Sleep apnea is a serious, potentially life-threatening breathing disorder. It is far more common than generally understood. Sleep apnea is a characterized by brief interruptions of breathing during sleep. It owes its name to a Greek word, apnea, which means "want of breath".
There are two types of sleep apnea: central and obstructive. Central sleep apnea is less common; it occurs when the brain fails to send appropriate signals to the breathing muscles to initiate respiration during sleep. Obstructive sleep apnea is far more common and occurs when air cannot flow into or out of a person's nose or mouth although efforts to breathe continue.
In a given night, the number of involuntary breathing pauses or "apneic events" may be as high as 20 to 30 or more per hour. These breathing pauses are almost always accompanied by snoring between apnea episodes, though not everyone who snores has this condition.
Early recognition and treatment of sleep apnea is important because it may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke.
Causes of sleep apnea
Certain mechanical and structural problems in a person’s airway cause breathing interruptions during sleep. In some people, apnea occurs when throat muscles and the tongue relax during sleep, partially blocking the opening of the airway. When muscles of the soft palate at the base of the tongue and the uvula (small fleshy tissue hanging from the center of the back of the throat) relax and sag, the airway becomes blocked, making breathing labored and noisy and even stopping it altogether.
People most likely to have or develop sleep apnea include those who snore loudly and also are overweight, or have high blood pressure, or have a physical abnormality in the nose, throat, or other parts of the upper airway. Sleep apnea seems to run in some families, suggesting a possible genetic basis. Sleep apnea also can occur in obese people when an excess amount of tissue in the airway causes narrowing of the airway.
Symptoms and effects of sleep apnea in Women
Women present symptoms of sleep apnea differently than men. Typically women complain of fatigue, insomnia, morning headaches, mood disturbances, lack of energy, restless legs or other symptoms that suggest reasons other than sleep apnea for their symptoms. A women's risk for sleep apnea increases as they transition through menopause, so post-menopausal women are up to three times more likely to have sleep apnea than premenopausal women. Also, women who are overweight and obese are at greater risk for having sleep apnea. Women with high blood pressure that is difficult to control despite taking medication who have some of these symptoms may also wish to be evaluated for sleep apnea, as diagnosis and treatment of sleep apnea can help with blood pressure control. Women with polycystic ovary syndrome are more likely to have sleep apnea.
Because of the serious disturbances in their normal sleep patterns, people with sleep apnea often feel very sleepy during the day causing their concentration and daytime performance to suffer. The consequences of sleep apnea range from annoying to life threatening; they include depression, high blood pressure, sexual dysfunction, irritability, learning and memory difficulties, and falling asleep while at work, on the phone, or driving. The risk for heart attack and stroke also may increase.
People with sleep apnea usually aren’t even aware they have a problem and may not believe it when told. Spouses of sleep apnea patients often are the first ones to suspect something is wrong (heavy snoring and apparent struggle to breathe). Coworkers or friends also may notice that the individual falls asleep during the day at inappropriate times (such as working, talking, or even while driving a car,). It is important that the person see a doctor for evaluation of the sleep problem.
Diagnosis and treatment of sleep apnea
In addition to the primary care physician, pulmonologists (lung specialists), neurologists, or other physicians with specialty training in sleep disorders may be involved in making a definitive diagnosis and initiating treatment. Diagnosis of sleep apnea is not simple because there can be many different reasons for disturbed sleep. Several tests are available to evaluate a person for sleep apnea and usually are performed in a sleep center.