Sleep apnea is a common breathing disorder that can be very serious. With sleep apnea, your breathing gets very shallow or stops while you are asleep. Pauses in breathing can last 10 to 20 seconds and can occur 20 to 30 times each hour during sleep. Normal breaths usually restart with a loud snort or choking sound. These pauses reduce the amount of oxygen that reaches your lungs causing your blood oxygen levels to drop. Reduced blood oxygen can increase the risk for high blood pressure, heart attack, stroke and diabetes. Sleep apnea can cause frequent waking at night and cause you to be very sleepy during the day. Frequent waking moves you out of deep sleep and into light sleep several times during the night, making your sleep not restful. Daytime sleepiness can increase the likelihood of work-related or driving accidents.

About 12 million Americans have the most common type of sleep apnea known as obstructive sleep apnea. More than half of the people with this type of sleep apnea are overweight, but thin people can also have sleep apnea. Most also snore loudly. Sleep apnea is more common in men, approximately 1 in 25 middle-aged men have it compared to 1 in 50 middle-aged women. Sleep apnea is more common in African Americans, Hispanics, and Pacific Islanders. A family history of sleep apnea also increases the risk of having it. Adults with sleep apnea are likely to have high blood pressure. They are also likely to have decreased size of airways in their nose, throat and mouth. This may be due to the shape of these structures or because of conditions such as allergy. Sleep apnea can also occur in children who snore. Parents of children who snore should discuss it with their child's doctor.

The most common symptoms of sleep apnea include loud snoring, choking or gasping during sleep, and daytime sleepiness. Often family members may notice the symptoms before the sufferer. Other signs include morning headaches, memory or learning problems, irritability, lack of concentration, mood swings or depression, dry throat upon waking, and frequent urination at night. The diagnosis may include a sleep history, examination of the airways, and possibly a sleep recording. A sleep recording is often done in a sleep center, but can also be done in the home. The sleep recording is done with a polysomnogram (PSG) which records brain activity, eye movement, muscle activity, breathing and heart rates, airflow to lungs, and percentage of oxygen in the blood. The PSG will be evaluated to determine if there are other causes of the sleep apnea, such as lung problems, brain or nerve problems, heart or blood pressure problems, ear, nose or throat problems, or anxiety or depression problems.

Mild sleep apnea can be treated with lifestyle changes such as avoiding alcohol, smoking or medications that make it harder to keep your throat open while asleep. Weight loss can often improve sleep apnea if the patient is overweight. Sleeping on the side rather than on the back may help to keep the throat open and improve airflow. Custom-made mouthpieces that help keep the airway open may also help mild sleep apnea. People with moderate to severe sleep apnea may also need to use a continuous positive airway pressure (CPAP) device. These devices are worn like a mask while sleeping. They blow air into the throat at the correct pressure to keep the throat open during sleep. CPAP is not a cure, so sleep apnea will return if the device is removed or is not adjusted properly. Surgery to remove excess tissue from the throat, sinuses or soft palate may also be recommended in severe cases. There are no medications to treat sleep apnea at the present.

Reference: NHLBI, Diseases and Conditions Index, available at http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_Treatments.html.

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