information…
For more information, contact the National Women's Health Information
Center at (800) 994-9662 or the following organizations.
National Center on Sleep Disorders Research
Phone Number(s): (301) 435-0199
Internet Address: http://www.nhlbi.nih.gov/sleep
National Heart, Lung, and Blood Institute
Phone Number(s): (301) 592-8573
Internet Address: http://www.nhlbi.nih.gov
National Institute of Neurological Disorders and
Stroke
Phone Number(s): (800) 352-9424
Internet Address: http://www.ninds.nih.gov
American Sleep Apnea Association
Phone Number(s): (202) 293-3650
Internet Address: http://www.sleepapnea.org
National Sleep Foundation
Phone Number(s): (202) 347-3471
Internet Address: http://www.sleepfoundation.org
The information in this FAQ was adapted from materials
from the National Heart, Lung, and Blood Institute, including,
Facts About Sleep Apnea and the National Institute of Neurological
Disorders and Stroke, including NINDS Sleep Apnea Information
Page and Brain Basics: Understanding Sleep.
All material contained in the FAQs is free of copyright
restrictions, and may be copied, reproduced, or duplicated without
permission of the Office on Women's Health in the Department of
Health and Human Services; citation of the sources is appreciated.
