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Sleep apnea is a sleep disorder that is described by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing is called an apnea. It can last anywhere from a few seconds to minutes. An apnea can also occur 5 to 30 times or more an hour. Likewise, each abnormally low breathing event is called a hypopnea.
Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, also called a sleep study. Sleep studies find out how often you stop breathing or have too little air flowing into your lungs during sleep. They also can determine how much oxygen you have in your blood during sleep. Clinically significant levels of sleep apnea are defined as six or more episodes per hour of any type of apnea.
Types of Sleep Apnea
Obstructive sleep apnea (OSA) is the most common category of sleep-disordered breathing. The muscle tones of the body usually relax during sleep, and the throat is composed of collapsible walls of soft tissue which can obstruct breathing during sleep. Chronic severe obstructive sleep apnea requires treatment to prevent low blood oxygen, sleep deprivation, and cor pulmonale (a severe form of congestive heart failure). The people at high risk for OSA are: obese, elderly, smokers, diabetics, and men.
In central sleep apnea, also called Cheyne-Stokes respiration, the brain’s respiratory control centers are imbalanced during sleep. The basic neurological controls for breathing rate break down and fail to give the signal to inhale, causing the individual to miss one or more cycles of breathing. The exact effects of the condition will depend on how severe the apnea is and on the individual characteristics of the person having the apnea.
Many people with sleep apnea have a combination of both obstructive and central sleep apnea. When obstructive sleep apnea syndrome is severe and longstanding, episodes of central apnea sometimes develop. Patients with complex sleep apnea display OSA, but upon application of positive airway pressure the patient displays persistent central sleep apnea.
Treatment for sleep apnea is based on its severity:
- For mild cases, a treatment option is lifestyle changes such as: lose weight, sleeping on your side, and avoiding alcohol and sleeping pills.
- For moderate to severe cases, the most common treatment is the use of a continuous positive airway pressure (CPAP) device. It generates the required air pressure to keep the patient’s airway open during sleep.
- If the non-surgical options have failed, surgical treatments are available to alter the airway.
- Surgical Treatment – The goal of most surgeries for breathing problems is to widen the airway. This is done by taking out or shrinking excess tissue where the mouth meets the throat. Nasal and jaw surgery can help correct nose or jaw problems that contribute to snoring and apnea.
This is the most common procedure for sleep apnea. It trims the soft palate and uvula, and removes the tonsils and other tissue. It is major surgery performed in a hospital. Most patients go home within 24 hours.
LAUP (Laser-Assisted Uvulopalatoplasty)
This procedure helps relieve snoring. It may also be used in some cases of mild apnea. The doctor uses a laser or electric current to remove some of the soft palate and part or all of the uvula. This treatment may be done over several sessions in the doctor’s office.
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