Sleep apnea and snoring can be very disruptive to those around you. Loud snoring or frequent gasping can lead to poor concentration, memory problems and mood swings. A sleep study (also known as polysomnography) is the gold standard for diagnosing sleep apnea treatments. This can be done at home or in a sleep center.
Obstructive Sleep Apnea
Most people who have sleep apnea have obstructive sleep apnea, which is caused when the airway becomes closed or blocked during sleep. This causes a loss of oxygen and can cause snoring and/or gasping or choking. Breathing usually restarts after a short time and normal sleep resumes. This pattern can repeat 30 times or more each hour of the night, preventing deep, restful sleep and leading to daytime drowsiness.
Obstructive sleep apnea is more common in men than women and is most often associated with excess weight, a large overbite, smoking, a family history of enlarged tonsils or adenoids, a large tongue or a genetic condition such as Down syndrome or Pierre-Robin syndrome. It can also be caused by a deviated septum, enlarged or swollen lymph nodes in the neck, or a heart disorder such as hyperthyroidism.
Over-the-counter nasal sprays and adhesive strips help some patients with mild or moderate obstructive sleep apnea by making it easier for air to pass through the nose. Positive airway pressure therapy is another option. This involves using a specialized device to push air down your windpipe when you breathe. It can be delivered through a hose that attaches to a mask you wear during sleep or through a mouthpiece or a nosepiece.
Central Sleep Apnea
CSA happens when something interferes with the brainstem’s ability to send signals that control breathing. It’s less common than obstructive sleep apnea and doesn’t cause snoring or gasping. It usually happens because of a health problem that affects the area of the brain that controls breathing or a medication that causes problems with breathing. Often it’s associated with heart failure or a stroke. CSA can also occur as part of a pattern called Cheyne-Stokes breathing, which is seen in patients with severe heart disease or in some cases of chronic lung disease.
Other health conditions that raise the risk of CSA include having an irregular heartbeat, known as atrial fibrillation; having coronary artery disease; and taking certain medications, including narcotics. CSA is more common in men and is more likely to affect those over age 60. It’s also more likely to affect people with other health conditions or those who have specific sleep patterns. It’s not clear why some people get CSA while others don’t.
Symptoms
If you or a loved one have loud, disruptive snoring and pauses in breathing during sleep, talk to your doctor. You may be diagnosed with obstructive sleep apnea, which can increase the risk of high blood pressure, heart disease, diabetes and stroke.
During obstructive sleep apnea, your airway becomes constricted or blocked, forcing you to take short breaths, sometimes accompanied by gasping and choking sounds. These episodes can repeat several times a night and reduce the quality of your sleep.
Other symptoms include fatigue upon waking, memory problems, sore throats or headaches, irritability and difficulty concentrating. Severe obstructive sleep apnea increases the risk of heart disease and can lead to high blood pressure, heart failure, and stroke. Untreated obstructive sleep apnea can cause arrhythmias, including atrial fibrillation, which can lead to sudden cardiac death.
Diagnosis
If you or a loved one has loud snoring or pauses in breathing while asleep and is often drowsy during the day, talk to your doctor. These symptoms can be signs of obstructive sleep apnea, which is a serious condition that can lead to heart problems, stroke, high blood pressure, depression or diabetes.
Your otolaryngologist will ask questions about your health history and perform a physical exam of your head, nose, throat and neck. If necessary, your doctor may recommend a home or in-lab sleep study to diagnose sleep apnea.
If your otolaryngologist determines that you have mild to moderate obstructive sleep apnea, lifestyle changes, mouthpieces or surgery may help. A mouthpiece that holds your tongue or jaw forward can increase space in your upper airway and reduce snoring and apnea. A surgical procedure to remove your tonsils and uvula, or the removal of other soft tissue in the back of your throat, can also reduce snoring and improve airflow.