Do you snore loudly? Do you regularly suffer from daytime sleepiness? If so, you could have sleep apnea, a common and serious sleep disorder that affects many people with cardiovascular disease. Sleep apnea is a series of pauses in breathing during sleep due to temporary airway obstruction, which taxes your cardiovascular system.
And even if you don’t yet have cardiovascular disease, sleep apnea increases your risk for cardiovascular disease. Sleep apnea increases your risk for high blood pressure and type 2 diabetes. People with sleep apnea are also more likely to have heart attacks and die in the middle of the night. And stroke and abnormal heart rhythm problems (atrial fibrillation) are associated with sleep apnea.
So, even though snoring is not always related to sleep apnea, snoring is no laughing matter and it could be a reason to be checked by your doctor for sleep apnea, especially if you already have cardiovascular disease.
What are the signs and symptoms of sleep apnea?
- Restless sleep
- Loud snoring
- Awakening to a feeling of choking, gasping or smothering
- Morning headaches, dry mouth, or sore throat
- Excessive daytime sleepiness
- Memory impairment, difficulty concentrating
What are the risk factors for sleep apnea?
- Older age (but not always)
- Male gender (but women are also affected)
- Obesity and/or enlarged neck size (greater than 17 inches in men or 16 inches in women)
- Small mouth and throat, or enlarged tonsils
- High blood pressure, especially if it is resistant to treatment with many medications
- Excessive alcohol use
How do you get checked for sleep apnea?
To diagnosis sleep apnea, a sleep medicine specialist will ask you questions about your medical history, perform a physical examination, and conduct a sleep test (called a polysomnogram).
Usually sleep tests are conducted in a hospital sleep laboratory. This means you stay overnight in the hospital hooked up to machines while you sleep. The machines measure your breathing effort and airflow, blood oxygen level, heart rate and rhythm, duration of the various stages of sleep, body position, and movement of your arms and legs. But home-monitoring devices are also available if the specialist decides they are appropriate for you.
What are the possible treatments for sleep apnea?
Continuous positive airway pressure (CPAP)
This mechanical device is the most effective treatment for obstructive sleep apnea. It requires wearing a mask over the nose and uses air blown through a tube to continuously maintain an open airway during sleep. It should be worn anytime you sleep (day or night). While it appears uncomfortable, noisy and cumbersome, most people usually stick with it when they feel better after getting a good night’s sleep on a regular basis. Check out these Tips for Coping with CPAP.
Changing sleep position
When you avoid sleeping on your back, it may help prevent the airway obstruction that results in sleep apnea. However, it is difficult to maintain a certain sleep position throughout the night, so this alone is likely not an effective treatment for sleep apnea.
Losing weight may help treat sleep apnea in overweight or obese people. However, weight loss takes time, so it is not an immediate treatment and it may not work as the only treatment of sleep apnea.
Avoidance of alcohol and sedatives
Alcohol increases sleepiness, which may raise the risk of accidents or injuries for a person with sleep apnea. It may also interfere with your ability to sleep. So, it’s best to avoid or limit alcohol. Also, if you take anti-anxiety medications or sedatives, or require anesthesia for surgery, you should discuss a diagnosis of sleep apnea with your doctor.
There are dental appliances that can be used to position the jaw or tongue during sleep to maintain an open airway. They are usually used if CPAP is not tolerated and they can be effective treatment for some people.
Surgery is usually reserved as a last treatment option. The most common surgery (called uvulopalatopharyngoplasty) removes some soft tissue at the back of the throat, including the uvula (the part that hangs down.) Sometimes the tonsils are removed (called a tonsillectomy) as well. But these surgeries are not always successful in treating sleep apnea.
In extreme cases where there are no other treatment options, a tracheostomy can be performed. This is a hole created surgically in the neck directly into the trachea to allow breathing while bypassing the mouth and nose. While this surgery always cures sleep apnea, it requires significant lifestyle changes and some serious risks.