Have you experienced waking up in the middle of the night gasping for breath, as if someone was choking you in your dreams? You feel shortness of breath, causing you to gasp, choke and cough. No matter how early you go to bed to sleep, do you wake up feeling tired and sleepy? If you answered yes to any of these questions, chances are, you have sleep apnea.

Before you worry and get stressed over sleep apnea, it’s best to know that this sleep disorder can be diagnosed, treated, and managed. There are several ways to treat the problem depending on the severity of the condition. Some patients go through lifestyle modification and strict dieting. Others use a CPAP machine or Continuous Positive Airway Pressure therapy. Severe cases even undergo surgery when necessary.

In this article, we will discuss everything you need to know about sleep apnea --- its different types, symptoms and causes, the diagnosis and tests done, as well as the management and treatment of this serious but often overlooked sleep disorder.

What Is Sleep Apnea?

Originated from the Greek word “apnea,” which means without breath, sleep apnea is a sleeping disorder that causes a person to stop breathing during sleep. The breathing stops not just once but repeatedly during the course of a person’s sleep.

Sleep apnea doesn’t cause full awakening, so normally, the patient doesn’t have the faintest idea of what’s going on. However, if you’re awake and you stop breathing 20 times in an hour, a visit to the nearest emergency room is the most likely solution. Many people are afflicted with this sleeping disorder, but most of the cases are left untreated.

One of the leading causes of sleep apnea in adults is obesity. Most obese people tend to snore and have difficulty breathing during sleep. This is due to the soft tissue of the mouth and throat that gets thicker as we get fatter, thus obstructing our airways.

According to medical researchers, around 936 million people suffer from sleep apnea worldwide. Unfortunately, despite the severe health repercussions that the untreated sleep disorder poses to sufferers, the majority of the patients are left undiagnosed due to a lack of public awareness from the government and healthcare professionals. As a result, many people with sleep apnea have no idea that they are dealing with a severe health condition.

What Are the Types of Sleep Apnea?

There are three different types of sleep apnea Here they are:

• Obstructive Sleep Apnea (OSA) — This is the most common type of sleep apnea. This type is caused by a blockage of the airways, whether partial or complete. It usually happens when the soft tissue located at the back of our throat collapses and closes during our sleep. In other cases, the tongue falls back against the soft palate, and the palate and uvula fall back to the back of the throat, closing the airways. Risk factors include obesity, being male, and those over 40 years of age.
• Central Sleep Apnea — In this type of sleep apnea, the airway is not blocked, but the brain forgets to signal the muscles to breathe. More specifically, it is the nerves that control the breathing rhythms that fail to send signals to our breathing muscles. Those who have a history of heart failure, stroke, or are taking opiate medications are more at risk of having this type of sleep apnea.
• Mixed Sleep Apnea — As the name implies, this type of sleep apnea is a combination of both obstructive and central sleep apnea.

What Happens When You Stop Breathing During Sleep?

When we stop breathing, our bodies will be deprived of oxygen. The longer we are deprived of oxygen, the more potential danger to our bodies. Our brain will detect the breathing malfunction and signal the breathing muscles to activate, causing our breathing to become activated again. During this sudden wake-up period, our heart rates suddenly accelerate, and our blood pressure rises.

These changes happen in just one apnea event, so imagine the chronic effects of sleep apnea on the person if this occurs more frequently.

How to Tell if You Have Sleep Apnea

Like any other disorder or illness, sleep apnea needs to be recognized, diagnosed and treated early before a person’s health condition worsens and complications arise. It is nearly impossible to feel the symptoms since you are usually sleeping or nearly sleeping when it happens.

Many patients diagnosed with sleep apnea see a doctor since their partners complain of their loud snoring or notice their disrupted sleep patterns.

Here are some clues or signs that you may have sleep apnea:

• Snoring — If you snore loudly to the point that your partner and your family members complain about it, then there’s a big chance you have sleep apnea.
• Difficulty sleeping — Restless during the night, frequently waking up, very light sleep, and insomnia are some of the symptoms.
• Sleepiness — A constant feeling of sleepiness during the day, no matter how much sleep you’ve had, is a sign that you may have sleep apnea. Some even doze off while driving, making this disorder life-threatening and can have severe consequences if left untreated.
• Gasping/choking — Waking up in the middle of the night gasping for air, short of breath, and a sensation of choking.
• Morning sickness — Headache when you wake up, dry mouth, and sore throat.
• Cognitive and mood swings — Memory lapses, loss of interest in sex, and for some even anxiety attacks and depression.

What Happens If You Have Sleep Apnea?

