Screening for Sleep Apnea

Sleep apnea affects 12 million Americans. Learn how doctors diagnose the condition and which sleep apnea treatment is right for you.

Sleep apnea is a common condition — it affects at least 12 million Americans, although many of those cases go undiagnosed. If you snore loudly, wake up feeling groggy even though you think you’ve gotten a good night’s sleep, or feel sleepy and irritable during the day, sleep apnea may be the cause.

People with sleep apnea briefly stop breathing while they sleep. These episodes last a few moments and may occur hundreds of times during the night. When you stop breathing, the oxygen levels in your blood drop until your brain alerts your breathing muscles to get working again, often punctuated by a loud gasp or snore. Because you don’t wake up from these breathing disruptions, you feel tired in the morning without knowing why.

Screening for Sleep Apnea: Evaluation and Diagnosis

Sleep apnea isn’t something that can be detected while you’re awake, and there are no blood tests for diagnosing the condition. So it’s up to you, a sleeping partner, or a family member who hears you snoring, to bring it to your doctor’s attention. Fortunately, diagnosis is straightforward, and usually sleep apnea can be treated effectively and inexpensively.

The first step is an evaluation by your primary care physician. Ideally, this should include a thorough medical history, including questions about your symptoms as well as a conversation with someone who lives with you about the degree and frequency of your snoring. Your doctor will most likely check your nose, mouth, and throat for swollen or enlarged tissue or anything else that might block the airway and interfere with breathing. He may ask if you have a history of allergies or respiratory infections, which can exacerbate tissue swelling or create mucus that obstructs air passages.

Next, your doctor may refer you to a sleep center for a more specialized evaluation. At the center, you’ll be hooked up to machines that measure breathing, heart rate, brain activity, and other physical functions while a patient sleeps. A doctor who specializes in sleep disorders can diagnose sleep apnea by looking at the test results in addition to the rest of your medical history.

Screening for Sleep Apnea: Treatment Options

The mainstay of sleep apnea treatment is continuous positive airway pressure (CPAP), says Rochelle Goldberg, MD, president of the American Sleep Apnea Association in Washington, D.C. With CPAP, you wear a special mask that fits over your nose and is attached by a tube to a generator. The generator blows air through the tube to the mask and into your nose. This keeps your airway open and allows you to breathe properly through the night. For people who can tolerate it, CPAP is highly effective and has virtually no side effects. It’s a low-risk, high-yield treatment, Dr. Goldberg says.

However, not everyone feels comfortable wearing a mask that’s hooked up to a machine during bedtime. For those people, other treatment options include:

  • Oral appliances that open the airway by pulling the lower jaw forward. Goldberg advises ordering a custom appliance made by a dentist rather than buying your device from stock online, which have a mediocre track record of success.
  • Surgery to remove tonsils or adenoids or reduce excess tissue in the soft palate. Goldberg warns that all surgery involves risk, and the success of these procedures is unpredictable. A newer, less invasive operation, called the pillar procedure, involves implanting three tiny silicone rods to stabilize the palate, but it’s effective in only 50 to 60 percent of cases, she says.

Goldberg also recommends these lifestyle changes:

  • Avoid dairy products or other foods that produce mucus or cause the membranes in your mouth or throat to swell.
  • Moisten the air in your bedroom with a humidifier if necessary — this can make it easier to breathe.
  • Stay away from airborne irritants whenever possible.
  • Don’t sleep on your back, as this allows the tissue in your mouth or throat to relax and collapse over the airway.
  • Lose weight when appropriate. Goldberg maintains, however, that the link between obesity and sleep apnea has been greatly overstated.

Sleep apnea may be hard to detect initially, but there is a lot of information available to help you spot the warning signs and eventually receive proper sleep apnea treatment.

By Norra MacReady – Medically reviewed by Pat F. Bass III, MD, MPH