Sleep Apnea - Symptoms, Tests, Diagnosis, and Treatment Options
I have sleep apnea. Well, I did before I began using a bi-pap sleep apnea machine and losing some weight. I have a lot of fellow sufferers, too, including family members and friends. In fact, my husband just found out he has obstructive sleep apnea, so I guess now we’ll have a nightly battle of the breathing machines. According to the American Sleep Apnea Association, some eighteen million people in the United States suffer from the condition, and it can be serious and sometimes fatal. Severe sleep apnea can pretty much wreck your day-to-day life, and if you don’t get help, the long term results can be disastrous. Even milder versions can make you miserable and threaten your health. If you think you or a loved one might suffer from breathing difficulties while sleeping, continue reading to learn more about sleep apnea.
What Is Sleep Apnea
What is sleep apnea? The word apnea literally means “without breath.” Sleep apnea means you don’t breathe sufficiently while you’re sleeping. Breathing stops numerous times during sleep. When the oxygen level in your body drops low enough, your brain usually wakes you up enough to breathe. You might fully wake up, gasping for air, or you might gasp for air while you’re in light sleep. Most people don’t even remember fighting for air during sleep.
There are two basic types of sleep apnea: central sleep apnea and obstructive sleep apnea, often shortened to OSA. OSA is much more common than central sleep apnea. You can read about the differences in the two conditions below. It’s also important to note that some people suffer from both conditions. When that occurs, it’s called mixed sleep apnea.
What Is Sleep Apnea:
Central Sleep Apnea
Central sleep apnea is basically the result of a communication failure. Muscles control your breathing, and those muscles, of course, are controlled by your brain. In some people, the brain fails to send the breathing signal to the muscles responsible for breathing. These people stop breathing periodically and repeatedly while they’re asleep. It’s sort of like they forget to breath. The condition might be caused by a stroke, certain medications, congestive heart failure, a brain tumor, or sleeping at high altitudes. Doctors can’t always identify the causes. People with central sleep apnea might or might not snore.
Obstructive Sleep Apnea
What does obstructive sleep apnea mean? Obstructive means that something is in the way of breathing. In the case of obstructive sleep apnea or obstructive sleep apnea syndrome, what gets in the way of breathing is soft tissue that lacks bone or cartilage. These tissues might involve the soft palate, the tongue, and/or the tonsils.
When you’re fully awake, these structures generally remain in a position that allows air to flow freely through the trachea, the mouth, and the nose. You also subconsciously use muscles to keep the airway free. When you’re asleep, however, these soft parts relax and fall into the path of the air, partially or completely blocking its progression.
When this happens, you miss breaths, causing you to awaken enough to correct the situation. People with sleep apnea might wake up as many as 60 times a night, and people with severe sleep apnea often awaken as many as 100 times during a night’s sleep.
Sleep Apnea Symptoms
The direct symptoms of sleep apnea are often not realized by the sufferer. Observers watching a person with the condition, however, might recognize several sleep apnea symptoms in the sleeper, including excessive snoring, restlessness, and a cessation of breathing for short periods of time, usually followed by a gasping for breath. The person might stop breathing for only a few seconds. People with severe sleep apnea can stop breathing for longer intervals.
Even though someone with sleep apnea cannot observe their own condition directly, they can most certainly feel the sleep apnea side effects the next day. Signs of sleep apnea include daytime drowsiness, loss of concentration, fatigue, and depression. Other signs of sleep apnea might include a headache upon waking, along with erectile dysfunction in men.
The sleep apnea side effects, especially in someone with severe sleep apnea, can be devastating. They can cause you to fall asleep while driving or while engaging in other activities in which you need to be fully alert. The condition can make you feel miserable. You can get so desperate for sleep that you might doze off anywhere and anytime.
Sleep apnea and snoring often, but not always, go hand in hand. When the soft tissues are relaxed, they often vibrate when air passes through them. This noise results in what we call snoring, and it can get unbelievably loud. For example, my Uncle Jack’s snoring used to be so loud that he was sometimes dismissed early from hospital stays because he kept patients in other rooms awake all night.
Sleep apnea and snoring are not always synonymous. More important than the snoring itself is whether or not the sleeping individual stops breathing while sleeping. If you have OSA, you might not even remember that you had trouble breathing because your brain might take over and force you to breathe before you’re fully awake. You might fall back to sleep immediately after taking a deep breath.
