Sleep Apnea: What Seems Like Nothing Serious Might Be

Sleep should be a restful, refreshing time. But it isn’t always, especially for those with sleep apnea.

Sleep apnea is a sleep disorder characterized by the frequent collapse of the airway during sleep.

“When the airway collapses, your brain will try to awaken you to start breathing again, and this leads to disrupted sleep and often intermittent drops in your body’s oxygen levels,” said Carol V. Blake, physician assistant with WellSpan Pulmonary and Sleep Medicine in Lancaster.

Is snoring or a state of not sleeping well always apnea?
Not necessarily, said Blake.

“Not everyone who snores has sleep apnea, but I would venture to say that most people with sleep apnea snore,” she explained. “There are many factors, other than sleep apnea, that can affect the quality of our sleep, including certain medical conditions, medications, pain, anxiety, depression, or insomnia. But certainly, sleep apnea can lead to very poor quality of sleep.”

What causes sleep apnea?
When you go to sleep at night, the muscles in your body relax, which is normal. But in some individuals, there is recurrent collapse of the upper airway (in the area of your windpipe). The tongue may drop back, which leads to reduced or blocked airflow.

To be counted as an “apnea” (stoppage in breathing) on a sleep study, the paused or reduced breathing must last for at least 10 seconds, although in some patients, noted Blake, that paused or reduced breathing can last much longer. These events occur over and over during the night and lead to very poor-quality sleep.

What are some of the symptoms of sleep apnea?
Symptoms can include snoring or gasping/choking for air during sleep. Bed partners often notice pauses in breathing that end in a loud snort.

“Other symptoms may include waking up still feeling sleepy, feeling sleepy throughout your day, morning headaches, restless sleep, and waking up during the night needing to urinate,” said Blake. “Sleep apnea in women may present as complaints of insomnia, sleepiness, and mood changes, rather than loud snoring and witnessed pauses in breathing.”

What are the risk factors for sleep apnea?
Common risk factors include male gender (although, when women reach menopause, their risk increases) and advancing age, and sleep apnea also has a very strong association with obesity.

What are some conditions that one might experience due to sleep apnea?
Untreated sleep apnea can put you at risk for daytime drowsiness, which may affect how you function at work or in school and can increase your chances of being involved in a motor-vehicle accident.

Untreated sleep apnea also increases the risk of a person developing a number of health problems, such as high blood pressure, irregular heart rhythms, stroke, heart attack, heart failure, and diabetes.

How do you diagnose sleep apnea?
Sleep apnea is diagnosed by conducting a sleep study. In a sleep study, a patient suspected of having sleep apnea stays overnight in a sleep center while hooked up to monitors. For many patients, sleep studies can now be done in the comfort of their own homes, with very minimal monitoring equipment.

The sleep study will determine how often you are having stoppages in breathing during sleep and if your oxygen levels are dropping during sleep. If you are found to have an average of five or more stoppages/reductions in your breathing per hour during the study night, this would indicate sleep apnea.

Will sleep apnea go away by itself?
No, said Blake.

“If you have been diagnosed with sleep apnea, depending on the severity and the symptoms you are experiencing, treatment is usually needed to correct the problem and improve your symptoms. For many patients, this treatment is needed for a lifetime,” she said.

What are the treatments for sleep apnea?
Fortunately, there are several very effective treatment options for sleep apnea.

Continuous positive airway pressure, or CPAP, as it is commonly known, is such a treatment. It uses a small machine that puts room air under pressure and sends it to a mask that you wear on your face at night when you sleep. This air pressure essentially pops open your airway for you. Although a CPAP works very well, it may take an adjustment period to get used to the machine.

Oral appliances, similar to a mouth guard, are another treatment. These tend to work best in people with mild to moderate sleep apnea.

“There are also several surgical treatments available for sleep apnea, but these may not work for everyone,” said Blake. “Weight loss can make a big difference in sleep apnea; in some people, it may eliminate it altogether. Your sleep specialist can help you decide which treatment is right for you.” BW