Sleep Apnea Causes and Treatment

Sleep Disorders

What is Sleep Apnea?

Loud, constant snoring can indicate a potentially life-threatening disorder called sleep apnea. The word “apnea” is derived from Greek to mean “without breath.” An estimated 5 in 100 people, typically overweight middle-aged men, suffer from sleep apnea. A person with sleep apnea stops breathing repeatedly while sleeping, anywhere from 10 seconds to 3 minutes.

Although an individual may not recall waking up, sleep is disrupted temporarily. As a result, sleep deprivation and excessive daytime sleepiness occur. If left untreated, sleep apnea can trigger high blood pressure and dangerous heart problems.

Sleep apnea can also occur in children and, in some cases, has been linked to Sudden Infant Death Syndrome (SIDS). In older children, sleep apnea occurs in those children who are overweight or who have unusually large tonsils and adenoids. Children with sleep apnea may snore, squeak, and thrash while sleeping. During the day, a child who suffers from sleep apnea will be sluggish or termed “lazy.” Since snoring is not normal for any child, parents should report this to their physician.

There are three types of sleep apnea: obstructive, central, and mixed. Obstructive sleep apnea (OSA) is the most common and severe form. This type of apnea occurs when the airway closes and remains obstructed, resulting in blocked airflow. As pressure to breathe increases, the diaphragm and chest muscles work harder. Blood pressure rises and the heart can beat irregularly or even pause for several seconds.

Every time breathing stops, the level of oxygen in the blood falls and the heart must pump harder. Every time there is an obstruction, the person must awaken momentarily to resume breathing. Sleep is temporarily interrupted, activating the throat muscles to open the airway.

Physical abnormalities are usually the cause of OSA. Excessive pharyngeal tissue, an overly large tongue, a congenitally small airway, or fatty deposits are often found to be the reason. Corrective surgery is a common solution to eliminating obstructive sleep apnea.

(Editor’s note: There are actually a number of forms of treatment for obstructive sleep apnea, not just surgery. These range from weight loss and other lifestyle changes to several surgical procedures. The most common, and still the most effective treatment, is the use of continuous positive airway pressure or CPAP, a device that uses pressurized air delivered through a nasal interface to hold the airway open while the patient sleeps. Combinations of these therapies are also used. There is more information about treatment options for obstructive sleep apnea later in this article and also in our overview article of apnea treatments.)

In central sleep apnea, the brain actually fails to signal the muscles to breathe. The airway is clear, but the diaphragm and chest muscles stop working. Eventually the decreased level of oxygen in the blood signals the brain to awaken the sleeper to restart breathing. This type of apnea becomes more common with age and is associated with heart disease or a neurological disorder.

Mixed sleep apnea is a combination of central and obstructive sleep apnea. This disorder initially occurs as central sleep apnea; where there is no brain signal to breathe. When the diaphragm suddenly begins moving, the airway is blocked by an obstruction (obstructive sleep apnea). It is not uncommon for a sleep disorder specialist to see all three types of apnea occur in one night.

What Treatments Are Available For Sleep Apnea?

Weight loss is often an effective treatment for snoring-related sleep apnea. Even just a few pounds can improve breathing during sleep. Another effective treatment is medication. Some antidepressants and asthma medications have been found to relieve sleep apnea because they are respiratory stimulants.

For severe sleep apnea cases, continuous positive airway pressure, or CPAP, therapy may be required. Patients receiving this treatment wear a light mask over the nose during sleep. An air compressor forces air through the nose and into the airway. Other sleep apnea patients find relief with oral appliances that prop the airway open by moving the jaw, tongue, and soft palate forward.

In some cases, surgery may be required to correct physical abnormalities. Sleep apnea as the result of enlarged tonsils (and adenoids in children) can be alleviated with a tonsillectomy. Another surgical technique called uvulopalatopharyngoplasty (UPPP) removes excess tissue at the back of the throat. For some patients, however, there are negative side effects or apnea symptoms are not resolved.

Somnoplasty is a non-invasive procedure that uses low power, low temperature radio frequency energy to reduce the tongue. The procedure takes place in the physician’s office under local anesthesia, and typically takes less than an hour. Multiple somnoplasty treatments may be required, but snoring and apnea episodes are often alleviated.

