Obstructive sleep apnea is a potentially serious sleep disorder. It causes breathing to repeatedly stop and start during sleep.
There are several types of sleep apnea, but the most common is obstructive sleep apnea. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnea is snoring.
Treatments for obstructive sleep apnea are available. One treatment involves using a device that uses positive pressure to keep your airway open while you sleep. Another option is a mouthpiece to thrust your lower jaw forward during sleep. In some cases, surgery may be an option too.
Signs and symptoms of obstructive sleep apnea include:
- Excessive daytime sleepiness
- Loud snoring
- Observed episodes of stopped breathing during sleep
- Abrupt awakenings accompanied by gasping or choking
- Awakening with a dry mouth or sore throat
- Morning headache
- Difficulty concentrating during the day
- Mood changes, such as depression or irritability
- High blood pressure
- Nighttime sweating
- Decreased libido
When to see a doctor
- Consult a medical professional if you experience, or if your partner observes, the following:
- Snoring loud enough to disturb your sleep or that of others
- Waking up gasping or choking
- Intermittent pauses in your breathing during sleep
- Excessive daytime drowsiness, which may cause you to fall asleep while you’re working, watching television or even driving a vehicle
Many people may not think of snoring as a sign of something potentially serious, and not everyone who snores has obstructive sleep apnea. Be sure to talk to your doctor if you experience loud snoring, especially snoring that’s punctuated by periods of silence. With obstructive sleep apnea, snoring usually is loudest when you sleep on your back, and it quiets when you turn on your side.
Causes of sleep apnea
Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These muscles support structures including the back of the roof of your mouth (soft palate), the triangular piece of tissue hanging from the soft palate (uvula), the tonsils and the tongue.
When the muscles relax, your airway narrows or closes as you breathe in and breathing may be inadequate for 10 seconds or longer. This may lower the level of oxygen in your blood and cause a buildup of carbon dioxide.
Your brain senses this impaired breathing and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don’t remember it.
You can awaken with shortness of breath that corrects itself quickly, within one or two deep breaths. You may make a snorting, choking or gasping sound.
This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you’ll probably feel sleepy during your waking hours.
People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they slept well all night.
Anyone can develop obstructive sleep apnea. However, certain factors put you at increased risk, including:
1. Excess weight
Most but not all people with obstructive sleep apnea are overweight. Fat deposits around the upper airway may obstruct breathing. Medical conditions that are associated with obesity, such as hypothyroidism and polycystic ovary syndrome, can also cause obstructive sleep apnea. However, not everyone with obstructive sleep apnea is overweight and vice versa. Thin people can develop the disorder, too.
2. Narrowed airway
You may inherit naturally narrow airways. Or your tonsils or adenoids may become enlarged, which can block your airway.
3. High blood pressure (hypertension)
Obstructive sleep apnea is relatively common in people with hypertension.
4. Chronic nasal congestion
Obstructive sleep apnea occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. This may be due to narrowed airways.
People who smoke are more likely to have obstructive sleep apnea.
Obstructive sleep apnea may be more common in people with diabetes.
In general, men are twice as likely as premenopausal women to have obstructive sleep apnea. The frequency of obstructive sleep apnea increases in women after menopause.
8. Family history
If you have family members with obstructive sleep apnea, you may be at increased risk.
Research has found an association between asthma and the risk of obstructive sleep apnea.
The goal of sleep apnea treatment is to open your airway so you can breathe better at night. Many devices can help that happen. Among the most common options are CPAP machines, mouth appliances, and specially designed pillows.
You can get these custom-made or buy them over the counter. Whatever type you choose, you’ll need to see a dentist to have it fitted.
- Mandibular advancement device (MAD). This looks like a mouth guard that athletes wear. It snaps over your top and bottom teeth. Hinges let your lower jaw ease forward, which keeps your tongue and soft palate stable so your airway stays open while you’re asleep.
- Tongue retaining device. This is sort of like a splint that holds your tongue in place to keep your airway open. Doctors don’t prescribe it as often as the MAD. It can be harder to get used to and less comfortable. Before you buy a mouth device, talk to your doctor about which one would be best for you.
Do a quick online search, and you’ll find many types of pillows to relieve sleep apnea. They’re designed for use with a CPAP machine or without. They come in different styles, including a wedge shape, which raises your upper body.
Sleeping on your back with your body elevated from the waist up may help keep your airway from collapsing and, in turn, improve your condition, the American Sleep Apnea Association says. Use foam wedges, not soft pillows.
Sleep apnea pillows that you can use without a CPAP machine position your neck so your airway is more likely to stay open. Ones you use with the machine are meant to make you more comfortable when you wear your CPAP mask. Some have features that reduce pressure from the mask or keep it from rotating out of place.
That stands for continuous positive airway pressure. These machines use a mask that fits over your nose, or nose and mouth. It blows air at a pressure that keeps your airway open during sleep. Your doctor can tell you the right pressure to use and how to set it on the machine.
Over the years, these devices have become smaller, lighter, and much quieter. Some common side effects include nasal congestion, dry mouth, and skin irritation --- but treatments can help relieve all of them.
The key to using a CPAP is to make sure it’s comfortable. You can choose from a few different models, so you should be able to find a mask that works for you.
The device works very well, according to the National Sleep Foundation. But doctors say the key to success is to use it every night.
Nerve Stimulation Devices
When your tongue and other tissue in your throat fall back and block your airway, a small device called a hypoglossal nerve stimulator can help.
About the size of a pacemaker, doctors put the device inside your chest through minor surgery. With a small remote, you turn it on before you go to sleep and off in the morning. It monitors your breathing patterns and sends signals to the nerves that control your tongue and other muscles. They move forward, and keep your airway open.
The device is an option for people who’ve tried CPAP without any success or don’t use it properly. And a few studies suggest it works about as well as the mask-machine combo. But ask your doctor if it’s a good choice for you.