Sleep apnea is a condition in which breathing is stopped during sleep. Usually this is due to obstruction of the airway by tissues relaxed during sleep. This interruption, or apnea, continues until the brain arouses itself for a few seconds in order to initiate breathing again. While the apneas and arousals are so brief and incomplete as to escape the patient’s notice, spouses often become acutely aware of snoring, paused breathing and the reactions which follow these pauses – such as snorts and jerks. The apneas disrupt the quality of sleep and, when seen in the sleep lab, there are often dramatic drops in the level of oxygen in the blood and abnormalities of heart rhythm.
Sleep apnea is common, affecting 5-10% of men and 1-3% of women. Children can also be affected. Untreated, sleep apnea is associated with increased mortality. Death most often results from heart disease such as heart attack, heart failure and/or pulmonary hypertension. There is also increased fatality from trauma as a result of falling asleep inappropriately – such as while driving. A substantial risk of motor vehicle accident has been associated with sleep apnea and is comparable to the risk of driving while intoxicated.
Common symptoms include loud snoring, observed pauses in breathing (apneas), loss of restful sleep (feeling tired or unrefreshed upon awakening) and excessive daytime sleepiness. Often this sleepiness is not recognized by the patient and may cause the patient to fall asleep inappropriately and involuntarily.
The diagnosis is dependent on the demonstration of apneas while asleep and usually requires an evaluation in the sleep laboratory. There are several treatment options, but the most effective and most appropriate for most people is the use of continuous positive airway pressure (CPAP). This treatment is very effective in eliminating the apneas, improving or eliminating snoring, and restoring good quality sleep. This in turn results in the resolution of daytime symptoms and a reduction in mortality risk to normal or near normal level. The spouse’s quality of sleep has also been shown to be improved!
Authored by: Robert Fayle, M.D.