Sleep Apnea Side Effects
A person with severe sleep apnea gets very little REM sleep and rarely reaches the deep levels of sleep needed to restore the body. Also, when you suffer from sleep apnea, your brain doesn’t get enough oxygen, which can cause confusion, trouble concentrating, and memory loss. In fact, according to a study conducted at the University of California at Los Angeles, sleep apnea can cause cell damage in the brain.
Other sleep apnea side effects that can result long term include high blood pressure, diabetes, stroke, chest pain, heart attack, congestive heart failure, obesity, and cardiac arrhythmias. Obstructive sleep apnea can also make other health conditions worse. These might include asthma, restless leg syndrome, inflammation, and chronic pain.
What Causes Sleep Apnea
What causes sleep apnea? Doctors are still studying the causes of sleep apnea. Several risk factors, however, have been identified as probable causes of sleep apnea. These include having a large neck, being overweight, enlarged tonsils and/or adenoids, having a large tongue, smoking, nasal congestion, a deviated septum, a receding chin, hypothyroidism, Down syndrome, and certain neuromuscular disorders. Other sleep apnea causes are a family history of the condition, as well as the use of sedatives and alcohol.
I was a prime candidate for sleep apnea. I’m overweight, I smoke, I have a large neck, and I have a huge tongue and tonsils. I also have a deviated septum and suffer frequently from nasal congestion due to allergies. On top of all that, practically every adult over fifty in my family has sleep apnea.
On the other hand, my husband was just diagnosed with obstructive sleep apnea, and he doesn’t really fit the typical profile. He’s not overweight, he doesn’t have a large neck, he doesn’t have a deviated septum, and he doesn’t have much nasal congestion. We don’t know if sleep apnea runs in his family or not, as he was adopted.
If your doctor suspects you might have sleep apnea, a sleep study will be ordered. Formally called a polysomnogram, the test typically requires an overnight stay away from home. With a sleep study, you’ll check into a sleep lab on the scheduled date, usually in the evening. Typically, you report to the center at around eight o’clock in the evening, ready for bed. At most sleep apnea centers, you’ll have a private room that is set up much like a guest room in a home rather than a hospital room. It usually has a television set, but it might be turned off at eleven o’clock. The temperature of the room will usually be set to what’s comfortable for you. The staff does its best to ensure your comfort because they want you to sleep.
After answering questions and taking a sleep apnea quiz, you’ll be hooked up to monitors that will measure your sleep and breathing patterns, along with your oxygen saturation levels. During the sleep test, health care professionals at the sleep apnea centers observe patients’ actions during slumber via a camera. The next morning, you’ll be unhooked from all the devices, and you’ll be allowed to return home.
The staff at the sleep center won’t tell you whether or not you have sleep apnea. If you get a call within a few days telling you to come back for another sleep study, you can pretty much be sure you have OSA. If the results of the sleep test indicate sleep apnea, most sleep apnea centers will schedule the patient with another visit. On the next visit, you’ll be fitted with one of the sleep apnea machines like a CPAP for sleep apnea. The results of the second sleep study will be compared to the first, and a sleep apnea diagnosis will be made – or not.
Sleep Apnea Diagnosis
A sleep apnea diagnosis is made through a sleep test or sleep study. Such a sleep test is conducted at sleep apnea centers. If you’ve experienced signs of sleep apnea, your doctor can send you to one of many sleep apnea centers for a sleep study or sleep test.
At a sleep center, you’ll be fitted with electrode patches on your face, head, chest, and arms and/or legs. The electrodes will measure things like rapid eye movement, brain activity, arm movements, leg movements, heart rate, cardiac rhythm, lung activity, and blood pressure. A small device will be placed on a finger to measure your blood oxygen. Belts will be placed around your abdomen and chest to measure how you breathe in and out. Something like a nasal cannula might be placed in your nose to measure the flow of air into your nostrils.
All the findings of the devices are recorded throughout the night. Your doctor or a sleep specialist studies the findings to determine whether you have sleep apnea or not. If it’s confirmed that you have OSA, the severity of the condition will also be evaluated. When you return for another sleep study, the best setting for your CPAP or other machine will be determined.
Something relatively new in diagnosing sleep apnea is a portable monitor that can be used at home. It records the same information that’s discovered during a study at a sleep center or sleep lab. Many patients prefer the portable home test because it’s less expensive, and you don’t have to spend a night away from home. You might also sleep much better in your own bed, which could result in a better reading.
