Sleep apnea is a condition in which disturbed breathing interrupts sleep. Obstructive sleep apnea (OSA), the most common type of sleep apnea, affects approximately 24% of middle-aged men and 9% of middle-aged women in Canada.
Most people suffering from sleep apnea also snore, but there’s a big difference between the two conditions. While snoring can be annoying, sleep apnea can be life-threatening. During an apnea episode, the body’s oxygen levels can drop noticeably, carbon dioxide builds up, and the heart has to work harder to cope. Each time it happens, the brain sends a wake up signal so that the person can breathe, and this means never getting a good night’s sleep.
Untreated sleep apnea can cause dangerous daytime sleepiness as well as contribute to a higher risk of high blood pressure, stroke, and heart attack.
There are 3 types of sleep apnea:
Obstructive sleep apnea (OSA), the most common type, happens when air cannot get into the lungs because the upper airway has collapsed. It’s more common in men and in people who are overweight, especially those who sleep on their backs. In people of normal weight who have the condition, there’s often an abnormality in the lower face, such as having a small chin, an overbite, or a large tongue. OSA typically has three phases:
Central sleep apnea, which is quite rare, results when the brain fails to send normal signals to the chest to breathe properly while asleep. Neurologic disease (i.e., disease of the brain) and severe heart disease can cause central sleep apnea, as can certain medications (especially strong pain medications like morphine and other narcotics).
Mixed sleep apnea, as the name suggests, is a combination of the first two types. It always starts out as central sleep apnea, and then turns into OSA.
Unfortunately, most people with sleep apnea don’t even know they have it. An estimated 30% of Canadian adults are at high risk for having or developing sleep apnea. The American Sleep Apnea Association has come up with a simple quiz to help people find out if they have sleep apnea. If you answer "yes" to any of the following questions you should talk to a doctor:
Daytime sleepiness is probably the most important symptom that people notice, since it can make it hard to stay awake, concentrate, and work. People can even end up losing their jobs if they’re always nodding off during the day. An especially dangerous problem is drowsiness while driving or operating machinery. People with sleep apnea get into more accidents than average. It’s best for people with sleep apnea to avoid driving if they feel sleepy, or to stop driving completely until their condition is under control.
Sleep apnea can also lead to headaches, memory problems, and depression. In severe cases, complications including high blood pressure, heart attacks, strokes, and abnormalities in heart function, such as heart failure and arrhythmias (irregular heartbeat), can develop or worsen due to sleep apnea.
A doctor will ask more detailed questions to find out whether someone has the symptoms of sleep apnea and will examine them physically to see what might be blocking the airway. Routine blood tests, blood pressure readings, and examinations of the heart might be done to see if there are physical complications from sleep apnea or to rule out other possible conditions.
To confirm that the condition is sleep apnea, a test called overnight polysomnography may be done. For this test, a variety of measurements are taken while the person sleeps in a specialized sleep laboratory. Some people can have their sleep study done at home instead of in the laboratory, though this might not be as accurate.
There’s no medication therapy for sleep apnea, but several treatments are known to be successful, alone or in combination:
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