Obstructive sleep apnea

DEFINITION

Obstructive sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep.

Several types of sleep apnea exist, but the most common type is obstructive sleep apnea, which occurs when your throat muscles intermittently relax and block your airway during sleep. The most noticeable sign of obstructive sleep apnea is snoring.

Anyone can develop obstructive sleep apnea, although it most commonly affects middle-aged and older adults and people who are overweight.

Obstructive sleep apnea treatment may involve using a device to keep your airway open or using a mouthpiece to thrust your jaw forward during sleep. Some people undergo a procedure to change the structure of their nose, mouth or throat.

CAUSES

Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These muscles support structures including the soft palate, the uvula — a triangular piece of tissue hanging from the soft palate, the tonsils and the tongue.

When the muscles relax, your airway narrows or closes as you breathe in and breathing may be inadequate for 10 to 20 seconds. This may lower the level of oxygen in your blood. Your brain senses this impaired breathing and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don’t remember it.

You can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths. You may make a snorting, choking or gasping sound.

This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you’ll probably feel sleepy during your waking hours.

People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they slept well all night.

SYMPTOMS

Signs and symptoms of obstructive sleep apnea include:

• Excessive daytime sleepiness
• Loud snoring
• Observed episodes of breathing cessation during sleep
• Abrupt awakenings accompanied by shortness of breath
• Awakening with a dry mouth or sore throat
• Awakening with chest pain
• Morning headache
• Difficulty concentrating during the day
• Experiencing mood changes, such as depression or irritability
• Difficulty staying asleep (insomnia)
• Having high blood pressure

When to see a doctor

Consult a medical professional if you experience, or if your partner observes, the following:

• Snoring loud enough to disturb your sleep or that of others
• Shortness of breath that awakens you from sleep
• Intermittent pauses in your breathing during sleep
• Excessive daytime drowsiness, which may cause you to fall asleep while you’re working, watching television or even driving a vehicle

Many people don’t think of snoring as a sign of something potentially serious, and not everyone who snores has obstructive sleep apnea. However, be sure to talk to your doctor if you experience loud snoring, especially snoring that’s punctuated by periods of silence.

With obstructive sleep apnea, snoring usually is loudest when you sleep on your back, and it quiets when you turn on your side.

Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. Excessive daytime drowsiness may be due to other disorders, such as narcolepsy.