A tracheostomy, a procedure in which a tube is inserted into the throat to make an opening in the windpipe, is only used for severe cases of sleep apnea and when other treatments fail. The tube is closed during the day, allowing for normal activities, and opened at night, bypassing the obstruction in the throat.

When Should I See A Doctor?

If sleep apnea is suspected, scheduling an appointment with a physician is recommended. The physician will take a medical history and a referral for a night in a sleep evaluation laboratory will be required. It is often helpful for the doctor or sleep specialist to interview the bed partner or other members of the household. It is a good idea to complete the Bed Partner Questionnaire and review it with the doctor or sleep specialist.

For a diagnosis of sleep apnea to be made, each abnormal breathing episode must last at least 10 seconds and occur at least 5 times for each hour asleep. Doctors call this the Respiratory Disturbance Index (RDI).

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Comments (22)

  1. I was recently diagnosed with moderate to severe sleep apnea, and fitted with a CPAP machine. I have a new ResMed machine and use the nasal pillows. I am not having any problems getting used to the equipment and it doesn’t leak. I don’t really notice it or the air pressure now after two weeks. I don’t feel as though I am breathing through my mouth. My wife says the snoring has been eliminated. I have days where I feel a little better and days that I am tired all day long. I still wake up a few times at night on average. The medical personnel who diagnosed me and fitted the machine were giving me the impression I should feel better more or less right away. It’s definitely taking longer than I hoped to see real improvement.

    How long after some of you started CPAP did it take to feel better? What are reasonable expectations for the device and its effect, short and long term? Do I have to pay off my sleep debt to really feel the effect? I don’t expect to feel eighteen again, but was hoping people here who use it could give some feedback on their experiences adjusting to the machine and seeing results from the treatment. Again I don’t feel like I am having a problem adjust to the equipment and it seems like I am doing everything right. I have been getting excellent scores as well.

    Thanks in advance!

  2. Cape Codder;

    Same here. I’ve been on cpap with Phillips Resperonics Machine and AirFit P10 nasal pillow mask for 4.5 mos. now, since first part of April. My main symptoms is fragmented sleep, unrefreshing sleep, and insomnia. Have had alittle difference in feeling sleepiness some afternoons and evenings. Apnea is severe on my back and mild on my side. I got my pressure changed from fixed 7 cm to variable and have been experimenting with various variable pressures. Right now my minimum is 7cm and max is 13. Machine shows pressure goes at high as 9.5 to 11 from night to night. Still can’t sleep long enough, usually 5 to 5.5 hrs a night. Also trying to break the habit of dropping off initially in my recliner (with no treatment) before going to bed. Most likely I’m having apnea and that disturbs my sleep after getting on the machine. But improvement is gradual for me too. My untreated apnea caused neurology problems too, like restless legs and repetitive jerking awake at sleep onset. That has gotten better off and on. Just have to keep working at it. Some nights I think air is leaking from my mouth, waking with very dry mouth. Lots to work out one night at a time. Good luck!

  3. I am a widow so I have no one to be with me to check on how I sleep. I am asleep and awake all night long. I don’t know what wakes me up but I have trouble going back to sleep. I also have nights when I will sleep for 15 minutes then I am awake. This will go on all night long. I do have a very bad back and have a lot of pain especially getting to sleep.Do you think I have sleep Apnea? I am so tired during the day. I usually have to take a 30 minute nap during the day.
    Thank you for your input.

  4. I have been diagnosed with sleep apnea and was never given a reason why I have it. Who should I see to determine why I have it and how to treat my case?

  5. I think I may have mixed sleep apnea although I dont think it can be cured with a CPAP. I feel that maybe surgury is the best solution, possibly the removal of my tonsils or adenoids could fix it. I have sturggled for a long long time but not sure how to find people who specialize in this. Do you need to get a specialist to have your adenoids or tonsils removed or should I just ask my GP

    • I suggest you contact your local hospital, or an ENT specialist and see if they have, or can recommend a sleep study center. You check in overnight, get hooked up to sensors to determine if you have sleep apnea. If you do have it, it is very important to address this.
      I was diagnosed with severe sleep apnea 5 years ago. I was a heavy snorer but blamed that on being a back sleeper. Then I had an unrelated procedure requiring sedation. After the procedure, the doctor told me to be checked for sleep apnea as I had stopped breathing during the sedation. I’ve been using a C-pap machine ever since. My daytime sleepiness has gone away, I feel much more clear headed and sleep better and I’ve stopped snoring.

