What You Need to Know About Sleep Apnea

Sleep apnea doesn’t necessarily affect overweight patients exclusively — anyone with a family history is susceptible. Other sleep apnea risk factors include high blood pressure and smoking.

Maybe your sleeping partner says your snoring sounds like a 747 landing in the next room; maybe you just don’t wake up refreshed after what you thought was a good night’s sleep and feel tired during the day. These are two signs of sleep apnea — brief periods when you stop breathing while sleeping — causing sleep disturbances that usually go unnoticed but can affect your ability to function during the day.

The Basics of Sleep Apnea

The most common type of sleep apnea is obstructive sleep apnea (OSA), in which breathing is disrupted by an obstruction in the airway of the nose, mouth, or throat. Another less common type is central sleep apnea, in which case there’s nothing blocking the airway, but the brain doesn’t alert your breathing muscles to get moving. Some people have both types at once, called mixed sleep apnea.

Whatever the cause, sleep apnea makes it hard to breathe while you’re asleep. The resulting drop in your blood oxygen level triggers your brain to disturb your sleep so you can breathe, but not enough to wake you entirely, so you’re not aware of what’s happening. This may be why you drag through the day without knowing the cause, explains neurologist Mark Mahowald, MD, medical director of the Minnesota Regional Sleep Disorders Center at the Hennepin County Medical Center in Minneapolis. Depending on the severity of the sleep apnea, these episodes can happen five to 100 times an hour, Dr. Mahowald notes.

Snoring and daytime sleepiness are the two most common sleep apnea symptoms, but other possible symptoms include:

  • Problems with memory, learning, or concentration
  • Headaches
  • Urinating at night
  • Irritability, depression, or mood swings
  • A dry throat after waking up

Sleep apnea is surprisingly common. According to the National Institutes of Health, it is estimated that more than 12 million Americans have this condition, most prevalent in men over age 65.

Although sleep apnea becomes more common as you age, it can occur at any time in your life, including childhood. Many cases go undiagnosed because doctors cannot detect sleep apnea during a routine office visit. The only way to get a proper diagnose is to undergo a sleep study, in which you’re hooked up to a special machine that records your brain activity, breathing pattern, and eye movements while you sleep.

Risk Factors for Sleep Apnea

A number of factors increase your risk of sleep apnea. These include a family history of sleep apnea, a large neck with recessed chin, abnormalities of the airway, alcohol use, and smoking. Additionally, certain groups of people are more susceptible to the condition — males are more likely to develop sleep apnea, as are certain ethnicities, including African-Americans, Pacific Islanders, and Hispanics.

Interestingly, many doctors and those outside the medical community think obesity is the main cause of OSA, but that’s a misconception, says Mahowald. “It used to be thought that OSA was confined to overweight, middle-aged men, but that’s absolutely not true. Most overweight people do not have OSA.”

Central sleep apnea usually is seen in people with conditions affecting the brain stem, which controls breathing. For example, people dealing with Parkinson’s disease, strokes, or injuries involving this area of the brain may develop central sleep apnea.

Treating Sleep Apnea

Fortunately, a safe, easy, and relatively inexpensive treatment is available for most people with OSA, says Mahowald. Known as continuous positive airway pressure (CPAP), this treatment consists of a mask that slips over your mouth and into your nose. A tube connects the mask to a small generator that delivers air with enough pressure to overcome the obstruction. He describes the CPAP system as an “air splint” because it keeps the airway open. CPAP is “one of the simplest treatments in all of medicine,” he explains. “All you have to do is blow air into the patient’s nose, and the OSA is gone.”

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