Sleep Apnea Overview

Sleep apnea is a condition in which breathing stops for brief periods of time while a person is sleeping. These episodes of interrupted breathing last anywhere from 10-30 seconds at a time, and may occur up to 20-30 times per hour. Over the course of a single night’s sleep, this can mean up to 400 episodes of interrupted breathing. Over 18 million Americans have sleep apnea, and the majority of these people are overweight.¹

Normal Upper Airway During Sleep © 2009 Nucleus Medical Media, Inc.

Every time you stop breathing, you interfere with the normal patterns of deep sleep. Without realizing it, sleep apnea sufferers awaken regularly in order to resume breathing. Sleep apnea is one cause of insomnia, because quality of sleep is seriously impaired. This results in severe daytime sleepiness, road safety impairment, and overall difficulty thinking and functioning.

Blocked Airway © 2009 Nucleus Medical Media, Inc.

Some of the risks associated with sleep apnea include:

• Increased risk of accidents (especially car accidents) due to inattention and inability to stay alert during normal waking hours
• Higher risk of heart disease
• Increased risk of stroke
• Increased risk of lung disease
• Increased risk of hypertension
• Increased risk of diabetes

There are three different kinds of sleep apnea:

Obstructive Sleep Apnea

This is the most common type of sleep apnea, commonly known as OSA or OSAS (Obstructive Sleep Apnea Syndrome). It is caused by a temporary partial or complete airway obstruction. Obstructive sleep apnea can occur when the tissues of your throat relax too much and cave in on each other. In overweight sleep apnea sufferers, excess tissue puts pressure on your airway, causing it to collapse.
Other possible structural causes of sleep apnea are

• Deviated septum
• Nasal polyps
• Large tonsils
• An elongated soft palate and uvula that obstruct the airway during sleep.

For children, the most common reason for obstructive sleep apnea is enlarged tonsils and adenoids.

Central Sleep Apnea

This occurs when the lower brain stem neglects to send signals to the muscles that control breathing. Conditions that cause problems with the lower brain stem include:

• Polio
• Encephalitis
• Stroke
• Brain tumors
• Other degenerative diseases affecting the brain and central nervous system.

Mixed Sleep Apnea

This form is a combination of both obstructive and central sleep apnea.

Who gets sleep apnea?

Overweight people over 40 are the most likely to develop sleep apnea. Children develop it only rarely, and generally it is caused by enlarged tonsils or adenoids. CPAP devices are available in special sizes for children.

What are the risk factors for sleep apnea?

What are the symptoms of sleep apnea?

How is sleep apnea diagnosed?

What are the treatments for sleep apnea?

Are there screening tests for sleep apnea?

How can I reduce my risk of sleep apnea?

What questions should I ask my doctor?

What is it like to live with sleep apnea?

Where can I get more information about sleep apnea?

References:

¹Agus, David. The End of Illness. (New York: Free Press, 2011): 250.

²American Sleep Apnea Association website. Available at: http://www.sleepapnea.org/resources/pubs/evaluated.html . Published May 2005. Accessed September 17, 2008.

³Botros N, Concato J, Mohsenin V, et al. Obstructive sleep apnea as a risk factor for type 2 diabetes. Am J Med. 2009;122(12):1122-1127.

⁴Cecil R, Goldman L, Benett JC. Cecil Textbook of Medicine.21st ed. Philadelphia, PA: WB Saunders Company; 2000.

⁵NINDS sleep apnea information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/sleepapnea/sleepapnea.htm . Updated June 2008. Accessed September 17, 2008.

⁶Sleep apnea: key points. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_Summary.html . Accessed September 17, 2008.