Sleep Apnea

Obstructive apneas are characterized by the absence of airflow for more than 10 seconds despite ongoing breathing effort. While breathing in, the upper airway is sucked closed, typically in the area behind the tongue.

Sleep apnea with predominant obstructive apneas occurs most commonly in:

• Pre-adolescents
• Adolescents
• Young and middle-aged adults

Being overweight or obese greatly increases your chances of developing obstructive sleep apnea.

Common symptoms of obstructive sleep apnea, aside from excessive sleepiness, include:

• Loud snoring
• Headaches
• Heart burn
• Cognitive impairment
• Awakening unrefreshed

Choking, coughing, excessive movement or regurgitation may occur. A small proportion of people with sleep apnea have awakenings triggered by involuntary closure of the vocal cords. Patients with obstructive sleep apnea often awaken with a dry mouth and, in some cases, headaches.

Breathing interruptions disrupt your sleep. They contribute to excessive sleepiness that is a primary symptom of sleep apnea syndrome. In addition to being overweight, many patients with obstructive sleep apnea have high blood pressure, a recessed chin, or narrow or shallow upper airway. Obstructive sleep apnea tends to run in families.

People with obstructive apnea often believe their sleep isn’t interrupted. However, their sleep is usually interrupted by awakenings that are so brief that they aren’t even aware of them.

Sleep apnea with predominantly non-obstructive apneas tends to be most common in older patients, but it may occur at any age.

The most common consequence of sleep apnea is disrupted sleep, which causes daytime sleepiness. There are other potentially serious consequences:

• Cardiac arrhythmias (irregular heartbeat)
• Diabetes
• Heart attack
• Heart failure
• High blood pressure
• Stroke
• Trouble with memory or attention

If you have symptoms of sleep apnea, your doctor will recommend a sleep study to diagnose your condition.

Your doctor may recommend these or other lifestyle changes to help manage your sleep apnea:

• Avoiding or limiting alcohol intake
• Avoiding sleeping pills and other sedating medications
• Losing weight
• Quitting smoking

Other treatment options for sleep apnea include:

• CPAP machine. Nasal continuous positive airway pressure (CPAP) is the most effective treatment for obstructive sleep apnea. The CPAP machine delivers sufficient air pressure into the nose to inflate the upper airway enough to prevent collapse during sleep. You’ll wear a CPAP mask while you’re sleeping to ensure you continuously breathe while you’re asleep.
• Dental appliance. Dental appliances that fit onto the teeth and hold the jaw and tongue forward widen the airway and can be helpful for mild sleep apnea.
• Hypoglossal nerve stimulation. In this treatment, a device stimulates the nerve to the tongue. The U.S. Food and Drug Administration (FDA) has approved this treatment for certain patients.
• Medication. Your sleep doctor may prescribe a medication, such as trazodone or theophylline, to reduce the severity of your apneas.
• Other sleep apnea devices. Provent is a nasal peel-stick valve that is effective in a minority of patients and is FDA-approved. Winx is a treatment that uses oral suction to move the tongue forward and is FDA-approved for sleep apnea treatment.
• Surgery. If you have large tonsils and/or adenoids, your doctor may recommend surgical removal. Doctors sometimes use another effective surgical procedure — called maxillomandibular advancement — in which they move the jaw bones forward.

Snoring is a noise made by vibration of tissue in the throat. Snoring occurs most often when the air passages are narrowed. This can happen in many people during an acute (lasting a short time) condition such as a head cold.

However, most individuals who snore loudly and persistently have sleep apnea.