Sleep Apnea Treatment
In treating sleep apnea, your doctor might try several sleep apnea remedies. Cures for sleep apnea might include weight loss, discontinuing the use of alcohol or sedatives, or simply changing sleep positions. Sleep apnea is more likely when the person sleeps on his back and less likely when he sleeps on his side. Sleep apnea treatment, especially with mild cases, could be as simple as arranging pillows so that the person cannot roll over onto his back.
For people who don’t respond to the above sleep apnea remedies, as well as for those with severe sleep apnea, several types of sleep apnea machines are available as effective cures for sleep apnea. These sleep apnea machines are called CPAP, which stands for continuous positive airway pressure. It forces air through your nose or mouth via a face mask or nasal tube. The pressure is adjusted to fit your individual needs.
Another of the sleep apnea machines is a Bi-PAP, a bi-level positive airway pressure machine. With the Bi-PAP, the force of the airflow decreases when the person exhales and increases as the person inhales. Many patients find the Bi-PAP much more comfortable than the traditional CPAP sleep apnea machines.
Sleep apnea aids also include autotitration sleep apnea machines. These automatically adjust the airflow according to the patient’s needs at that specific time, unlike the CPAP and the Bi-PAP.
Oxygen may also be prescribed by your doctor. This is usually in the form of an oxygen concentrator that works directly with other sleep apnea machines.
Sleep Apnea Mouthpiece
Some people find relief by using a sleep apnea mouthpiece. These usually work best for patients with mild OSA. They can be purchased over the counter, or they might be prescribed by your physician. Most doctors don’t recommend the over-the-counter versions, but my best friend uses one, and it has served her well. Still, it’s better to go through a sleep study to find out just how bad your condition is. Without the sleep study, you have no way of knowing.
Sleep apnea aids like tongue devices might provide sleep apnea help. This device provides suction between the top and bottom teeth, pulling the tongue forward in an effort to avoid its obstructing the airway. A sleep apnea dental appliance is made by a dentist. A custom-made device is made to specifically fit the patient’s mouth. The oral appliance usually performs specific functions, depending on the underlying problem or problems. Some pull the tongue forward with suction, getting it out of the way of the airway.
Another type of sleep apnea mouthpiece is the mandibular advance teeth mold. This causes the bottom teeth and the jawbone to protrude slightly, which helps keep the airway open and the mouth closed. It also stimulates the tongue muscles, making the tongue stiffer. That way, it’s less likely to fall over the airway and stop the flow of air.
Sleep Apnea Mouthpiece:
Sleep Apnea Machine
For people who don’t respond to simple sleep apnea remedies, as well as for those with severe sleep apnea, a sleep apnea machine might be ordered. Several types of machines are available as effective cures for sleep apnea. The most common device is called CPAP, which stands for continuous positive airway pressure. It forces air through your nose or mouth via a face mask or nasal tube. The pressure is adjusted to fit your individual needs.
Another type of sleep apnea machine is a Bi-PAP, a bi-level positive airway pressure machine. With the Bi-PAP, the force of the airflow decreases when the person exhales and increases as the person inhales. Many patients find the Bi-PAP much more comfortable than the traditional CPAP sleep apnea machines.
Sleep apnea aids also include autotitration machines. These automatically adjust the airflow according to the patient’s needs at that specific time, unlike the CPAP and the Bi-PAP.
If your blood oxygen dropped low enough during the sleep study, oxygen may also be prescribed by your doctor. This is usually in the form of an oxygen concentrator that works directly with other sleep apnea machines. I had an oxygen machine for a while, but I no longer need it. My machine was large, and it set next to my Bi-Pap. In fact, it was hooked up to it. It wasn’t noisy, and I didn’t have to bother with tanks of oxygen. It made its own oxygen by concentrating O2 from the surrounding air.
For some people, getting used to a sleep apnea machine is difficult, but I had no problem taking to mine immediately. My face mask covers just my nose, but there are different types of masks. My brother’s, for example, covers his entire face. My mask is covered with a soft gel-like substance, so it’s not uncomfortable. It has two straps that can be adjusted around my head for a snug fit. Periodically, my old mask has to be traded in for a new one.
I never had to pay anything out of pocket for my sleep apnea machine or for my oxygen concentrator. I have two health insurance policies that covered the costs. The Bi-PAP has made such a huge improvement in my life, however, I think I’d pay anything to keep it, even if I had to give something else up in order to be able to afford it.
Sleep Apnea Machine: different masks
Sleep Apnea Surgery
Surgery for sleep apnea usually involves removing part of the soft tissues that obstruct the airway and/or repositioning the bones involved, including the hyoid, the geniotubercle, and/or the jawbone.
