Sleep Disorders, Sleep Apnea and Snoring

Sleep Apnea

If you have sleep apnea, you’re not getting a deep restorative sleep. Sleep apnea is a breathing disorder characterized by brief interruptions in breathing while you sleep. It’s a common, but serious, disorder that affects people of all ages. And it impacts men more often than women.

You may have one of two types of sleep apnea:

• Obstructive sleep apnea occurs when the upper airway becomes blocked briefly, but repeatedly, during sleep — reducing or completely stopping airflow.
• Central sleep apnea is a condition in which the brain does not properly control your breathing during sleep. (Central sleep apnea is less common than obstructive sleep apnea.)

During either form of apnea, your breathing pauses many times during sleep — as many as 20 to 30 times per hour.

Health Risks of Sleep Apnea

Long term sleep problems can lead to serious health conditions, such as:

• Cardiac arrhythmias
• Diabetes
• Heart disease
• High blood pressure.
• Increased risk of driving accidents.
• Irregular heartbeat
• Stroke
• Weight gain

Signs and Symptoms of Sleep Apnea

With sleep apnea, your body does not experience a peaceful night’s rest. The most common signs and symptoms of obstructive sleep apnea include:

• Episodes in which you stop breathing during sleep.
• Loud snoring. (However, not everyone who snores has sleep apnea.)
• Loud snorting or gasping for air during sleep.

Due to frequent breaks in deep sleep, you may not feel well during the day. You may experience:

• Difficulty staying asleep (insomnia).
• Excessive daytime sleepiness.
• Irritability and poor attention.
• Morning headache and dry mouth.

Why Your Sleep Is Interrupted With Snoring and Apnea

While you sleep, your body starts making noisy, snoring sounds if the flow of air through the passages at the back of the mouth and nose is partially obstructed. Sometimes, this obstruction happens if the muscles in the back of your throat relax and your airway narrows. The tongue, upper throat, uvula and soft palate meet each other and vibrate while you breathe — and snoring occurs.

When the blockage of airflow is severe, apnea happens. You can’t get enough air when you try to breathe. Your body wakes up briefly so that your airway can reopen allowing you to breathe. You might snort, choke or gasp. This happens repeatedly through the night, making it difficult to get a deep, restful night’s sleep.

What Causes Apnea?

Other factors contribute to snoring and sleep apnea too. Common causes include:

• Excess weight. Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway can obstruct your breathing.
• Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.
• Smoking. Smokers are three times more likely to have obstructive sleep apnea than people who've never smoked. Smoking can cause inflammation in the upper airway.
• Nasal congestion. If you have difficulty breathing through your nose, you're more likely to develop obstructive sleep apnea.
• A narrowed airway.  Enlarged tonsils or adenoids can block the airway, particularly in children.
• Being male. Men are two to three times more likely to have sleep apnea than women. However, a woman’s risk is increased if she is overweight.
• Being older. Sleep apnea occurs significantly more often in older adults.
• Family history. Your risk for sleep apnea is higher if a family member also has it. You may inherit traits such as obesity or recessed jaw that put you at higher risk.

Sleep apnea can also be a problem for people with chronic sinus infections, a deviated septum, problems with the soft palate and uvula, and other abnormalities of the throat, tongue, jaws and neck.

Diagnosis of Sleep Apnea

To diagnose your sleep apnea, your doctor will evaluate your signs and symptoms. You may be referred to a sleep specialist who will monitor your breathing and other body functions during sleep. Home sleep testing might also be an option. Tests to detect sleep apnea include:

• Night-time polysomnography. This equipment monitors your heart, lung and brain activity, breathing patterns, movements, and blood oxygen levels while you sleep.
• Home sleep tests. These tests usually measure your heart rate, blood oxygen level, airflow and breathing patterns.

Our fully accredited sleep lab at El Camino Health Los Gatos provides the latest testing techniques to determine what’s causing your sleep problems.

Treatment for Sleep Apnea

If you have a mild case of apnea, your doctor may recommend you lose weight or quit smoking. If you struggle with nasal allergies that contribute to sleep apnea, your doctor might prescribe allergy treatment.

A common treatment for obstructive sleep apnea is a device called a CPAP, which stands for continuous positive airway pressure. A CPAP is a mask that fits over the nose and/or mouth. It gently blows air into the airway to help keep it open during sleep.

If lifestyle changes and other treatment methods don’t help, your doctor may recommend surgery.

Surgical options include:

• Tissue removal. Your surgeon removes tissue from the rear of your mouth and top of your throat. Enlarged tonsils and adenoids may be removed. This procedure allows for more airflow.
• Tissue shrinkage. The surgeon shrinks the tissue at the rear of your mouth and the back of your throat using energy (radiofrequency ablation). This procedure allows for more airflow.
• Jaw repositioning. In this procedure, your jaw is moved forward from the remainder of your facial bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely.
• Implants. In the Pillar Procedure, plastic rods are surgically implanted into the soft palate to stiffen it so it doesn’t lie flat and block the throat.
• Nerve stimulation. A nerve stimulator is surgically inserted to keep the tongue in a position that keeps the airway open.
• Bariatric surgery. If a person’s BMI (body mass index) is high and the obesity is contributing to sleep apnea, doctors might suggest bariatric surgery to help a person lose weight.