Recognizing & Treating Sleep Apnea

An estimated 45% of American adults snore on occasion. Caused by the vibration of tissues near the airway in the back of the throat as you inhale and exhale, occasional snoring is usually harmless. But, in the case of loud, disruptive snoring, a more serious, life-threatening issue may be to blame: sleep apnea. 

Affecting an estimated 30 million Americans, sleep apnea is a serious threat to health. In fact, people with severe untreated apnea have three times the risk of dying from any cause. In addition, sleep apnea is strongly linked to high blood pressure, heart disease, stroke, depression, and an increased risk of dementia.

Unlike snoring, which may be noisy but doesn’t interfere with breathing, sleep apnea causes an individual to repeatedly stop and start breathing while sleeping. A person with sleep apnea may stop breathing for up to a minute at a time. Individuals often find themselves gasping awake throughout the night and missing out on quality sleep.

The most common type is obstructive sleep apnea (OSA occurs when your throat muscles intermittently relax to the point of collapse and block your airway during sleep and contributing to the loud, often interrupted, snoring.

Common symptoms of OSA include:

In Adults

• Excessive daytime sleepiness 
• Loud snoring interrupted by choking or gasping for air
• Restless sleep
• Dry mouth or headache upon waking
• Excessive daytime sleepiness
• Reduced ability to focus
• Depression, anxiety, or irritability

In Children

• Bedwetting
• Exacerbated asthma
• Hyperactivity
• Learning and academic performance issues

Diagnosing OSA involves ‘measuring your sleep’ through a sleep study either at home or at a sleep disorder center.
The at-home option requires the patient to wear small recording device, sensors, belts, and related cables and accessories while sleeping at home. While not an option for everyone, are beneficial for adults between the ages of 18 and 65 who have a high probability of moderate-to-severe OSA and no other medical conditions.

Sleep studies performed at a sleep disorder center often include one or all of the following:

• Polysomnography sleep study that measures brain waves, blood oxygen level, heart rate, breathing, and movement and to diagnose sleep disorders or to adjust treatment
• Multiple Sleep Latency Testing, or a daytime nap study, to measure excessive daytime sleepiness
• Maintenance of Wakefulness Test to test whether you are able to stay awake for a defined period of time

Based on the finding of your study, your treatment may include on of the following:

Continuous Positive Air Pressure (CPAP) Therapy: Placed at the bedside, a CPAP machine forces pressured air through a flexible plastic tube that connects to a face mask you wear while sleeping.  

Dental Appliance: Like a mouthguard, this device holds the lower jaw forward just enough to keep the airway open and prevents blockage in the upper airway. Dental appliances are recommended for individuals who are unable to use a CPAP.

Behavioral and Lifestyle Changes: Often, simple lifestyle changes can improve or eliminate OSA. These include:

• Weight loss
• Sleeping on your side rather than your back
• Eliminating alcohol intake at night

Surgery: Enlarged tonsils and/or adenoids are the most common cause of snoring or sleep apnea children. In 75% of cases, surgery resolves the problem.

If you are experiencing any of the signs of sleep apnea—or notice signs in your bed partner, don’t disregard them. Contact a healthcare provider for diagnosis and treatment. 

Dr. Michael Algus is a pulmonary specialist who performs sleep testing at Southwestern Vermont Medical Center.