The oldest from of surgery for sleep apnea is tracheostomy. This procedure involves making an incision in the neck and inserting a plastic tube, completely avoiding the soft tissues altogether. This surgery is rarely used now as a cure for sleep apnea.
The newest form of surgery for sleep apnea is called palatal restoration. This procedure is much less invasive than other procedures and is often performed in a doctor’s office, under local anesthesia. Small inserts are placed in the small palate to give it additional support. This way, it won’t relax during sleep to obstruct the airway.
My uncle had severe sleep apnea, and his physician recommended surgery to correct the condition. uncle Bob took his doctor’s advice and had the surgery. He had a lot of pain afterwards, and the procedure didn’t help with his nightly breathing issues. I don’t know which type of sleep apnea surgery he had, but it was years ago, so it wasn’t the new procedure.
Hypertension Sleep Apnea
Long term sleep apnea effects include hypertension, or high blood pressure. Doctors are not sure about the relationship between hypertension and sleep apnea, but studies show that over 50% of patients with untreated obstructive sleep apnea have hypertension. Hypertension sleep apnea usually abates once effective sleep apnea remedies are used by the patient.
As you probably already know, high blood pressure can lead to some serious health problems. These include stroke, heart attack, kidney failure, aneurism, and arterial disease. Having chronic high blood pressure can significantly shorten your life. If you have trouble breathing at night, get help as soon as possible. Your hypertension might very well be cured without prescription drugs.
Sleep Apnea Death
Most people don’t realize how serious OSA can be. It can cause all sorts of problems, and in some cases, it can even be fatal. Sleep apnea death is a serious concern for those with obstructive sleep apnea syndrome. Causes of sleep apnea death include myocardial infarction and stroke, especially in individuals with severe sleep apnea.
Using a CPAP or similar sleep apnea machines, however, drastically reduces the risk of sleep apnea death. Studies show that people who use a CPAP for at least six hours a night reduce their risk of death by as much as 96%. That’s an extremely good reason for using a breathing machine religiously!
My Experience with Obstructive Sleep Apnea
Several years ago, I never slept more than an hour at the time. Every hour, I would have to get up to go to the bathroom. At first, I thought I had diabetes because of the frequent urination. I often had headaches in the morning, and I was always tired and sleepy. On my way home from work, I had to fight to stay awake on the interstate. It was very scary, and I never felt rested. How scary and dangerous was it? More than once, I actually fell asleep while driving. One time I woke up just as I was about to run into a semi.
I was pretty sure I had severe sleep apnea. Many members of my family have it, and I certainly fit the profile. I was overweight, with a thick neck, a large tongue, and huge tonsils. I talked to my doctor about it, and he set up a sleep study.
After my first visit to the sleep study center, I got the news. I did, indeed, have severe sleep apnea. A second sleep study was scheduled. On the second visit, I was fitted with a CPAP. I slept like a baby for the first time in years! It was great. I slept for six hours straight, with no getting up to go to the bathroom. After that night’s sleep, I felt wonderful.
I was sent home with an order for a CPAP, which was changed to a bi-Pap, and I love it. Now, I never have to get up during the night. As long as I can get six hours of sleep, I never get drowsy during the day, either. I think I’d shoot someone over my sleep apnea machine!
There is sleep apnea help available. If you think you might have sleep apnea, see your doctor. Submit to a sleep study – what are two nights out of your life? Actually, if you don’t have OSA, you’ll have to submit to just one night at the sleep center, in most cases. Sure, it’s inconvenient, but there’s no pain involved in the study, and all you have to do is sleep. Admittedly, you might have trouble falling asleep in a strange place with gadgets hooked up to you, but the results far outweigh the nuisance. You’ll get back your life, and you won’t believe how much better you’ll feel. I really can’t stress this enough. Effective sleep apnea help will definitely change your life for the better!
Sleep Apnea Quiz
Think you or a loved one might have this serious sleep disorder? Take the sleep apnea quiz below. If you answer “yes” to two or more questions, you might have obstructive sleep apnea.
1. Do you still feel tired after a night’s sleep?
2. Do you snore loudly and frequently?
3. Have you been observed gasping for breath in your sleep?
4. Have you been observed holding your breath during sleep?
5. Do you suffer from depression?
6. Do have trouble concentrating?
7. Do you feel sleepy during the day?
8. Do you have morning headaches?
9. Are you unusually irritable during the day?
10. Do you have trouble remembering things?