Illness & Conditions - Health Conditions
Focuses on obstructive sleep apnea. Discusses causes, including narrowed airways and obesity. Covers symptoms like snoring, gasping during sleep, and daytime sleepiness. Info on treatment with CPAP and oral or nasal breathing devices.
What is sleep apnea?
Sleep apnea means that your breathing often is blocked or partly blocked during sleep. The problem can be mild to severe, based on how often your lungs don't get enough air. This may happen from 5 to more than 50 times an hour.
This topic focuses on obstructive sleep apnea, which is the most common type.
A less common type of apnea, called central sleep apnea, can occur in people who have had a stroke, have heart failure, or have a brain tumor or infection. Even though this topic isn't about central sleep apnea, some of the treatments discussed here may also help treat it. Talk with your doctor to find out more about central sleep apnea.
What causes obstructive sleep apnea?
Blocked or narrowed airways in your nose, mouth, or throat can cause sleep apnea. Your airways can become blocked when your throat muscles and tongue relax during sleep.
Sleep apnea can also occur if you have large tonsils or adenoids . During the day, when you are awake and standing up, these may not cause problems. But when you lie down at night, they can press down on your airway, narrowing it and causing sleep apnea. Sleep apnea can also occur if you have a problem with your jawbone.
In children, the main cause of sleep apnea is large tonsils or adenoids.
Sleep apnea is more likely to occur if you are overweight, use certain medicines or alcohol before bed, or sleep on your back.
What are the symptoms?
The main symptoms of sleep apnea that you may notice are:
Your bed partner may notice that while you sleep:
Children who have sleep apnea:
But children may not seem very sleepy during the day (a key symptom in adults). The only symptom of sleep apnea in some children may be that they do not grow as quickly as most children their age.
Can sleep apnea cause other problems?
If you have sleep apnea, you may not be sleeping as well as you could. And you may be more likely to end up with serious problems such as:
How is sleep apnea diagnosed?
Your doctor will probably examine you and ask about your past health. He or she may also ask you or your sleep partner about your snoring and sleep behavior and how tired you feel during the day.
Your doctor may suggest a sleep study . A sleep study usually takes place at a sleep center, where you will spend the night. Sleep studies find out how often you stop breathing or have too little air flowing into your lungs during sleep. They also find out how much oxygen you have in your blood during sleep. You may have blood tests and X-rays.
How is it treated?
You may be able to treat mild sleep apnea by making changes in how you live and the way you sleep. For example:
If lifestyle changes don't help sleep apnea, you may be able to use an oral breathing device or other types of devices. These devices help keep your airways open while you sleep.
Sleep apnea is often treated with a machine that helps you breathe while you sleep. This treatment is called continuous positive airway pressure , or CPAP (say "SEE-pap"). Sometimes medicine that helps you stay awake during the day may be used along with CPAP. If your tonsils, adenoids, uvula, or other tissues are blocking your airway, your doctor may suggest surgery to open your airway.
Frequently Asked Questions
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Obstructive sleep apnea usually occurs when the throat muscles and tongue relax during sleep and partially or completely block the airway . When you stop breathing or have reduced flow of air into your lungs during sleep, the amount of oxygen in your blood decreases briefly.
Bone deformities, enlarged tissues
Obstructive sleep apnea can also occur if you have bone deformities or enlarged tissues in your nose, mouth, or throat. For example, you may have enlarged tonsils . During the day when you are awake and standing up, this may not cause problems. But when you lie down at night, the tonsils can press down on your airway, narrowing it and causing sleep apnea.
In children, the main cause of sleep apnea is large tonsils or adenoids.
Other things that may contribute to sleep apnea include:
With sleep apnea , there are symptoms that you may notice and symptoms that others may notice when you're asleep.
Symptoms you may notice include:
Symptoms others may notice include:
Symptoms in children
Children who have sleep apnea nearly always snore. But they may not appear to be excessively sleepy during the day (a key symptom in adults).
Other conditions with symptoms similar to sleep apnea include other sleep disorders and an underactive thyroid.
Obstructive sleep apnea causes your airway to narrow or close off, reducing or stopping breathing for short periods during sleep.
If your breathing stops, you may make grunting, gasping, or snorting sounds and restless body movements. As breathing resumes, loud snoring starts. This may happen many times during a night.
The more often it happens, the more severe your sleep apnea is. Sleep apnea is called either mild, moderate, or severe.
When you stop breathing, the oxygen levels in your blood go down and carbon dioxide levels go up. This makes your heart and blood vessels work harder and can affect your heart rate and nervous system. That in turn may:
Because sleep apnea disturbs your sleep, it can make you very tired during the day. So if you have sleep apnea, you may:
What Increases Your Risk
Certain things make it more or less likely that you will have obstructive sleep apnea. Some of these you cannot change, while others you can.
