The Symptoms Of Sleep Apnea
Learn how to recognize the symptoms of sleep apnea and how to treat it.
A person with sleep apnea is often unaware of his/her condition. The only symptom of sleep apnea he/she might recognize is excessive daytime sleepiness. In truth, the person with sleep apnea snores loudly and his/her breathing will stop for several seconds at a time while he sleeps. A person with sleep apnea will often find him/herself so tired during the day that he/she cannot concentrate or stay alert for extended periods of time. He/she will frequently fight the urge to fall asleep at work, behind the wheel of the car, or in front of the television.
The disorder, sleep apnea, is named for the Greek word apnea, which means "want of breath." There are two types of sleep apnea. The first type, central sleep apnea, is less common. It occurs when the brain fails to send the appropriate signals to the muscles responsible for initiating breathing. The second type, obstructive sleep apnea, is far more widespread. Nearly 2% of women and 4% of men have obstructive sleep apnea to some degree. Obstructive sleep apnea occurs when air cannot flow into or out of the nose or mouth although the sleeper continues to breathe.
Apnea often results when the throat muscles and the tongue relax during sleep and partially block the airway opening. Overweight people may have an excessive amount of tissue narrowing their airway, blocking the flow of air into and out of their mouth and nose. A person whose airway is narrowed during sleep will not be aware of it but will snore heavily and experience periods of no breathing. Then, he/she will gasp for air, frequently waking from deep sleep to light sleep as these "apneic events" occur. In any one night, the sleeper may experience from 20 to 60 or more apneic events per hour! That means that his/her sleep is disturbed more than 200 times a night.
This frequent interruption of sleep leads to excessive daytime sleepiness. This is the first complaint of sleep apnea patients. Left untreated, sleep apnea can be associated with numerous other health problems. These include irregular heartbeat, high blood pressure, heart disease, and stroke.
If a person snores, it doesn't necessarily indicate sleep apnea, but if the patient complains of fatigue, it is a possibility. When a doctor becomes aware of the symptoms, he/she will probably refer the patient to a sleep specialist for further evaluation and diagnosis. The sleep specialist will discuss the symptoms and sleep habits. Then, the patient will stay overnight at a sleep clinic where tests will be administered while the patient sleeps.
Polysomnogaphy tests are used to monitor the heart, lung, and brain activity, as well as breathing patterns, blood oxygen levels, and arm and leg movements. In some cases, there is technology that lets sleep studies be conducted while the patient sleeps at home.
Behavioral therapy, in some cases, may be all that is needed to relieve a patient's labored breathing during sleep. For people who are overweight, losing weight offers some relief by opening the airway for improved airflow. Studies have shown that even a ten percent reduction in weight can reduce the number of apneic events for most patients.
For some patients with mild sleep apnea, apneic events occur when they sleep on their backs. Using pillows and other devices to keep them from turning over onto their backs in sleep helps the symptoms. Avoiding the use of alcohol and tobacco helps because these are likely to make the airway collapse during sleep. This prolongs apneic periods.
The most common effective medical treatment for sleep apnea is nasal continuous positive airway pressure (CPAP). With this therapy, the patient sleeps with a small lightweight mask over the nose, or with padded prongs inserted just into the nostrils. A specifically prescribed amount of air blows through the mask or prongs from an air blower. This forces air through the nasal passages. The constant, continuous air pressure is adjusted so that it is just enough to prevent the throat from collapsing during sleep. Once the CPAP treatment is stopped, the symptoms return.
For some patients with mild sleep apnea, or for those who snore but do not have sleep apnea, dental appliances that reposition the lower jaw have been helpful in treating symptoms.
Surgical procedures are sometimes used to increase the size of the airways. Some of the more common procedures include the removal of the adenoids and tonsils (especially in children), nasal polyps or other growth, or other tissue in the airway and correction of structural deformities.
One procedure called a uvulopalatopharyngoplasty (UPPP) removes excess tissue at the back of the throat. The success of this procedure appears to range from 30 to 60 percent, and it is not always clear which patients will benefit from this technique.
A new non-surgical procedure to treat snoring uses low levels of radio frequency energy to shrink excess tissue in the soft palate and uvula. This procedure is called a somnoplasty.
Patients who have been treated successfully for sleep apnea often claim to feel renewed. In addition to alleviating excessive daytime sleepiness, a restful night's sleep can improve many ailments related to the sleeplessness.