What is sleep apnea?

This graphic shows a blocked airway, symptomatic of apnea.  Source: Atlanta Institute for ENT

Apnea means “not breathing.”  Sleep apnea means you have episodes of not breathing when you sleep. These episodes can occur hundreds of times per night and last ten seconds or more.  Your body hates not having oxygen and arouses you. Once you wake up, you breath normally and may immediately fall asleep again — until the next episode. Think about that… you may be waking up hundreds of times each night without knowing it. No wonder you're sleepy!

Health consequences

During apneic episodes, the levels of oxygen in your body can drop to dangerously low levels and can result in cardiac arrhythmias (irregular heart beats), which can at times be fatal.  As your oxygen levels drop, your body may give its usual "danger" response, which is to let loose a burst of adrenalin.  This can make your blood pressure shoot up, making you more prone to heart attacks and strokes. 

About 20 million Americans suffer some degree of sleep apnea.  The most common treatment is a Continuous Positive Air Pressure (CPAP) device.

Types of sleep apnea

Central sleep apnea occurs in about 10% of patients with sleep apnea.  The center in the brain that controls respiration somehow loses control of the muscles that make you breathe. When you hit a dangerously low oxygen level, your brain will cause you to wake-up and resume breathing. This process is repeated all night, so that in the morning you feel as tired as when you went to bed.

Obstructive sleep apnea  (sometimes abbreviated as OSA or OSAS) occurs in the other 90% of patients with sleep apnea. In this condition, the airway becomes obstructed by the tongue, tonsils, uvula, or by a large amount of fat tissue in the neck. This results in the flow of air being cut-off.  You snore as you struggle for air, and, quite typically, your bed partner will notice you gasp and gurgle as you resume breathing after each apneic episode. 

In September 2006,  Mayo Clinic researchers proposed a new category of sleep apnea they call "complex" -- referring to patients who appear to have obstructive sleep apnea, but unlike typical OSA sufferers, do not respond to CPAP, but soon show symptoms of central sleep apnea. About 15% of apnea sufferers treated at Mayo over the course of one month fell into this category.

Symptoms of sleep apnea

	heavy snoring, especially -- but not necessarily -- accompanied by choking or gasping after a few seconds of not breathing.
	falling asleep at inappropriate times such as at work, while driving, sitting in a chair, or watching TV.
	morning headaches, memory difficulties, low energy

How do you get diagnosed?

The definitive diagnostic tool is a polysomnogram where you stay in a sleep laboratory overnight while measurements of your brain activity, respiratory activity, oxygen levels, and cardiac activity are performed. 

Sleep clinics are not cheap, so several companies, such as SleepQuest, are pioneering less expensive at-home studies. In addition, at least three devices which will allow you to screen yourself for apnea are now available, although their reliability remains unknown.

How is sleep apnea treated?

Apart from CPAP, there are a range of potential treatments.  Major categories of remedy are listed here.  Take our questionnaire to see which remedies may be most appropriate for you.

A new drug still in testing is being developed to help reduce OSA symptoms.

There is an online forum at apneasupport.org available to anyone who may still have questions regarding sleep apnea.