Sleep apnea is a common disorder that can be very
serious. In sleep apnea, your breathing stops or
gets very shallow while you are sleeping. Each pause
in breathing typically lasts 10 to 20 seconds or
more. These pauses can occur 20 to 30 times or more
an hour.
The most common type of sleep apnea is
obstructive sleep apnea. During sleep, enough air
cannot flow into your lungs through your mouth and
nose even though you try to breathe. When this
happens, the amount of oxygen in your blood may
drop. Normal breaths then start again with a loud
snort or choking sound.
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Sleep apnea happens more often in people who are
overweight, but even thin people can have it.
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Most people don’t know they have sleep apnea. They
don’t know that they are having problems breathing
while they are sleeping.
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A family member and/or bed partner may notice the
signs of sleep apnea first.
Untreated sleep apnea can increase the chance of
having high blood pressure and even a heart
attack or stroke. Untreated sleep apnea can
also increase the risk of diabetes and the risk for
work-related accidents and driving accidents.
What Causes It?
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Your throat muscles and tongue relax more than is
normal.
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Your tonsils and adenoids are large.
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You are overweight. The extra soft tissue in your
throat makes it harder to keep the throat area
open.
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The shape of your head and neck (bony structure)
results in somewhat smaller airway size in the
mouth and throat area.
Treatment Options
If you have mild sleep apnea, some changes in
daily activities or habits may be all that are
needed:
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Avoid alcohol, smoking, and medicines that make
you sleepy. They make it harder for your throat to
stay open while you sleep.
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Lose weight if you are overweight. Even a little
weight loss can improve your symptoms.
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Sleep on your side instead of your back. Sleeping
on your side may help keep your throat open.
People with moderate or severe sleep apnea will
need to make these changes as well. They also will
need other treatments, such as the following.
Continuous Positive Airway Pressure
Continuous positive airway pressure (CPAP) is the
most common treatment for sleep apnea. For this
treatment, you wear a mask over your nose during
sleep. The mask blows air into your throat at a
pressure level that is right for you. The increased
airway pressure keeps the throat open while you
sleep. The air pressure is adjusted so that it is
just enough to stop the airways from briefly getting
too small during sleep.
Treating sleep apnea may help you stop snoring.
Stopping snoring does not mean that you no longer
have sleep apnea or that you can stop using CPAP.
Sleep apnea will return if CPAP is stopped or if
it is not used correctly. Usually, a technician
comes to your home to bring the CPAP equipment. The
technician will set up the CPAP machine and make
adjustments based on your doctor’s orders.
CPAP treatment may cause side effects in some
people. Some side effects are:
If you are having trouble with CPAP side effects,
work with your sleep medicine specialist and
technician. Together you can do things to reduce
these side effects, such as:
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Use a nasal spray to relieve a dry, stuffy, or
runny nose.
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Adjust the CPAP settings.
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Adjust the size/fit of the mask.
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Add moisture to the air as it flows through the
mask.
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Use a CPAP machine that can automatically adjust
the amount of air pressure to the level that is
required to keep the airway open.
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Use a CPAP machine that will start with a low air
pressure and slowly increase the air pressure as
you fall asleep.
People with severe sleep apnea symptoms generally
feel much better once they begin treatment with CPAP.
When using CPAP, it is very important that you
follow up with your doctor. If you are having side
effects, talk to your doctor.
Mouthpiece
A mouthpiece (oral appliance) may be helpful in
some people with mild sleep apnea. Some doctors may
also recommend this if you
snore loudly but do not have sleep apnea.
A custom-fit plastic mouthpiece will be made by a
dentist or orthodontist. An orthodontist is a
specialist in correcting teeth or jaw problems. The
mouthpiece will adjust your lower jaw and your
tongue to help keep the airway in your throat open
while you are sleeping. Air can then flow easily
into your lungs because there is less resistance to
breathing.
Possible side effects of the mouthpiece include
damage to your:
Follow up with your dentist or orthodontist to
check for any side effects and to be sure that your
mouthpiece fits.
Surgery
Some people with sleep apnea may benefit from
surgery. The type of surgery depends on the cause of
the sleep apnea.
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Surgery may be done to remove the tonsils and
adenoids if they are blocking the airway. This
surgery is especially helpful for children.
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Uvulopalatopharyngoplasty (U-vu-lo-PAL-a-to-fa-RIN-go-plas-te)
(UPPP) is a surgery that removes the tonsils,
uvula (the tissue that hangs from the middle of
the back of the roof of the mouth), and part of
your soft palate (the roof of your mouth in the
back of your throat). This surgery is only
effective for some people with sleep apnea.
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Laser-assisted uvulopalatoplasty
(U-vu-lo-PAL-a-to-plas-te) (LAUP) is a surgery
that can stop snoring but is probably not helpful
in treating sleep apnea. A laser device is used to
remove the uvula and part of the soft palate.
Because this surgery stops the main symptom of
sleep apnea (snoring), it is important to have a
sleep study first.
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Tracheostomy (TRA-ke-OS-to-me) is a surgery used
in severe sleep apnea. A small hole is made in the
windpipe and a tube is inserted. Air will flow
through the tube and into the lungs. This surgery
is very successful but is needed only in patients
not responding to all other possible treatments.
Other possible surgeries for some people with
sleep apnea include:
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Rebuilding the lower jaw
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Surgery on the nose
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Surgery to treat obesity
Currently, there are no medicines for the
treatment of sleep apnea.