About Sleep Disorders

About Sleep Disorders Snoring and Sleep Apnea

Snoring and sleep apnea are the most common sleep-disordered breathing (SDB) problems that can affect your sleep, health and quality of life.

Did you know that approximately one in every five adults* has SDB? If you are one of these people, you are certainly not alone! Snoring and sleep apnea often occur together, but they are different. You need to understand the difference. So what is Sleep Apnea? Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

What happens to your airway during sleep apnea?

Normal, healthy breathing with no limited airflow.

Breathing passageway narrows, limiting airflow as you breathe. Your throat tissue vibrates, commonly heard as snoring

Tissues obstruct the upper airway completely. They prevent breathing, suffocating the sleeper.

Your airway may:

  • Narrow, limiting airflow as you breathe
  • Vibrate, commonly heard as snoring
  • Collapse, so you stop breathing

This third effect above is called obstructive sleep apnea (OSA). It is the most common type of SDB, and each incident may last for 10 seconds or longer.

Outlook

Untreated sleep apnea can:

  • Increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes
  • Increase the risk of, or worsen, heart failure
  • Make arrhythmias (ah-RITH-me-ahs), or irregular heartbeats, more likely
  • Increase the chance of having work-related or driving accidents

There are several types of sleep apnea and many causes. Learn more:

Symptoms

Here are the symptoms that are easiest to identify without diagnostic testing:

  • Excessive sleepiness (use the Epworth Sleepiness Scale to evaluate your sleepiness)
  • Snoring (people with OSA usually snore but not always)
  • Witnessed apneas or irregular breathing during sleep (gasping, long pauses, etc – a spouse or partner may notice these)
  • Impaired concentration
  • Impaired memory
  • Morning headaches
  • Sexual dysfunction (decreased libido)
  • Depression

High blood presure (hypertension) and decreased blood oxygen levels are common symptoms for people with sleep apnea, but these are not easily detected.

Types

There are three types of sleep apnea:

1. Obstructive sleep apnea (OSA)

  • The most common type of sleep apnea; occurs when your upper airway closes but your efforts to breathe continue
  • Upper airway obstruction caused usually by lack of muscle tone during sleep, extra upper airway tissue and/or anatomical abnormalities in the upper airway and jaw

2. Central sleep apnea (CSA)

  • Occurs when your breathing stops but your airway is open Results from the body’s failure to breathe automatically.
  • It’s as if a short circuit prevents the brain from keeping the respiratory system functioning properly

3. Mixed apnea

  • A mixture of both OSA and CSA

Causes

Causes and risk factors of sleep apnea:

  • Obesity
  • Snoring (Snoring can cause the soft palate to lengthen, which in turn can obstruct the airway)
  • Family history of OSA or snoring
  • Family history of sleep apnea – No specific genetic marker for sleep apnea has been discovered, but obstructive sleep apnea seems to run in families. This may be a result of anatomic abnormalities that run in the family
  • Small upper airway (large tongue, large uvula, recessed chin, excess tissue in the throat and/or soft palate)
  • Shape of head and neck may create a smaller than normal airway
  • Large tonsils or adenoids or other anatomical differences (A deviated septum, enlarged tongue or receding chin can also create difficulties breathing during sleep)
  • Throat muscles and tongue relax more than normal during sleep (This can be due to alcohol or sedative use before bedtime, but not necessarily)
  • Smoking or exposure to secondhand smoke
  • Nasal congestion, nasal blockages and nasal irritants
  • Other disorders and syndromes, such as Hypothyroidism, acromegaly, amyloidosis, vocal cord paralysis, post-polio syndrome, neuromuscular disorders, Marfan’s syndrome and Down Syndrome
  • Other physical conditions, such as immune system abnormalities, severe heartburn or acid reflux and high blood pressure. It isn’t clear whether the conditions are the cause or the result of sleep apnea

Health Risks

Research shows that snoring and sleep apnea are associated with many serious conditions. Left untreated, your sleep apnea can be a contributing risk factor to:

  • High blood pressure
    • More than 35% of people with sleep apnea suffer from high blood pressure, increasing their risk of heart disease(1)
    • More than 80% of people who continue to suffer from high blood pressure (despite taking three or more drugs) also have sleep apnea(2)
  • Stroke – Almost 70% of people who have had a stroke have sleep apnea(3)
  • Traffic accidents – A person with sleep apnea is 7 times more likely to have a car accident(4)
  • Type 2 diabetes
  • Depression

Treating sleep apnea can reduce the risk of developing associated diseases. It can also help you feel more energetic so you can do more of the things you want to.

1. Worsnop et al. Am J Respir Crit Care Med 1998 2. Logan et al. J Hypertens 2001 3. Bassetti et al. Sleep 1999 4. Young et al. Sleep 1997

Treatments

What treatments are available for Obstructive Sleep Apnea (OSA)?

OSA is most commonly treated with non-surgical approaches such as:

  • Continuous positive airflow pressure (CPAP) or Bi-level positive airway pressure (BPAP): the most common and noninvasive treatment for OSA. It involves wearing a mask that supplies a steady or an adjusting stream of air through the nose during sleep. The airflow keeps the upper airway open, like a “splint.” It is an ongoing treatment
  • Weight loss: a weight loss of even 10 percent can reduce sleep apnea significantly
  • Changing sleep habits: for some people, sleeping on one’s side instead of on one’s back can reduce sleep apnea
  • Behavior modification: subtle changes such as avoiding sedatives and alcohol can sometimes help
  • Less commonly, there are a range of surgical procedures that may assist
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