Things you can't change
Things you may be able to change
When To Call a Doctor
Call your doctor if:
Watchful waiting is a wait-and-see approach. If you get better on your own, you will not need treatment. If you get worse, you and your doctor will decide what to do next. Watchful waiting may be right for you if you snore but are not excessively sleepy during the day.
Watchful waiting may not be right if you notice that your sleep partner snores loudly and heavily, is restless during sleep, and is sleepy during the day. If you think your sleep partner may have periods when breathing stops, suggest that he or she talk with a doctor.
Who to see
Health professionals who can check people who have symptoms of obstructive sleep apnea include:
Other health professionals may be able to help you if you have other problems that are caused by sleep apnea. If you:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Your doctor will examine you and ask you and possibly your sleep partner some questions about your lifestyle, snoring, sleep behavior, and how tired you feel during the day (this is called a medical history).
Your doctor may ask you to complete a questionnaire, such as the Epworth Sleepiness Scale. The answers to questions in this questionnaire can help the doctor find out if you have sleep apnea. If your doctor thinks that you may have sleep apnea, he or she may suggest sleep studies or other tests.
Other tests that you may have include:
Diagnosing sleep apnea in children
Most doctors follow these guidelines from the American Academy of Pediatrics: 3
Testing after initial treatment
To see how well your treatment is working, you may need sleep tests after treatment begins.
If your sleep apnea has not improved after initial treatment, and if enlarged tissues in your mouth and throat are causing it, your doctor may do one or more tests before suggesting surgery to remove the excess tissue. These tests may include:
Treatment for obstructive sleep apnea may include:
Your doctor will probably have you try lifestyle changes and CPAP first. Surgery might be a first choice only if the sleep apnea is caused by a blockage that is easily fixed.
You may need to be treated for other health problems before you are treated for sleep apnea. For example:
If your sleep apnea gets worse, talk to your doctor:
Treatment for children
Children have the same treatment options as adults.
You can help prevent obstructive sleep apnea if you:
Home treatment for obstructive sleep apnea includes lifestyle changes and changing some sleeping habits.
One study found that people with sleep apnea who tend to have fluid collect in their lower legs and ankles may be helped by wearing compression stockings during the day. 6 Keeping the fluid from collecting in the legs during the day may prevent the fluid from causing swelling of tissues in the nose and throat at night.
Sleeping habit changes
Your doctor may also suggest that you use a breathing device while you sleep. It helps keep your airways open. This could be a device that you put in your mouth. Other examples include strips or disks that you use on your nose.
Doctors typically don't suggest using medicines to treat obstructive sleep apnea. Children may be given intranasal corticosteroid medicine for mild sleep apnea if surgery cannot be done or if the surgery did not work. 3
But medicine can help reduce daytime sleepiness when continuous positive airway pressure (CPAP) is reducing the number of times you stop breathing at night but you still feel sleepy during the day. 7, 8
People with sleep apnea who take these medicines to reduce daytime sleepiness should keep using CPAP to treat sleep apnea.
Surgery for obstructive sleep apnea usually isn't done unless other treatments have failed or you are unable or choose not to use other treatments.
What to think about
If you are thinking about having surgery to treat sleep apnea, talk with your doctor about having a sleep study done first.
Experts typically suggest that you try continuous positive airway pressure (CPAP) before considering surgery.
Laser-assisted uvulopalatoplasty uses a laser to perform surgery. It is sometimes used to treat mild to moderate sleep apnea, although not all people benefit. This surgery is not recommended by the American Academy of Sleep Medicine to treat sleep apnea. 10
Continuous positive airway pressure (CPAP)
CPAP is nearly always the first medical treatment for sleep apnea. With CPAP, you use a breathing device that prevents your airways from closing during sleep.
Research shows that:
It may take time for you to be comfortable using CPAP. You may find that you want to take off the mask, or you may find it hard to sleep. If you can't get used to CPAP, talk to your doctor. You might be able to try another type of mask or make other adjustments.
Some CPAP devices automatically adjust air pressure or use different air pressures when you breathe in or out. They are easier and more comfortable for some people to use.
If you use CPAP to treat sleep apnea, you need to use it every night. If you don't use it, your symptoms will return right away.
If CPAP isn't working, you may need another sleep study to find out whether your CPAP machine needs to be adjusted. You may also need to think about surgery.
Other devices to help you breathe
Oral breathing devices reposition your tongue and jaw during sleep, which opens up your airways. They may be used for people who have mild to moderate sleep apnea. They may also be used for people with severe sleep apnea who try CPAP but find out that it does not work for them.
Your doctor may suggest that you use nasal dilators (such as nose strips or disks) to help keep your airways open while you sleep. Nose strips widen the nostrils and improve airflow. Nasal disks have a valve that makes it harder for you to breathe out. This causes a little back-pressure in the airways that may help keep them open. You can get many of these devices without a prescription. Talk to your doctor or pharmacist about your options.
Other Places To Get Help
Last Revised: October 10, 2013
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