Sleep Apnea: Types and Treatments

If you wake in the morning feeling sleepy, irritable, sad, forgetful, and headachy, there’s a good chance that you have sleep apnea, a sleep-related breathing disorder that affects 20 million of us — particularly when we’re pregnant.

When you have the disorder, your breathing actually stops or gets very shallow as you sleep. Hundreds of times every night, your breathing may pause for 10 or more seconds, depriving your body of oxygen and increasing your heart rate. You may awaken slightly as you struggle to take a breath. But the next morning, says Rochelle Goldberg, M.D., president of the American Sleep Apnea Association (ASAA), you may not recall any of your nighttime awakenings.

There are three types of sleep apnea: obstructive, central, and complex. Obstructive sleep apnea, or OSA, is the most common, accounting for approximately 90 percent of all sleep apnea. OSA occurs when the soft tissue in the back of your throat relaxes and blocks the passage of air until your airway opens — often with a loud choking or gasping sound — and you begin to breathe again.

Approximately 10 percent of people with apnea suffer from central sleep apnea, in which the brain “forgets” to signal the airway muscles to breathe. Many people with central sleep apnea have some other disease, such as congestive heart failure, brain disease, stroke, or hypothyroidism (low thyroid function), and researchers are still working to discover the reason for the association. In some cases, though, the underlying cause is unknown.

A third type, complex sleep apnea, is rare. It’s a combination of obstructive and central sleep apnea. For people with complex sleep apnea, the brain not only fails to send a message to breathe, but the airways are obstructed as well.

Untreated sleep apnea has been linked to a number of health concerns, including hypertension, heart disease, stroke, diabetes, and weight gain. And since poor sleep results in slower reflexes, poor concentration, and the risk of nodding off behind the wheel, it also puts you at risk for driving accidents.

Unfortunately, however, many people just don’t take the snoring of sleep apnea seriously, and 80 to 90 percent of us with sleep apnea are undiagnosed and untreated, according to the American Academy of Sleep Medicine.

“Sleep apnea is far less likely to be diagnosed in women than in men. That’s a real challenge we have to overcome,” says Dr. Goldberg.

There are many reasons why fewer women get evaluated and treated than men. Women may blame their daytime sleepiness on other causes, such as insomnia or chronic fatigue. Women also tend to be more embarrassed by their loud snoring, which can keep them from discussing their condition with their doctors. Also, men tend to sleep more soundly than women, so a woman’s breathing pauses and loud snoring may not get noticed as readily by their male partners.
Do You Have Sleep Apnea?
Here are the key signs to watch for:

  • Do you snore loudly? About half of all people who snore loudly have obstructive sleep apnea (OSA). It’s a sign that your airway is partially blocked.
  • What’s your neck size? The size of your neck can be a telltale sign. Women with OSA often have a neck size of more than 16 inches (17 inches for men).
  • Are you waking often to take bathroom breaks? “Most adults who don’t drink lots of water before bed and are not uncontrolled diabetics or on high doses of water pills should not have to wake repetitively to use the bathroom,” says Rochelle Goldberg, M.D., president of the American Sleep Apnea Association.
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