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:

There are a variety of treatments available for sleep apnea, but what works for you will depend on the severity of your problem and your commitment to treatment. Making the following lifestyle changes will help you get a good night’s sleep.
Keep that airway toned. Avoid alcohol, sedatives, sleeping pills, and any medication that relaxes the central nervous system, making it more difficult to keep your throat open while sleeping.
Dump pounds. Work with your doctor on a weight-loss plan if you are overweight. Even a small drop in weight can improve your symptoms. Unfortunately, sleep apnea can make losing weight more difficult because it interferes with leptin and ghrelin, two brain chemicals that signal the body that it’s full.
Quit smoking. Add sleep apnea to the long list of reasons why you should kick the habit. If you have sleep apnea, your body is hungry for oxygen. Unfortunately, smoking will reduce the amount of oxygen available.
Sleep on your side. You’re more likely to snore loudly when you sleep on your back. Try special pillows that make back sleeping impossible or at least uncomfortable. For example, you can wedge a pillow stuffed with tennis balls behind your back to make rolling over unpleasant.
See a sleep specialist. If your apnea is moderate to severe or you’ve made lifestyle changes and you still have symptoms of sleep apnea, then you need to see a sleep specialist who can observe and evaluate your sleep and help you find the best solution for you and your problem. A sleep doctor will check your mouth, nose, and throat and make a recording of what happens with your breathing while you sleep. This may require an overnight stay at a sleep center.