Sleep apnea is a serious and potentially life-threatening condition occurring in all age groups and both genders. Although more common in men, it may be under-diagnosed in women and young African-Americans. It is estimated that as many as 18 million Americans have sleep apnea and is treatable.
Early recognition and treatment of sleep apnea is important, as it may be associated with:
- Irregular heartbeat
- High blood pressure
- Heart attack
- Daytime sleepiness
- Increased risk of motor vehicle accidents
Who is affected by sleep apnea?
Sleep apnea appears to run in some families and may be based in genetics. However, even those with no family history may be likely to develop sleep apnea if they:
- Snore loudly
- Are overweight
- Have high blood pressure
- Have some physical abnormality in the nose, throat, or other parts of the upper airway
Use of alcohol and sleeping pills increases the frequency and duration of breathing pauses in people with sleep apnea.
How is sleep apnea diagnosed?
Diagnosing of sleep apnea can be complicated as there can be many different causes. Primary care physicians, pulmonologists, neurologists, or other physicians with specialty training in sleep disorders may be involved in making a definitive diagnosis and initiating treatment. Several tests are available for evaluating a person for sleep apnea, including:
- Polysomnography is a test that records a variety of body functions during sleep, such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow, and blood oxygen levels.
- Multiple Sleep Latency Test (MSLT) is a test that measures the speed of falling asleep. People without sleep problems usually take an average of 10 to 20 minutes to fall asleep. Individuals who fall asleep in less than five minutes are likely to require some type of treatment for sleep disorders.
Diagnostic tests usually are performed in a sleep center, but new technology may allow some sleep studies to be conducted in the patient's home.
How is sleep apnea treated?
Specific treatment will be determined by your physician based on:
- Your age, overall health, and medical history
- Severity of the disease
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
Medications are generally not effective in the treatment of sleep apnea. Therapy for sleep apnea is specifically designed for each individual patient, and may include the following:
- Oxygen administration may safely benefit certain patients, but does not eliminate sleep apnea or prevent daytime sleepiness. Its role in the treatment of sleep apnea is controversial.
- Behavioral changes are an important part of a treatment program, and in mild cases of sleep apnea, behavioral therapy may be all that is needed. The patient may be advised to:
- Avoid the use of alcohol.
- Avoid the use of tobacco.
- Avoid the use of sleeping pills.
- Lose weight if overweight (even a 10 percent weight loss can reduce the number of apneic events for most patients).
- Use pillows and other devices to help sleep in a side position.
- Physical or mechanical therapy options are also available. Nasal continuous positive airway pressure (CPAP) is a procedure in which the patient wears a mask over the nose during sleep, and pressure from an air blower forces air through the nasal passages. Dental appliances that reposition the lower jaw and the tongue have been helpful to some patients with mild sleep apnea, or who snore but do not have apnea.
- Some patients with sleep apnea may need surgery. Examples of these procedures include:
- Common surgical procedures to remove adenoids and tonsils, nasal polyps or other growths or tissue in the airway, and correction of structural deformities.
- Uvulopalatopharyngoplasty (UPPP) is a procedure used to remove excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate).
- Surgical reconstruction for deformities of the lower jaw may benefit some patients.
- Surgical procedures to treat obesity are sometimes recommended for sleep apnea patients who are morbidly obese.