  6. Looking at your computer and or TV , especially if you have Glocoma or other bright light sensitivities , is bad news. I would invest in orange or red tinted glasses and wear them ,say, from 9-12 at night or whatever three hour pre bedtime unit is.

  7. Also, if the nostril passages are tiny then the least bit of post nasal drip will really stop the sleep clock. Fior this I recommend the regular use of a Himalayan Salt Inhaler.

    • HI, my events are 81, I have not treated my apnea. I am confused between bipap and surgery. please share with me your experience with bipap. I have used bipap on trial basisi for 3 days. but I was not comfortable at pressure of 4/16.

  8. I have started using a pair of round nose dilators at night and find that my breathing is much better. Right nostril used to give me trouble by closing up partially, possibly due to deviated septum.
    Round nose dilator with vertical slits has made a great improvement in my breathing at night. Should I wear this during the day also ?
    Can I avoid CPAP simply by using the dilator every night ?

  9. It’s good to know that the bed partner of someone with sleep apnea will most likely be needed by the doctor to provide an accurate diagnosis. My wife and I are trying to get her father to see a specialist about his sleep apnea. we’ll be sure to let my mother-in-law know that her side of things will be needed by a specialist.

  10. I have used a cpap machine for the past 7 years. Recently, when I use it, I wake up with cold or allergy type systems. My nose runs for several days. When I stop using the machine, the symptoms go away. Can you help me understand?

    • I realize this is almost a year late but here goes anyway. Did you find out what your problem is ? If not it may be due to the cleanliness of your CPAP hose and mask. Washing your mask and hose tends to not be totally effective. Everything from the Humidifier to the mask needs extreme cleansing. it is difficult to get the middle of the hose clean. it needs a mild bleach solution. Mold will not totally be killed and although reduced will begin to grow after your first use. I would say that is possibly what you are experiencing.

  11. I have sleep apnea, and so far can not tolerate the CPAP at all. So I am basically untreated. In addition to being exhausted all the time, I have short bursts of dizziness or unsteadiness. I had read this could be related to the sleep apnea, and it makes sense because the dizziness started after the sleep apnea started. Is this connection confirmed? Should I attempt to treat the dizziness too?

    • you really have to try to tolerate the machine maybe help pad the mask out.I suffer the dizziness too ive even fallen asleep or blacked out whilst standing up a few times on and off the toilet its the poorly oxygenated blood and the brains condition most probably,if your energy levels are still good maybe try a jog or deep breathing exercises to see if there is an improvement ,if not trying certain herbs and spices may help

  12. Tina G is a D*c^ loving Snore Hound with Penial on her mind every day and night, she had back to back SQUIRTING WET DREAMS TWO NIGHTS IN A ROW, It was about Big Black D*c& which she absolutely cannot get enough of, we went to Dallas for T-G and she did it with DFWKNIGHT 9 Times if shes knot prego I dont know why KNOT!

  13. I went through surgery for sleep apnea in Singapore last year June.
    4.Inferior Turbinate Reduction
    5.Sinus Wash
    However still I feel sleepy and Drowsy during day time.
    Kindly help me.

  14. I have mild sleep apnea and went on CPAP 3 months ago. At first I tried the nasal pillow but the computer results confirmed I was sleeping with my mouth open so I switched to a face mask covering my mouth and nose which , not only solved this problem but also improved the straps. My main problem is constipation which no doctor seems to address or know about. My other problem is my legs which, at the beginning of CPAP, got very cold are now weak and sore when I get up in the morning. Found other people with the constipation problem when I entered CPAP and constipation problems in computer dating from 2002 to 2016 but couldn’t find any that offered solution. I live in Kansas and the temperature has been cold and my indoor humidity under 40% for the last three months. Left here for a week and went to Punta Cana with CPAP where the temp in room was 75 and humidity was 75%. Didn’t have any constipation or leg problems but after 5 days on CPAP could not put up with it and took it off. Upon return to Kansas resumed using CPAP and problems returned. Any replies and advise would be appreciated.

  15. does anyone else feel like your short of breath as soon as you take off your cpap mask I did this morning and still do I also feel like all I wanna do is cough I am a first time user to this equipment it makes me a little scared feeling the way I do can anybody let me know if you felt the same way and how long it took to get back to breathing again its really got my anxiety going crazy because im nervous can anybody offer some comfort or encouragement of how to deal with this issue

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