It is noteworthy to reiterate that sleep apnea is a serious matter and can cause life-shortening consequences if left untreated. It can cause a plethora of health problems which includes but is not limited to the following:

• Heart failure
• Heart attack
• Heart flutter or arrhythmia
• Hypertension
• Stroke
• Diabetes
• Memory lapses
• Depression
• Anxiety
• Mood swings
• Night sweat
• Frequent urination
• Headaches
• And many more

Diagnosis and Tests for Sleep Apnea

If you think you have sleep apnea based on the symptoms presented above, it is best to consult a doctor to diagnose and treat your sleep disorder. The doctor can make a proper evaluation based on the symptoms you have and information provided by someone who shares your bed or your household.

Most likely, the next step would be to refer you to a sleep specialist for further evaluation. There are sleep evaluation tests administered to diagnose if you have sleep apnea objectively.

Some tests to accurately detect sleep apnea include:

Nocturnal polysomnography

Usually done in sleep centers or sleep laboratories, this evaluation procedure is called a Polysomnogram (PSG). Under the supervision of a trained sleep specialist, you are hooked to equipment where various bodily functions are recorded at night while you sleep. This includes heart rate, eye movements, breathing patterns, airflow, electrical activities of your brain, muscle activity, and blood oxygen levels. Once the numbers are monitored, the amount of time the breathing is impaired is measured, and the level of sleep apnea is graded.

Polysomnogram is relatively safe and is non-invasive. Aside from diagnosing sleep disorders like sleep apnea, Polysomnography is also used to create or adjust a treatment plan if the patient is already diagnosed with a sleeping disorder.

Home sleep apnea tests

This is a much-simplified version of the polysomnogram test.

As its name connotes, this is a modified form of sleep evaluation that can be done at home. Ideal for those who are not comfortable sleeping in an unfamiliar setting, with specialists watching you as you sleep. It monitors your heart rate, blood oxygen level, breathing pattern, and airflow. It records less variables than the PSG, but it is sufficient data to diagnose obstructive sleep apnea.

Alternative tests

Many sleep specialists will agree that polysomnography and home sleep apnea tests are currently essential in the accurate and appropriate diagnosis of sleep disorders. Still, ongoing research is being conducted to make the tests easier for patients. In addition, some devices are currently being developed, such as apps and wearables, but it has not reached the level of accuracy to be approved for medical diagnosis.

One promising device that will soon be approved in the United Kingdom is a piece of under-the-bed testing equipment. At the same time, research is still ongoing on touchless monitoring of sleep and breathing patterns which will accurately diagnose sleep apnea in the future.

Can Sleep Apnea be Cured?

Luckily for us, sleep apnea can be successfully treated. Treatments vary depending on the severity of the disorder, whether it’s moderate, severe, or just mild. It can be as simple as modifying your sleeping position.

For others, it can be as challenging as losing weight or kicking the smoking habit. In addition, there are devices that help open up the airways, and in some cases, surgery is the best option.

Whatever the treatment option may be, the ultimate goal is to regulate the patient’s erratic breathing pattern and cure all underlying health issues associated with the disorder. Here are the different kinds of treatment options available for people with sleep apnea.

Conservative Treatments or Lifestyle Remedies

Usually given to patients with mild obstructive sleep apnea, lifestyle modifications effectively cure or lessen the disorder’s symptoms. Here are some of the conservative or alternative treatments of sleep apnea:

Weight loss

Obesity is one of the underlying causes of sleep apnea, so it is appropriate that sleep specialists recommend losing weight to treat the disorder.

Obese people tend to have narrow nasal passages, thus increases the risk for airway obstruction. However, studies reveal that even a 10% weight reduction can significantly reduce the apneic events for patients.

Exercise

Sometimes weight loss can be very challenging, especially for those with sleep apnea since there are metabolism changes and increased appetite caused by the disorder itself.

Another form of treatment is to engage yourself in maintaining fitness through exercise and other physical activities. Yoga and Tai-Chi are said to be effective in improving oxygen flow and respiratory strength.

Quit smoking

Aside from the apparent harmful effects of tobacco and smoking, such as lung and throat cancer, tobacco can cause inflammation in our airways, which causes it to swell and can result in louder snoring and worsen your sleep apnea.

In addition, the active ingredient nicotine present in cigarettes can cause havoc to our respiratory system and disrupts our sleep cycle.

Alter your sleeping position

Sleeping on your back or what sleep experts call the supine position will worsen your sleep apnea since gravity can help worsen the collapse of your airways.

By sleeping on your side, it will help keep your airways open. Your head should be adequately propped up by a pillow four to six inches thick.

Avoid alcohol, sedatives, and intoxicating substances

Excessive alcohol use can be harmful to the quality of one’s sleep as alcohol is well known to fragment sleep. Avoiding significant alcohol intake, especially late into the evenings, is recommended for patients with sleep disturbances.

Using nasal sprays and breathing strips

People with sinus problems often have difficulty sleeping during the night because of nasal congestion. Breathing strips and nasal sprays can work wonders in improving airflow and can help the patient avoid snoring, and induces comfortable breathing.

Using a humidifier

Humidifiers add moisture to the air, and since dry air can cause irritate our respiratory system, it is helpful in some cases. Humidifiers can clear congestion, open our airways, and encourage better breathing.

Adding aromas like lavender and eucalyptus oils can also be beneficial since these essential oils have anti-inflammatory effects.

Mechanical Treatments

There are also some mechanical treatments you can consider. Here are the following:

1. Oral appliances/mandibular advancement devices

These are dental devices that are often used for mild to moderate obstructive sleep apnea. The mandibular advancement or repositioning device looks like a mouth guard that repositions our jaw temporarily to increase the airway and prevent snoring.

Another oral appliance that is used for treatment is the tongue retaining device. Unlike the mandibular repositioning device, where the tongue is moved forward, this device holds the tongue in place to prevent it from going to the back of the throat and blocking the airway.

These kinds of oral treatments are used for their convenience, and some patients prefer them for treatment of their sleep apnea.

2. Hypoglossal nerve stimulator

This treatment requires a stimulator to be implanted under the patient’s skin on the right side of his chest. Electrodes are tunneled under the skin and travel to the hypoglossal nerve located on the patient’s neck and intercostal muscles in the chest. This remote-controlled device is turned on during bedtime. The hypoglossal nerve is stimulated in each breath, which in turn causes the tongue to move forward to keep the airway open.

3. Surgery

Surgery is an option of last resort. It is done when all other treatments fail. Most doctors recommend a three-month trial of different treatment options before putting surgery down on the table. Surgery is ideal for people who have malformed tissue that obstructs the airflow, such as enlarged tonsils, deviated nasal septum, or a small lower jaw that causes the throat to be narrow. Some of the surgery performed are:

• Tonsillectomy — A procedure to remove the tonsillar tissue located at the back of the throat
• Somnoplasty — Reduces the soft tissue in the upper airway using radiofrequency energy
• Mandibular advancement surgery — Surgery to correct facial abnormalities as well as throat obstructions that cause severe sleep apnea
• Uvulopalatopharyngoplasty (UPPP) — Removes soft tissue on the palate or back of the throat, widening the airways
• Nasal surgery — Surgery to correct obstruction on the nose, such as nasal septum

4. Continuous positive airflow pressure (CPAP) machines

Currently, CPAP is the most widely used and the most effective treatment option for sleep apnea. It is the leading choice of therapy and the most reliable method at the moment.

With CPAP therapy, patients wear a mask interface (either a nasal mask or a full face mask) while the device gently forces air into their airway. The air pressure keeps the upper airway open and prevents snoring.

One of the downsides of CPAP therapy is that patients may have discomfort when using the device. New users often need to acclimate themselves prior to regularly using the device at night. Eventually, they will get used to wearing the machine during sleep.

How Well Do CPAP Machines Work?

CPAP is the best non-surgical treatment option for sleep apnea. It is the preferred treatment of choice for sleep apnea, and here are some benefits:

• Studies show that CPAP decreases daytime sleepiness and improves symptoms.
• Better than other non-surgical procedures for treating sleep apnea.

Side effects of CPAP

Like any treatment or medication, CPAP also has some side effects, especially during the first few usages. You might feel some mild discomfort after using CPAP for the first time, but it usually wears off in typical cases.

However, don’t hesitate to contact your doctor if you feel any pain or discomfort after using CPAP for several days. Here are some of the known side effects of CPAP:

• Excessive dreaming during use
• Sore throat
• Dry nose
• Nasal congestion; sneezing; runny nose
• Abdominal bloating
• Face and eye irritation

Other Types of Positive Airway Pressure Machines

There are also other types of positive airway pressure machines, such as:

Bi-Level PAP

This machine uses one pressure during inhalation and another type of pressure, usually lower, during exhalation. Bi-level PAP is typically used when CPAP fails to deliver the expected results and treatment outcome.

Auto CPAP / Auto Bi-level PAP

This type of PAP machine is self-regulating and uses various pressures depending on the requirement detected by the machine.

Adaptive Servo-Ventilation

Used for patients with central sleep apnea, this non-invasive ventilation machine keeps the airways open and provides a mandatory breath if the need arises.

Takeaway

Sleep apnea may be dangerous, but it is treatable. The treatment options may be expensive, but they may all be worth every penny if you’re cured of this debilitating disorder.

When deciding on what type of treatment to pursue, one crucial thing to remember is that treatment is personalized. Treatment requires individualization; what may work for you may not be as effective for others and vice versa.

It is also ideal for dealing with sleep apnea early before any underlying health problems complicate the situation. Investing in a CPAP machine may be the best option for those suffering from sleep apnea. It may be expensive at the outset, but you will get your money’s worth with all the benefits that long-term CPAP use has to offer in the long run.

Want to try something to treat your sleep apnea? Read ”How Does Resmed AirSense 10 Treat Sleep Apnea?” to learn more.